HPV primary screening and abnormal screen follow-up for cervical cancer

Lessons for Canada

Other countries employed several strategies to successfully implement HPV primary screening that could be leveraged in Canada, including:

• Tailoring programs to communities experiencing inequity in screening and follow-up services
• Communicating the superiority of HPV testing to clinicians and the public
• Developing a screening and follow-up care pathway
• Creating a plan to manage the temporary increase in demand for colposcopy

Background

Cervical cancer is a largely preventable gynecologic cancer. Organized cervical screening programs exist in most Canadian provinces and in many countries around the world. These programs screen eligible individuals who do not have symptoms and are at average risk for cervical cancer.

Until recently, cervical screening programs used the Pap test as the primary screening test. But now that the link between the persistent presence of HPV, especially high-risk strains like HPV 16 and 18, and risk of cervical cancer is well established, HPV testing is emerging as the leading approach to cervical screening because it identifies individuals who are at increased risk of cervical cancer earlier than the Pap test and results in significantly lower likelihood of developing cancer.

Several countries, including Australia, the United Kingdom, the Netherlands, and Finland, have transitioned from the Pap test to the HPV test in their organized cervical screening programs and work is underway to do the same in Canada.