Cervical Cancer Screening

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Why do we screen?  - Cervical cancer used to be one of the leading cause of deaths in young females. In developing countries, it continues to have significant morbidity and mortality rates. In the late 1970's, Pap tests were made available. This breakthrough has led to detection and elimination of pre-malignant cells. Here is a graph demonstrating the decrease in cervical cancer mortality in Canada. Cervical Cancer deaths dropped a whopping 70% in the last 50 years!

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HPV - Human Papilloma Virus is responsible for almost all cases of Cervical Cancer. It is also responsible for cancers of the throat, anus, vulva, penis and a few other regions. There are over 100 strains of HPV, however strains 16 and 18 are responsible for more than 70% of cancers. HPV is transmitted from intimate skin to skin contact. It is the most common sexually transmitted infection and usually asymptomatic.

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HPV Vaccine - In 2007/2008, the provincial government introduced HPV vaccination for students in grade 7. Prior to vaccination, 75% of adults would be infected with HPV at some point in their life. The HPV4 vaccine covers strains 6/11/16/18. As above, strains 16/18 are responsible for over 70% of cancers associated with HPV. We can now immunize against certain cancers, HOW COOL IS THAT?!?!

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Who needs screening? - All people with a cervix who have ever been sexually active and are over the age of 25 should be screened. Screening now involves identification of the HPV virus (high or low risk strains) with a swab of the cervix. If negative for HPV or low risk strains without any cell changes, repeat pap is done in 5 yrs. Other results and some specific patients will require earlier or additional testing as per the current Cancer Care Ontario guidelines. If you have had a hysterectomy, you should have a discussion with your health care provider as to whether you require continued screening.

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