HPV At-Home Screening Tests – Will they replace the PAP test in Canada?
Currently the Canadian Task Force on Preventative Health recommends a routine PAP smear for all women age 30-60, every 3 years regardless of family history, sexual orientation, sexual frequency, monogamous relationship or being postmenopausal.
The PAP test screens for cancerous or precancerous cervical cells. The main cause of abnormal cervical cells and cervical cancer is infection from particular subtypes of the Human Papilloma Virus (HPV). Cervical cancer is almost universally associated with HPV infection (99.7% of cases) after contracting the virus through sexual activity. The lag time between HPV infection and development of invasive cancer is about 15 years.
While the PAP test is an effective test at screening for cervical cancer, there are barriers to PAP screening. It requires women having access to a primary care doctor. We know in some regions in Canada this isn’t happening. And it can be a screening test with poor compliance – for reasons ranging from being inconvenient and unpleasant to extremely painful, especially for menopausal women with GSM or triggering for women with history of trauma.
Since 2021 years several provinces have been running trials with HPV self-screening tests. It’s anticipated screening guidelines in most provinces will shift to favouring HPV home testing over PAP tests in the next few years. Not only is at-home screening more convenient and comfortable for women, HPV screening is proving to be a more accurate screening test for cervical cancer.
Starting later this month, Jan 29 2024, British Columbia will be the first province in Canada to endorse the HPV at-home test as an alternative to the PAP smear test. Women between the age of 25 to 69 due for routine cervical screening and meeting certain eligibility criteria will be able to opt for cervical at-home screening. PAP tests will still be available for women if they choose.
The self-screening kit provides a swab, instructions and return shipping bag. A woman gently inserts the swab into the vagina, turns it for 20 seconds, follows the instructions to package the sample and sends it off in a prepaid return shipping envelope to the lab for analysis. Results are available by mail in 4-6 weeks. It’s not recommended to collect a sample during your period and a few conditions may preclude you from at-home screening: if you’re pregnant, if you have any unusual bleeding symptoms, if you use a pessary or have your cervix removed with complete hysterectomy.
If the HPV test is negative, you won’t need to submit another sample for 5 years. If HPV is found you’ll be referred to your family doctor or community clinic for further evaluation.
HPV self-collection kits are available online for all women in Canada at www.switchhealth.ca at a cost of $99/test. It is currently not covered through OHIP.
Stay tuned for more details as they evolve.