A BC Cancer-authored paper in the Canadian Association Medical Journal (CAMJ) has concluded that, with increased HPV screening rates, cervical cancer can be eliminated in Canada by almost a decade earlier than the federal government target of 2040.
Two of the paper’s authors —Dr. Reka Pataky and Dr. Stuart Peacock, Simon Fraser University’s Leslie Diamond Chair in Cancer Survivorship and professor in the faculty of health sciences — found that HPV-based screening at current vaccination, participation and follow-up rates can eliminate cervical cancer by 2034. Increasing on-time screening and follow-up compliance could achieve the target by 2031.
The authors found that, in order for cervical cancer to be eliminated in Canada by the federal government target date of 2040 (or the paper’s target date of 2034 or 2031), HPV primary screening is necessary, as the target dates cannot be achieved with cytology screening.
The paper’s findings coincide with the rollout in B.C. of HPV primary screening for cervical cancer, featuring the option for self-screening at home— the first such program in Canada.
Since its launch on Jan. 29, BC Cancer has sent out more than 30,000 cervix self-screening kits and more than 1,000 clinics ordered vaginal swabs for cervix self-screening, with both figures exceeding initial expectations. The greater sensitivity of HPV primary screening means the recommended testing interval is every five years, instead of every three years for cytology screening.
The paper in the CAMJ found that screening for high-risk HPV infection is more effective than cytology screening (Pap testing) to identify cervical pre-cancer. HPV primary screening has a lower false negative rate than cytology and detects cervical pre-cancer earlier and better than cytology.
“The paper’s findings, that HPV screening is a crucial component to eliminating cervical cancer, is very encouraging,” said Dr. Lily Procter, medical director of the cervix screening program. “The findings reaffirm the importance of BC Cancer’s groundbreaking cervix self-screening program, which we expect to help with the elimination of cervical cancer.”
Cervical cancer is caused by certain types of human papillomavirus. Although cervical cancer is almost entirely preventable through HPV vaccination and with early detection and treatment through screening, cervical cancer continues to claim about 55 lives per year in B.C. People between the ages of 25 and 69 should participate in cervix screening.
The paper also noted that adopting HPV primary screening can increase uptake in under-screened or never-screened populations through vaginal self-collection of samples.
Cervix self-screening is an accurate, comfortable and convenient way to screen and is encouraging more people, including more vulnerable populations like trans people, newcomers to Canada and Indigenous people, across the province to get screened. People can self-screen in the comfort of their home or at the office of a health-care provider.
Until Canada’s first at-home self-screening option for cervical cancer was introduced in B.C. on Jan. 29, the primary test in the province was a Pap test, which remains an option for those who wish to choose that option.
However, the province will transition over the next three years to make HPV testing by a health provider its primary screening method. That transition is being done by age group, beginning with people ages 55 and older.