Leading the way

Health Updates and Alerts

 

Cervical Cancer Screening Policy Change:

There are 2 major changes to the screening guidelines for average risk women:

1.Start age of screening has been delayed until age 25 (previously age 20)

2.Frequency of screening has been decreased to every 3 years (previously every 2 years)

 

This is all you really need to know, but if you want further information, see below for FAQ’s.

 

  1. Start Age – Why has this changed?

Screening women younger than age 25 has not changed the number of cervical cancer cases or cervical cancer deaths in this age group.

Cervical cancer is rare in younger women regardless of whether they have received the HPV vaccine or not. In BC, for example, the peak incidence occurs between the ages of 35 and 44, with very few cases under the age of 25.

Cervical cancer screening is less effective in women under age 25, and this age group is more likely to have pap abnormalities that clear without treatment.

There are risks associated with unnecessary treatment, including undue anxiety and stress, as well as long-term consequences for pregnancy.

Regardless of age, talk to your doctor if you experience any of the following symptoms (pap “screening” is only for people without symptoms):

  • Abnormal vaginal bleeding (such as bleeding in between periods, bleeding during/after sex or after menopause)
  • Abnormal or persistent vaginal discharge
  • Pelvic pain, or pain during sexual intercourse
  1. Screening frequency – Why has this increased to 3 years?

Evidence shows that cytology screening (Pap test) every three years is just as effective and safe as every two years.

Cervical cancer screening every three years after age 25 is sufficient. Screening earlier and more often increases the likelihood of causing harm, including unnecessary follow-up and treatments, many of which may have long-term consequences for pregnancy or cause undue anxiety and distress.

Cervical cancer is caused almost exclusively by certain strains of human papillomavirus (HPV), HPV can take more than a decade to progress to pre-cancerous cells or cervical cancer.

  1. Human Papillomavirus – What is the link between HPV and cervical cancer?

HPV is a common virus; most people who are sexually active have been exposed to HPV at some point in their lives without even knowing they had it. There are many types of HPV, and most of them clear up by themselves without causing any problems.

There are two groups of HPV that may infect the cervix – low risk and high risk. Low risk types are not associated with cervical cancer but may cause genital warts and abnormal screening results. Long term infection with a high risk type of HPV may lead to cervical cancer or its precursors.

HPV is transmitted through sexual activity, including intimate touching, oral, vaginal and anal sex.

Sometimes HPV does not clear from the body. Over time it can cause changes in the cells on the cervix that cannot be seen or felt. These cells can change to cervical cancer if not found and treated early enough.

  1. Cervical Cancer – How long does it take to develop?

HPV generally takes more than a decade to progress to pre-cancerous cells or cervical cancer. Screening can identify early abnormalities caused by HPV, which could develop into cervical cancer over time.

By identifying abnormalities early, they can be treated and cancer can be stopped form developing. If cervical cancer is caught at its earliest stage, the chance of survival is more than 85 percent.

  1. HPV Vaccine – Do people who received the HPV vaccine still need to be screened?

Yes, women who have received the HPV vaccine still need to be screened regularly.

The HPV vaccine protects against the main types of HPV that can cause changes in the cells of the cervix, but not all.

The HPV vaccine is recommended for females age 9 to 45.

The HPV vaccine is provided free to girls in Grade 6 in BC. Girls and young women born in 1994 or later who missed getting the HPV vaccine may contact their health care provider to get immunized at no cost.

  1. Harms of Cervical Cancer Screening – What are they?

Although most screening interpretations are accurate, there are some cases where women are identified as possibly having a cervical abnormality when they do not (false-positive) or, some cases of pre-cancer or cervical cancer may not be identified (false-negative).

Cervical cancer screening is not as effective in younger women. Women under 25 have a higher prevalence of lesions that often clear without treatment.

Cervical cancer screening identifies women who are at increased risk of developing cervical cancer. In young women, most of the abnormalities identified are transient and will resolve on their own within about 2 years. Treatment can lead to unnecessary anxiety and distress, or long-term consequences for pregnancy.

Abnormal cells in the cervix are a result of persistent infection with high risk HPV. Infection with HPV is extremely common in women under age 25, however, most of these infections clear on their own within about 2 years.

Starting cervical cancer screening at age 25 will reduce the number of unnecessary follow-up and treatments.