Cervical Cancer Screening

Transcript for: Dr. Neil Naik talking about the new cervical screening test in Ontario.

With HPV being the new way we are going to do the Ontario's cervical screening program. We are going to have a little more accurate, more precise, test that we can offer people with cervix's, so that they can get the care they need earlier and more accurately than before. And also reduce the harms, in terms of not having to do referrals when not necessary.

So it's still a pap test in the test in the sense that you still have to go see a clinician, and they're going to do a swab of the cervix for anyone who does have a uterus. It's still the same brush that we use, but it's the test that's run on the backend that's going to change. Before we were looking under a microscope at the cell changes. That introduced more subjective aspects of whos reading it, what their training was, things like that. Now what we're doing is taking it a step further, ahead of the pathophysiology. And actually looking at the infection of HPV and that's going to tell us, hey, do you have HPV? What type of cancer causing HPV do you have? and then we are going to look at the cells afterwards. Because the majority of cervical cancers are caused by HPV.

And we are hoping now that we are increasing that awareness of HPV as the virus that causes, which we've known for quite some time, that's also going to help encourage more vaccination against the HPV virus. People are eligible for the HPV vaccine at a young age. Public health offers it from grade 7, but you can get the HPV vaccine all the way into adulthood. So if you read the monograph for the HPV vaccine it does say that it was studied up till the age of 46, but if we look at the section of Gynecologists of Canada, they actually says there is no upper age limit for getting the vaccine. So I'm encouraging everyone to get the vaccine no matter what your age is.

So historically, going back, all the way back to the beginning of the OCSP program, it used to be 18, then it got changed to 21, and now we're changing it to 25. As we're learning more and more about the disease, we're learning more about how the virus interacts with the human body. We're understanding that sometimes our bodies can clear it, but sometimes it can't, and so what we're doing is we're saying, hey, we know your body could clear it, so we are going to start it at 25, cause those who do have the HPV virus at that stage, we should be looking for it.

The cancer is caused by persistent infection. I think that's key. And it takes years for that infection to turn into cancer. But what we want to make sure is that we are catching it when somebody's not feeling the symptoms. There's no point in waiting until you start feeling symptoms, because it could be too late at that stage. And so the whole reason of getting a screening test done is that we catch it early, when you're not feeling symptomatic, and then we can intervene at an earlier stage should the cells change.

Screening is still important, repetitive screening is really important. We are changing the interval between screenings. So for somebody who is healthy in body, it is every 5 years now, so we are making it less stressful. But that doesn't mean it's any less important. So please, do reach out; get screened; find out what your HPV status is, get vaccinated, because all those things add up to living a long, healthy life.

So the test that we are offering here in Ontario is checking for the cancer causing HPV. Just because somebody might come back with a negative HPV test, does not mean they don't have HPV. HPV also causes warts and so when you do get that HPV negative test, it does not mean you are immune to all types. And on top of that, just because you have cleared HPV once, it doesn't mean that you are immune against all the different strains of HPV. And so it's still important to get screened on a regular basis, it's still important to get the vaccination. And just cause you got vaccinated doesn't mean you shouldn't get screened with a pap test, uh, it is just as important, and it just means you were better protected at that stage.