As a gynaecologist, I see women in my clinic every day who dread having a Pap test. The biggest worries that I hear are that the Pap test will tell them they have cancer and that the Pap test will be uncomfortable. My patients are right, Pap tests can be uncomfortable for many reasons, but they are an important test that helps prevent cancer. Many women are afraid of Pap testing because they don’t really understand what their health care provider is looking for.
October 17th to the 2st is Cervical Cancer Awareness Week. To help with understanding Pap tests and cervical cancer, I’ve answered some of the most common questions that I hear in my clinic.
A Pap test screens for cervical cancer. During a Pap test, your health care provider wipes off some cells from the surface of the cervix. A doctor looks at these cells under a microscope to see if they look normal or if they are starting to have changes that could lead to cervical cancer.
HPV is short for human papilloma virus. It is the virus that causes changes on the cervix that can lead to cervical cancer. A Pap test doesn’t look for HPV directly. Instead, a Pap test looks for signs of infection caused by HPV.
HPV is a sexually transmitted infection that is spread very easily. Nearly everyone (75- 80% of people) who has had sexual touching or sexual intercourse has been exposed to HPV at some point in their life.
HPV testing is available in Ontario, but it is not covered by OHIP. We don’t recommend testing everyone for HPV because so many people have HPV and it doesn’t cause problems for everyone. Currently, we only offer HPV testing to some women who have abnormal Pap tests to help us understand their risk of developing cervical cancer.
The HPV vaccine, called Gardasil, reduces the risk of cervical cancer and genital warts. Vaccination is available, at no cost, as part of a school-based program for boys and girls in grade 7. Once a student is eligible, they can begin or complete the HPV vaccine series until the end of August of their grade 12 year. The vaccine is also available for purchase for women up to the age of 45 and men up to the age of 27. For more information, you can visit the Thunder Bay District Health Unit’s website at www.tbdhu.com.
The best way to test for HPV infection is to have regular Pap tests. If your Pap test is normal then it is unlikely that you have an HPV infection or if you do have an HPV infection, your body is able to fight it off.
If you have an abnormal Pap test, your health care provider may need to repeat it in 6 months or send you to see a colposcopist. A colposcopist is a doctor who cares for women with abnormal Pap tests. The goal of the colposcopy clinic is to get rid of the abnormal cells on the cervix and prevent the women from developing cervical cancer. Canada has some of the lowest rates of cervical cancer in the world because we screen women with Pap tests and then treat pre-cancer changes on the cervix quickly.
Recently, Ontario has changed from offering Pap tests every year to offering them every three years. This change has been very distressing to many women because they are concerned that they will be at higher risk of developing cervical cancer.
There are two main reasons that this change was made:
By doing Pap tests every three years, we are still able to effectively screen for cervical cancer. We also decrease the number of women who have unnecessary tests and procedures in the colposcopy clinic.
No, it doesn’t mean that you have cervical cancer. Now that Pap testing is every three years, Cancer Care Ontario is sending reminder letters to all women who are eligible for cervical cancer screening. The letter reminds you to contact your health care provider to book an appointment for a Pap test.
Once you’ve had your Pap test, Cancer Care Ontario will send you another letter telling you the results of your Pap test and the recommended follow-up.
There are many places that you go to for a Pap test:
Your health care provider can answer many questions about Pap testing and HPV. You can also visit Cancer Care Ontario’s website at www.cancercare.on.ca/pcs/screening, or www.hpvinfo.ca. You can also learn about your cancer risk by completing an online risk assessment tool called My CancerIQ at www.mycanceriq.ca
Women can call the Cervical Cancer Screening Hotline at (807) 684-7787 to find out where they can get screened for cervical cancer.