Download Backgrounder: Ontario Cervical Screening Program Cervical cancer

Backgrounder: Ontario Cervical Screening Program
Cervical cancer
Cervical cancer is cancer arising in the cervix, which is located at the opening of the uterus. Certain types of
human papillomavirus (HPV) cause cervical cancer. HPV is a family of viruses commonly found in both men
and women. It is passed from one person to another through intimate sexual contact.
The cells of the cervix are constantly growing and changing. Sometimes infection with HPV causes cells on the
cervix to become abnormal. Usually, abnormal cells return to normal on their own. In other instances, HPV
infections persist (do not go away) and over a number of years (10 years or more) unhealthy cell changes can
slowly lead to cancer of the cervix.
The good news is that cervical cancer is almost entirely preventable with regular screening, appropriate and
timely follow-up of abnormal Pap test results and, recently, HPV immunization. Regular cervical cancer
screening, which is currently done with a Pap test, can show cell changes that can be treated before they
become cancer.
Cervical cancer in Ontario
It is projected that in 2012, about 550 women will be diagnosed with cervical cancer in Ontario and about 160
women will die from this disease. [Reference: Canadian Cancer Society’s Steering Committee on Cancer Statistics.
Canadian Cancer Statistics 2012. Toronto, ON: Canadian Cancer Society; 2012.]
Who should be screened?
In May 2012, Cancer Care Ontario (CCO) released updated cervical screening cytology (Pap test) guidelines.
Cervical cancer screening is recommended every three years for all women starting at age 21 who are or ever
have been sexually active. Pap tests can stop at 70 years of age in women who have had three or more
normal tests in the prior 10 years. Cervical cancer rarely occurs before age 21. It is also rare in women over
the age of 70 who have been appropriately screened in the previous 10 years. Sexual activity includes
intercourse, as well as digital or oral sexual activity involving the genital area with a partner of either gender.
Women who have not been sexually active by 21 years of age should delay cervical cancer screening until
they are sexually active. Regardless of sexual activity, there is no evidence to support screening women under
21 years of age. Based on the latest clinical evidence, cervical cancer screening is effective when completed
every three years.
Women still need to be screened for cervical cancer if they:
 feel healthy and have no symptoms
 are no longer sexually active
 have only had one partner
 are in a same-sex relationship
 have been through menopause
 have no family history of cervical cancer
Women who have had a hysterectomy should talk to their healthcare provider to see if they still need to be
screened for cervical cancer.
Screening is the only way to detect the changes that lead to cancer. Treating
these changes prevents cancer. Treatment of significant abnormalities is safe,
has limited risks and is highly successful. Most cervical cancers are diagnosed in
women who have not been screened at all or have not been screened regularly or
have not had appropriate follow-up after an abnormal test result.
In the past 30 years, incidence and mortality rates for cervical cancer in Ontario have declined by more than 60
percent in all age groups due to widespread cervical cancer screening.
A Pap test is a simple screening test that looks for abnormal cell changes of the cervix. Some of these
abnormal cell changes indicate a process that can give rise to cervical cancer. The cell changes can be
followed appropriately and, if necessary, treated so that cancer does not develop.
Both screening and HPV immunization are important elements of cervical cancer prevention. Immunization can
block cancer causing HPV infections before they occur. However, it is not a substitute for cervical cancer
screening. Even if vaccinated, women still need regular screening because immunization does not protect
against all cancer-causing HPV types. Also, immunization does not protect against prior HPV infection. Only
screening can protect against cervical cancer arising from prior HPV infection.
About the Ontario Cervical Screening Program (OCSP)
The OCSP is an organized, population-based screening program with the goal of reducing cervical cancer
incidence and mortality. It also supports family physicians and nurse practitioners so that they can provide the
best possible cervical screening for their patients. Recent data show, 72 percent of Ontario women aged 20 to
69 years were screened for cervical cancer. While no screening process is perfect, screening all women
regularly will increase our ability to prevent cervical cancer.
For more information about the OCSP, visit www.cancercare.on.ca/screenforlife.
HPV facts

HPV infections are common. Most sexually active people will acquire an HPV infection in their
lifetime. HPV is transmitted through sexual activity and intimate skin-to-skin contact. Usually there
are no symptoms and often people do not know that they have an HPV infection. The infection
usually goes away naturally within two years.

Infection with HPV causes cell changes in the cervix. For most women, these changes are minor
and the cells change back to normal when the infection goes away. Sometimes an HPV infection
stays in the body for a long time and causes more significant cell changes. Over a number of years,
this may slowly lead to cancer if abnormal cells are not followed closely and, if necessary, treated.

Most women with HPV infection do not develop cervical cancer.

In Ontario, a publicly-funded school-based HPV immunization program offers the vaccine at no cost
to grade 8 girls. The HPV vaccine protects against the cancer-causing HPV types that are
responsible for 70% or more of cervical cancers and can also cause other cancers. Protection from
the vaccine is expected to be long-lasting, though further study is needed.

In addition to the publicly-funded program, HPV vaccine is available on a user-pay basis (about
$500). It is approved for use in females nine to 45 years of age. Women are encouraged to speak
to their healthcare provider about getting immunized.
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For more information, please contact:
Marko Perovic, Senior Public Affairs Advisor
Cancer Care Ontario
Tel: 1-855-460-2646
E-mail: [email protected]
Version française disponible
09/12