PAP TESTS
Screening for Cervical Cancer + HPV Immunization
A Pap test is a quick and simple screening test that can identify cell changes in the cervix that may lead to cancer before women feel any symptoms. Screening is designed to detect signs of disease before people have symptoms. The goal is to detect it early enough to treat it most effectively.
Cells on the cervix may become abnormal when a woman has a human papillomavirus (HPV) infection. Abnormal cells often return to normal on their own, especially in young healthy women. Pap test screening allows us to detect abnormal cells so they may be monitored, and (when necessary) treated. Otherwise, slowly over a number of years, they may become cervical cancer.
REDUCE YOUR RISK OF CERVICAL CANCER
Regular Pap Test Screening & HPV Immunization
WHY GET A PAP TEST?
Deaths from cervical cancer are more common in areas of the world where cervical screening is not available. According to Cancer Care Ontario, there has been a dramatic decline in the rate at which Ontario women develop and die from cervical cancer since the 1980s, and this is almost entirely due to Pap testing and screening.
WHEN TO GET SCREENED?
Ontario Cervical Screening Program recommends that women (and people with a cervix) who are or have ever been sexually active have a Pap test every 3 years starting at age 25. First Pap tests will not be provided to people under the age of 25. Pap tests can stop at the age of 70 if a person has had 3 or more normal tests in the previous 10 years, unless their health care provider has advised them to continue beyond this age.
If you meet the above criteria you should have regular screening for cervical cancer with a pap test even if you:
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feel healthy and have no symptoms
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are no longer sexually active
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have only had 1 sexual partner
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are in a same-sex relationship
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have been through menopause
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have no family history of cervical cancer
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have received the HPV vaccine
WHAT TO EXPECT DURING YOUR PAP TEST?
A pap test is done in the doctor's office. You will be asked a few questions about your medical history. Then, when you are comfortable and with your consent, an instrument call a speculum is inserted into the vagina so that the cervix can be seen. A small, soft plastic broom is used to sample cells from the surface of the cervix, and the speculum is removed. Some women find the procedure a bit uncomfortable, but the entire procedure takes just a few minutes.
The sampled cells are sent off to a laboratory to be examined under a microscope. The results are sent back to the doctor, who will then advise the patient on appropriate follow-up.
WHAT IS HPV?
Human papillomaviruses (HPV) are viruses that can infect many parts of the body. HPV is a family of viruses commonly found in both men and women. There are more than 100 strains of HPV, and each one is named with a number.
Some types of HPV are sexually transmitted and can cause warts or other consequences such as cancer (e.g., cervical, throat, and anal). The types of HPV that infect the anal and genital (anogenital) areas are not the same as the ones that infect other areas of the body such as the fingers, hands and face.
Certain types of HPV cause cervical cancer (and mouth/throat cancer) and are passed from one person to another through intimate sexual contact. Most sexually active people (80%) come into contact with HPV at some point in their lifetime. People at high risk of HPV infection include those who are dating; people who have had an abnormal pap test; and those who are immune suppressed. Even people in monogamous relationships are at risk: 40% of marriages end, and the percentage of relationships with infidelity is significant. Therefore, HPV infection occurs throughout the lifetime and the risk for disease is life-long.
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 for most people, but for 1 in 10 people it does not, and it can cause disease; the time from infection to invasive cancer is between 9 and 15 years.
HPV VACCINE: GARDASIL® 9
HPV vaccine (Gardasil® 9) provides protection against 9 types of HPV that cause cervical, vaginal, and vulvar cancers in females, anal cancer, certain head and neck cancers, such as throat and back of mouth cancers and genital warts in both males and females. There is no upper age limit for the use of the HPV vaccine. In 2018, the Society of Gynecologic Oncology of Canada recommended universal HPV vaccination.
Book an appointment with Dr. Manning to discuss vaccine benefits, schedule, costs and risks, and she can prescribe the vaccine, for administration in the clinic, or at your pharmacy. The vaccine is covered by most drug insurance plans, and costs about $170 - 195 per dose (individuals receiving their first dose after age 15 years require a three-dose series).
The vaccine is fully covered for girls and boys in Grade 7 across Ontario. Girls or boys who are unable to begin or complete the HPV vaccine series in Grade 7 are eligible to catch-up missed doses through their local public health unit, free of charge, until the end of Grade 12
HPV TESTING
HPV testing is available with your Pap test, however, at this time the HPV test is not covered by OHIP and is generally recommended for people who have had an abnormal pap test. The fee for the HPV test is approximately $90, charged directly to the patient by the laboratory (after the test).
