Cervical cancer is a disease mainly caused by human papillomaviruses (HPV), which can be easily detected with an HPV test or Pap test. While the Pap test was recommended as a primary test in Quebec, the HPV test, which has proven to be more effective, will gradually replace it.

In our article we help you understand the difference between these tests, why this transition and where to get tested. If you have any additional questions, please contact a healthcare professional.

Human Papillomavirus and cervical cancer in Canada

Canada faces a high prevalence of HPV infections. More than 70% of the population is infected with this virus, which increases the risk of triggering several diseases and cancers, including cervical cancer.

In 2023, approximately 1150 people in Canada were diagnosed with cervical cancer. It is therefore crucial to follow health recommendations in terms of screening in order to prevent, detect and limit cases of cancer.

Cervical cancer screening tests

There are two screening tests that can be done to detect and prevent cervical cancer: the Pap test and the HPV test. In both cases, it is a simple and quick gynecological examination, which consists of taking a sample of the cells of the cervix using special tools. The sample is then analyzed differently depending on the test.

The Pap test

The Pap test can detect the presence of abnormal cells and precancerous bonds. Although this test is effective, it has limitations such as the possibility of false negatives, i.e. not detecting any anomalies present.

Recommended from the age of 21 to 65, the Pap test should be repeated every 2 years. After the age of 65, the Pap test could be maintained as an additional examination in certain circumstances

The HPV test

The HPV test can detect the presence of the human papillomavirus (HPV). It therefore makes it possible to detect the virus that can potentially lead to the development of cervical cancer.

HPV testing is now recommended from 25 to 65 years of age and should be done every 5 years. This five-year interval is recommended because of the increased sensitivity of the test. In addition, the period between HPV infection and the appearance of precancerous lesions is very long.

In fact,  the HPV test has a sensitivity of nearly 95%, compared to 55% for the Pap test. The HPV test is therefore considered to be more effective in detecting cervical cancer compared to the Pap test.

gynecological exam HPV test for cervical cancer

Transition from Pap smear to HPV smear in Quebec

Faced with this reality, Quebec and INESSS have issued new recommendations and have been considering a gradual transition from Pap tests to HPV tests for several years.

While the Pap test was recommended for Canadian women during their gynecological examination, it is the  HPV test that becomes the primary test for detecting cervical cancer, before the Pap test. This decision is driven by the effectiveness and benefits of HPV testing, including early detection of precancerous lesions and spacing out screening tests.

INESSS Recommendations for Cervical Cancer

In summary, INESSS recommends the following protocol:

  • The HPV test becomes the primary test for detecting cervical cancer.
  • It should be done from 25 to 65 years of age, in 5-year intervals, whether you are vaccinated or not. Vaccination does not protect against all types of HPV that can cause cervical cancer.
  • If the HPV test results are positive, the Pap test can still be used as a background. Other tests, such as a colposcopy, may be recommended by a healthcare professional.
  • These recommendations do not apply to people who are at high risk of developing cervical cancer, such as people who are immunosuppressed.

Get an HPV test in Montreal

In Quebec, the transition from the Pap test to the HPV test will be gradual. As of today (February 2024), the HPV test is not available in all clinics. However, some clinics such as ELNA Medical have been able to anticipate the transition and already offer the HPV test, in addition to the Pap test, as a screening test.

HPV test in RAMQ clinic

To perform an HPV test, it is necessary to obtain a referral from a doctor. He or she will refer you to a professional who can perform the test (gynecologist, family doctor, nurse, etc.). The consultation is covered by the RAMQ.

The samples are then sent for analysis to a public (hospital) or private (laboratory) body. For the public, the analyses are reimbursed but delays can be up to 6 months.

HPV testing in a private clinic

If you have an urgent situation or don’t want to wait, you can make an appointment at a private clinic. Wait times are almost non-existent, and you can easily get an appointment on the day.

In addition, the doctor performs the HPV test during the consultation, so you don’t have to make a second appointment. The samples are then sent for analysis to a private laboratory in our CDL Laboratoires subsidiaries. Results are obtained quickly in 2 to 5 days.

Please note that the consultation and test are reimbursed by most private insurances. Don’t hesitate to contact our clinics to get screened for cervical cancer!

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