B.C. to begin at-home HPV, cervical cancer testing

Good news is on the horizon for those at risk of cervical cancer.

The B.C. government says the province will become the first in Canada and move from its current model of screening for cervical cancer to a far more accurate, accessible, and long-lasting test.

In a news conference Tuesday, Premier David Eby and Health Minister Adrian Dix explained that the province will transition away from Cytology (lab tests looking for abnormal cells in swabs taken at doctor’s offices) to human papillomavirus (HPV)-based screening for cervical cancer.

The new tests are nearly twice as accurate as the screening done in B.C. now, the province says, with data from the BC Cancer showing the test detects pre-cancer cells 96 per cent of the time — current screening only 53 per cent.

Moving away from Cytology will mean that instead of having to go into a doctor’s clinic for a pap test — which takes cells to then be examined in a lab under microscope — the new tests come in a kit via mail, where you self-swab and then return by mail.

“It’s not every day that a province can set an achievable goal of eliminating a deadly cancer, but today’s launch of the first at-home self-screening program means ending deadly cervical cancer in British Columbia is now a very real possibility,” said Eby.

“As of January 29, women will be able to order a quick, easy, and highly accurate test kit to use at home, and will be able to access a network of highly trained and compassionate medical professionals who will support those identified to be at higher risk. This more accurate, comfortable, and convenient way to test will encourage more women, and vulnerable populations like trans people, across the province to get screened, including in more rural and remote communities. By working together, we can eliminate deadly cervical cancer in B.C. in the next decade.”

The transition to order an at-home test kit will first begin with those 55 years old and older, and broadening to those aged 25 years and older over the next three years.

HPV researcher and senior public health scientist at the BC Centre of Disease Control Dr. Gina Ogilve shared that in 1955, B.C. launched the world’s first cervical cancer screening program with the use of pap smear tests. “We were able to find abnormal cells before they became cancer and catch cervical cancer in its earliest stages, when the chance of survival is the highest — about 85 per cent.”

“Today, we are taking the next major leap forward with the goal of not just reducing the incidence of cervical cancer but ultimately eliminating it altogether. Cervical cancer is preventable cancer through immunization and through screening,” Ogilve said.

“When a high-risk HPV infection persists over many years, it may cause changes to the cells that then ultimately may lead to pre-cancer and then cervical cancer. So, unlike the conventional Cytology, or pap test, which looks for abnormal changes in the cervix itself, HPV testing looks for the virus that causes these abnormal changes to occur,” she explained.

General practitioner Dr. Cailey Lynch explained that the first person she saw die of cervical cancer has stayed with her for the past 20 years. “I still have dreams about the patient at the end of the hall, who we didn’t reach in time.”

Lynch says as a family doctor, she gently reminds, or “perhaps harangues and downright boss” her patients into her officer for “no one’s favourite procedure. … If I’ve done an excellent job, they’d say, ‘That wasn’t so bad.'”

“This incredible research will make a high barrier procedure into a simple home test. It will save countless lives,” Lynch said.

According to the province, cervical cancer is the fourth most common cancer in females globally. Rates of that cancer are “among the fastest increasing amongst females in Canada, but it is preventable through immunization and screening programs. 99 per cent of cervical cancers are caused by high-risk HPV.”

The province explains that it is also making the HPV testing its primary screening, as it detects the virus before it can cause cancer.

Dix explains the new program does have an associated cost of about $12 million, with some “additional costs,” but says for the benefits, it is money well spent.

The province says the pilot project for transitioning to an HPV test from screening, which started in 2021, had 40 per cent of participants choose to self-swab versus having the swab taken at a doctor’s office. The province explains due to this, it is optimistic that, over time, more and more people will be comfortable with the self-administered aspect of the new test.

For those who do not have a family doctor, the province explains that if an abnormal result is found, the results will go to a clinic in the patient’s community that has agreed to do a follow-up. The patient will also receive the information of the clinic that has taken over their results.