Nova Scotia wants to change the way it screens for cervical cancer

Nova Scotia plans to follow the lead of other provinces in how it screens for cervical cancer, but the transition from Pap smears to HPV testing will take at least two years, the legislature’s health committee heard Tuesday.

Dr. Robert Grimshaw, medical director of Nova Scotia Health’s cervical cancer screening program, told the committee that the effectiveness of the human papillomavirus test in cervical cancer screening is one of the main reasons for making the change, but it will take time.

“We are engaged in an active planning process where we are mapping out the transition,” said Grimshaw.

Untreated persistent HPV infections cause 95 percent of all cervical cancers, according to the World Health OrganizationHPV is a common sexually transmitted infection that affects most sexually active people at some point. However, it often occurs without symptoms and goes away on its own.

According to the Canadian Cancer Society, there are two high-risk types: HPV16 and HPV18. are responsible for 70 percent of cervical cancer casesAn HPV test can detect these risk types.

British Columbia and PEI previously announced plans to transition to HPV testing as the primary screening method for cervical cancer, a disease in which abnormal cells in the cervix — the organ that connects the uterus to the vagina — become cancerous. In B.C., eligible patients can request an at-home screening kit that includes a vaginal swab that can be mailed in for processing.

Grimshaw said home testing will be an option in Nova Scotia, though he could not say how big a role it will play in overall screening.

“It depends on the acceptance,” he said. “We know from the initial information in B.C. that about 30 to 40 percent of people might be interested in [at-home tests].”

“For a woman who has lost her family doctor, like my wife, she’s probably very interested in it,” he continued. “For a woman who has a good relationship with a family doctor and sees them for other things, she might not be as interested.”

A man wearing glasses and a suit in front of the Nova Scotia flags.
Dr. Robert Grimshaw is the Medical Director of Nova Scotia’s Cervical Cancer Screening Program. (CBC channel)

The HPV vaccine is offered to students in Nova Scotia through the provincial school vaccination program. Grimshaw said the HPV test is “a better test to screen females who are vaccinated in the school-based program.”

Grimshaw said the hope is that the new tests will be done every five years instead of every three years, which is recommended for Pap tests.

He said the “five or six labs” that currently process up to 60,000 Pap tests a year would see their workload drop to about 3,000 to 4,000 tests a year. The plan is for those Pap smears to be processed at a single testing center.

The growing shortage of technicians who can read Pap smears is one reason for the move to HPV testing, Grimshaw said, noting that there are only two schools in Canada that train such professionals.

The machines used for the HPV testing have yet to be purchased and the locations for the testing centres have yet to be chosen, Grimshaw added.

New Democrat Committee member Susan Leblanc on Tuesday urged the county to make the change as quickly as possible.

“Of course I want the program to start as soon as possible,” Leblanc told reporters after the meeting. “I understand that there are many things that need to be in the program, but I also know that we put our dollars where the government decides.”

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