Cervical cancer is definitely not in the past
So what is HPV?
HPV stands for human papillomavirus. It is transmitted through sexual skin-to-skin contact (penetration is not required), and it is VERY common.
HPV infects women and men:
Approximately 75% of sexually active Canadians will get at least one HPV infection in their lifetime.3
150+
types of HPV2
At least
high-risk types known to cause most cases of cervical cancer2
Up to
types covered by the vaccine4
Most strains of HPV are not serious and often don’t have any symptoms. However, some of the strains that are transmitted during sexual contact (vaginal, oral, penile, or anal) can cause cancer.
HPV 16 and HPV 18 are the highest-risk types. They account for more than
%
of all cervical cancer.2
How would I know if I have HPV or cervical cancer?
You should get tested!
Most HPV infections don’t have any signs or symptoms. So you may not be able to tell if you or your partner is infected. That also means that you or your partner may be unknowingly transmitting HPV.3
Good news: Most HPV infections clear on their own.
However, a persistent infection with a high-risk strain of HPV can lead to pre-cancer or cancer.
Testing for these high-risk strains can tell you if you’re at risk before a problem develops.
So how do we screen for cervical cancer?
Screening is an important part of prevention and one of three pillars in the World Health Organization’s (WHO) global strategy to eliminate cervical cancer by 2030.
Learn more about the WHO strategy and the role of HPV screening in the elimination of cervical cancer.
In Canada there are currently two tests that screen for cervical cancer.
The Pap test
(sometimes also called a Pap smear)
An HPV DNA test
(the “New Pap”)
- Used for more than 70 years
- Looks for abnormal changes in cervical cells
- Technicians analyze cells by appearance (normal or abnormal) under a microscope
- Used for over 10 years
- Detects DNA of high-risk HPV in cervical cells
- Uses modern lab technology to analyze a woman’s risk for pre-cancer or cancer
What results should I expect?
Both tests start the same way: Your healthcare professional takes a sample of cells from your cervix.
cervix
The tests can then be performed together or one after the other, depending on age and medical guidelines.
Pap test5
HPV DNA test
- The Pap test does not detect the presence of HPV and is subject to human error.
- It looks for current changes in your cervical cells.
- The HPV test uses DNA technology to look for high-risk HPV strains.
- The results can help determine your risk for cervical cancer now and in the future.
All women aged 25–70
who are sexually active, or who have been in the past, should get regular screenings for HPV.
The general Canadian screening recommendation for women aged 25–70 is to have a routine screening every 3 years. If you have had an abnormal screening in the past, or have other risk factors, talk to your healthcare provider about how frequent your screenings should be.6
A low-level HPV infection can exist for years before it ever progresses and leads to health problems. And, because most HPV infections do not cause symptoms, a person may never know they have one.
Understanding your test results
What a negative result means
Pap test
HPV DNA test
Abnormal cells were not seen under a microscope.
- You are at low risk of having pre-cancer or cancer right now.
A high-risk HPV infection that could lead to cancer was not detected.
- You are at very low risk of having pre-cancer or cancer now.
- You are at very low risk of developing pre-cancer or cancer in the next 5–10 years.
The Pap test can miss up to
1/3
of invasive cervical cancer cases. This is what is known as a “false negative.” 7,8
What a positive result means
Pap test
HPV DNA test
Abnormal cell changes were found on your cervix. These changes could be minor or more serious.
You have a high-risk HPV infection and are at an increased risk of developing pre-cancer or cancer.
A positive HPV test result does not mean you already have, or that you will develop, cancer.
Depending on your test results, your healthcare professional may want to do the following:
- Repeat the test at a later time.
- Take a closer look at your cervix using a colposcopy.
What is a colposcopy?
A colposcopy allows your healthcare professional to take a closer look at your cervix in order to look for abnormal areas. A sample of these areas may be taken for further evaluation—this is called a biopsy.
If you have a positive result from either a Pap test or an HPV test and are worried about transmitting HPV, talk to your healthcare provider.
The Pap test has been used in Canada for over 70 years, and has greatly reduced the number of women who die from cervical cancer.
However, for a variety of reasons, there is still a risk of a “false negative.” 8
Ask your doctor if an HPV DNA test is right for you.
Cervical cancer is preventable, and an HPV DNA test can tell you if you’re at risk.
References:
- Cervical Canada. Public Health Agency of Canada. Available from: https://www.canada.ca/en/public-health/services/chronic-diseases/cancer/cervical-cancer.html. Accessed November 2019.
- Doorbar J et al. Rev Med Virol. 2015;25(1):2–23.
- What is HPV? The Society of Canadian Obstetricians and Gynaecologists of Canada. Available from: https://www.hpvinfo.ca/what-is-hpv/. Accessed November 2019.
- Gardasil Product Monograph. Merck Canada Inc. December 7, 2016.
- Pap tests. Canadian Women’s Health Network. Available from: cwhn.ca/en/node/44806. Accessed November 2019.
- Dickinson J et al. Recommendations on screening for cervical cancer. Can Med Assoc J. 2013;185(1):35–45.
- Leyden WA et al. J Natl Cancer Inst. 2005;97(9):675–683.
- Andrae B et al. J Natl Cancer Inst. 2008;100(9):622–629.