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On March 3, 2025, Ontario will switch from Pap testing to HPV testing as the primary test for cervical cancer screening. Previously, HPV testing was available to patients for a cost but was not covered under Ontario’s provincial health plan. Other provinces, including Prince Edward Island and British Columbia, have already made the move or are in the process of doing so. This is an exciting change that promises earlier, more accessible and more accurate detection of cervical cancer risk.
Here are five key points to know about HPV testing.
Ontario replacing Pap test with more effective procedure that detects HPV
1. Why are we switching from Pap tests?
According to the Canadian Cancer Society, an estimated 1,600 Canadians are diagnosed with cervical cancer each year despite provincial programs that encourage regular Pap testing. To understand the switch to HPV tests, it’s important to first understand what causes cervical cancer. High-risk strains of the human papillomavirus (HPV) cause changes in the cells of the cervix that can, over time, lead to cervical cancer. While Pap tests are 50 to 70 per cent sensitive for detecting changes in the cells of the cervix caused by HPV, testing directly for the virus has higher sensitivity, at 90 per cent. In essence, instead of waiting for abnormal cell changes to develop, doctors can identify the root cause of cervical cancer much earlier.
2. What does this mean when I go for my appointment?
At present, the HPV test is performed in much the same way as a Pap smear test. You’ll still undergo a pelvic exam that involves a speculum, during which a sample is collected from your cervix. The real difference isn’t in the exam itself but in what happens afterward. While a Pap test relies on a microscopic examination of cells to spot abnormalities, the HPV test uses advanced molecular techniques to detect the DNA of high‑risk HPV types. Looking ahead, there’s the possibility of self-swabbing for HPV without the pelvic examination. This could make the process more comfortable for those who struggle with internal examinations, and more accessible, particularly for people in remote or underserved areas.
3. How often must I get an HPV test?
One of the major benefits of HPV testing is its high negative predictive value, which means it is more likely that negative results will correctly identify people who do not have a cervical precancer or cancer and who will not develop a cervical cancer in the next five years. Given the more reliable results, guidelines suggest HPV testing every five years – a longer interval than the three years recommended for Pap testing.
4. What happens if I have a positive HPV test?
A positive HPV test is not a diagnosis of cancer. It indicates the presence of high-risk HPV strains. Further review and potentially additional testing and referral to specialist care may be required to ensure any potential issues are caught early.
5. What does this mean for women’s health across Canada?
For patients, the move to HPV testing will mean more accurate assessments and potentially less frequent testing. More importantly, it represents a forward step in preventive care, giving people across Canada the benefit of earlier detection and more informed treatment decisions.
The change in tests is more than just an upgrade in technology – it’s an important evolution in how we approach cervical cancer prevention. By detecting the root cause earlier, we can offer more precise and pro-active care. This shift – together with the impact of the HPV vaccine, which has significantly reduced the incidence of HPV-related cancers – marks a transformative era in women’s health. As a family doctor, I’m excited to see how these positive changes will enhance patient outcomes nationwide.
Dr. Sheila Wijayasinghe, known as Dr. Sheila to her patients, is a menopause and sex therapy certified family physician practising at St. Michael’s Hospital in Toronto, and the medical director of primary care outreach at Women’s College Hospital. She is also the resident health expert on CTV’s The Social, and co-host of The Doc Talk Podcast. Dr. Sheila is dedicated to improving access to care and supporting individuals in achieving better health outcomes and confidently navigating the health care system.
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