“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 a now a very real possibility,” said Premier David Eby. “As of Jan. 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.”
Beginning Jan. 29, 2024, women and individuals from 25 to 69 with a cervix can choose to order a kit to self-screen for the human papillomavirus (HPV), the leading cause of cervical cancer, or have their screening sample collected by a health-care provider.
“B.C. has been a world leader in cervical cancer prevention for almost 70 years and we’re at the forefront again as the first Canadian province or territory to offer cervix self-screening at home province-wide,” said Adrian Dix, Minister of Health. “By transitioning cervix screening to HPV primary screening and offering the self-screening option province-wide, we are removing barriers to accessing care and giving people the tools they need to take prevention into their own hands. This is part of our commitment to eliminate cervical cancer in our province in 10 years.”
Cervical cancer is the fourth most common cancer in women globally. Rates of cervical cancer are among the fastest increasing among females in Canada but it is preventable through immunization and screening programs. Ninety-nine per cent of cervical cancers are caused by high-risk HPV.
The self-administered HPV test means that patients can easily self-collect a sample at home or at their health-care provider’s office. This is an expansion to the pilot program launched in 2021, when people in specific communities could order cervix self-screening kits.
Self-screening removes obstacles such as cultural barriers, history of trauma, the need for transportation, child care and booking time off from work for traditional testing. Cancer screening programs are an important component of preventative health care and are intended for people with no identifiable symptoms as an effort to detect cancer sooner. This can improve outcomes for patients, reduce demands on the health-care system and expedite care for others.
“Whereas pap tests detect changes to the cells of the cervix that have been caused by HPV, HPV testing can detect the presence of high-risk types of HPV before cell changes have occurred,” said Dr. Gina Ogilvie, Tier 1 Canada research chair in global control of HPV-related diseases and prevention, University of British Columbia, and affiliate scientist, BC Cancer. “Cervix self-screening is not only more effective, but also safe and easy and will help us prevent many unnecessary deaths.”
In addition to the self-screening program, the Province is making HPV testing its primary screening method because it detects the virus before it can cause cancer and is more accurate and widely accessible. Pap tests are the current primary screening method.
The transition to HPV screening by a medical-care provider will be phased in over the next three years by age group, starting with people 55 and older. All self-collected samples will be processed using HPV testing from the end of January.
“When I first saw the ad on social media for the cervix self-screening pilot, I thought I’d give it a try. I’m so glad I did,” said Christina Price, BC Cancer pilot study participant from Port Alberni. “I found out I had a high-risk type of HPV and ended up needing a procedure to remove the cancerous tissue from my cervix. We caught it early and I’m now cancer-free. I’m grateful this opportunity was there for me. I am thrilled too that at home as self-screening is now being made available to anyone in B.C. who needs it.”
Several jurisdictions around the world have transitioned to this approach for cervical cancer screening. British Columbia will be the first jurisdiction in Canada to launch this new accessible self-screening test province-wide and one of the first to fully implement HPV testing as its primary screening method.
Completing the transition to the HPV test as the primary screening test for cervical cancer is part of B.C.’s 10-year Cancer Care Action Plan to better prevent, detect and treat cancers. Expanding cervix self-screening province-wide is part of the Province’s commitment to increase equity in health care.
To order the self-screening kits as of Jan. 29, 2024, visit: http://www.bccancer.bc.ca/screening/cervix
To learn more about B.C.’s 10-year Cancer Care Action Plan, visit: https://news.gov.bc.ca/releases/2023HLTH0012-000229
Two backgrounders follow.
What people are saying about B.C.'s cervical self-screening program
Jennifer Rice, Parliamentary Secretary for Rural Health –
"Being able to order a free self-screening kit and receive results online or by mail will make a real difference in rural and remote communities. This will help ensure everyone has access to the care they need and reduce the number of people needing to travel outside their home community for cervical cancer screenings. Expanding cervical self-screening shows our government's commitment to bringing preventative cancer care within reach for all of us."
Kelli Paddon, Parliamentary Secretary for Gender Equity –
"Screening is crucial to preventing cervical cancer. But a Pap test can be uncomfortable or not easily available for some people. We know that some individuals are not as likely as others to discuss reproductive health with a health-care provider, so self-screening can better connect them with the care they need. Self-screening improves accessibility for people, including transgender and gender-diverse people, new Canadians, Indigenous people and people who live in rural or remote communities."
David Byres, president and chief executive officer, Provincial Health Services Authority –
"Through this partnership between BC Cancer and the Provincial Laboratory Medicine Services, both programs of the Provincial Health Services Authority, we're making screening easier, more accessible and more accurate. HPV self-screening allows women and individuals with a cervix to screen where and when they want and detect the presence of high-risk types of HPV, making it possible to stop cancer before it starts."
Andrea Seale, CEO, Canadian Cancer Society –
"In recent years, the rate of cervical cancer has been increasing despite it being the most preventable cancer. Because of this, cervical cancer screening, one of the most effective ways to reduce the incidence of cervical cancer and find it early, is critically important. The Canadian Cancer Society commends BC Cancer and the Government of B.C. for its world-class leadership by transitioning from cytology to primary HPV screening and introducing cervix self-screening."
Bianca Michell, Tache (father)/Yekooche (mother), Lusilyoo clan –
"As someone who has experienced trauma, I avoided Pap tests because I did not feel safe or trust anyone to do this procedure. When I did a Pap test, it was always traumatic and it took a long time for me to recover mentally and emotionally. Today, with the at-home HPV self-screening test, survivors like me can do a self-test where and when we feel safe. I was able to access this test through the Carrier Sekani Family Services and the BC Cancer pilot project and ended up needing further testing. This saved my life."
- Introducing the new test province-wide allows traditional screening intervals to be extended from three to five years, which makes preventative care more convenient for people.
- Demand for the traditional pap test will diminish over time. However, it will continue to be an important secondary test as needed.
- There are more than 100 types of human papillomavirus (HPV) that men and women can contract.
- While most types of HPV cause no symptoms and go away on their own, some can cause health problems like a variety of cancers including cervix, anus, mouth and throat, penis, vagina and vulva, as well as genital warts.
- Only long-term infection with high-risk HPV can cause pre-cancerous changes to the cells of the cervix, which can develop into cervical cancer if undetected and untreated.
- HPV is transmitted through intimate skin-to-skin contact and can cause a variety of cancers.
Facts about the HPV test and self-screening:
Screening for HPV is a more accurate test than cervical cytology for identifying people at risk of developing cervical cancer. The HPV test has a higher sensitivity and negative predictive value than the current pap test.
A positive HPV test helps flag if a person is at risk for developing abnormal cells of the cervix, so those cells can be detected and treated early to prevent cervical cancer.
In December 2021, cervix self-screening was offered to people on central Vancouver Island and the Sunshine Coast in a pilot program later extended to include New Westminster, the Tri-Cities and Pemberton. Data showed an increase in the number of people who have never been screened or not screened in 10 years willing to participate in cervix self-screening.
Since the pilot launched, more than 13,000 people have participated. Through the pilot, 767 number of people tested positive for HPV and were recommended for followup.
How the cervix self-screening program works?
People will receive a letter in the mail when they are due to screen. They can then request a kit directly from the cervix-screening program by phone at 1 877 702-6566 or online at https://www.bccancer.bc.ca/screening/cervix. Once the sample is collected, the completed kit can be mailed free for analysis.
Results will be sent by mail or online to both the patient and their health-care provider within four to six weeks from the time the kit is mailed in. If people don't have a family doctor or nurse practitioner, and they receive a positive test, they will be connected to a linked clinic in their community, where they can receive followup care and support.
