More cases of cervical cancer detected too late: Canadian Cancer Society

The latest Canadian data show that cervical cancer is now the fastest-growing cancer among women. Screening remains the best way to prevent this cancer, which is avoidable when detected at the pre-cancerous stage.

After declining for three decades, the incidence of cervical cancer increased by 3.7 per cent per year between 2015 and 2019, according to the Canadian Cancer Society (CCS). This is the first significant increase since 1984.

The CCS estimates that 1,600 Canadian women will be diagnosed with cervical cancer in a year, and 400 will die from it. “They are often found too late,” says gynecologist Dr. Céline Bouchard.

“There are more and more cases, and the cases are more advanced,” she observes. And it’s a pity when you know that when it’s precancerous, it’s easily cured and treated.”

With vaccination and screening, it would be possible to virtually eradicate cervical cancer.

It’s the third most common cancer in women aged 40-44, said the gynecologist. “It’s a shame because it’s the only cancer that can be prevented. The others can’t be prevented,” she points out, adding that it is still possible to act on risk factors such as smoking for other cancers.

What’s more, the costs to society also increase when it’s detected too late, including radiotherapy, chemotherapy and invasive surgery.

According to Dr. Bouchard, several factors may explain the rise in cases of cervical cancer. Firstly, because many Quebec women do not have access to a family doctor who will follow up on the frequency of screening.

Also, there is no registry. Women don’t receive a letter like they do for breast cancer,” adds Dr. Bouchard. For 40 years, gynecologists have been asking the Ministry [of Health] to set up a patient registry and send out letters. How do you expect people to remember when they had their screening test when it’s going to be every five years? Already at three years, they hardly ever remember. It’s not easy to remember all that.”

Unlike the Pap test, which has to be taken every two or three years, the new HPV test will be taken every five years.

Discontinuation of the slow Pap test

In May 2022, the Minister of Health and Social Services, Christian Dubé, announced that the HPV test would be implemented as a primary screening test for cervical cancer, in line with INESSS recommendations.

The HPV test is much more accurate than the Pap test,” says Dr. Bouchard. It’s relatively the same procedure for the patient, i.e. the gynecologist passes over the cervix with an instrument to collect cells.

With HPV testing, the sample is placed in a liquid for analysis. If the test is positive, the same sample can be used for follow-up examination of the cells.

This detects the presence of high-risk HPV, which can lead to the development of precancerous lesions and, if left untreated, lead to cervical cancer.

According to the Ministry of Health website, Bas-Saint-Laurent, Gaspésie, Chaudière-Appalaches and Lanaudière are the only regions to offer the HPV test.

“The Minister announced that in 2022 we would transfer [to HPV testing], but right now, there are only four regions that have converted to HPV [testing]. These are the least populated regions,” laments Dr. Bouchard.

With the HPV test, “we don’t lose cases that would be positive and not detected [with the Pap test]”, and it can detect 14 precancerous types. “It’s the best test to have,” stresses the doctor.

In June 2024, the Ministry of Health indicated in a written response to The Canadian Press that the goal is still to replace the Pap test with the HPV test in all regions of Quebec by 2026.

The explanation given for the delay in deployment is that the new test requires the acquisition and installation of specific equipment.

–Canadian Press health content receives funding through partnership with Canadian Medical Association. The Canadian Press is solely responsible for editorial choices.

–This report by La Presse Canadienne was translated by CityNews