Nova Scotia plans to change cervical cancer testing method

Nova Scotia plans to follow other provinces in testing for cervical cancer, but the switch from Pap smears to HPV tests is at least two years away, a health committee in the provincial legislature heard Tuesday.

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

“We're currently going through a planning process with an eye towards the transition,” Grimshaw said.

Untreated persistent HPV infection causes 95% of cervical cancers. According to the World Health OrganizationHPV is a common sexually transmitted disease that most sexually active people will be infected with at some point, but in many cases it causes no symptoms and goes away on its own.

According to the Canadian Cancer Society, the two high-risk types, HPV16 and HPV18, It is responsible for 70% of cervical cancer casesHPV testing can detect these high-risk types.

British Columbia and Prince Edward Island previously announced plans to move to HPV testing as the primary method of screening for cervical cancer, a disease caused by abnormal cells in the cervix, the organ that connects the uterus to the vagina. In British Columbia, eligible patients can apply for a kit with a vaginal swab to test at home, which will be delivered by mail.

At-home testing will be offered as an option in Nova Scotia, but Grimshaw declined to say what role it will play in overall testing.

“It really depends on the uptake,” he said. “Early information in B.C. tells us that about 30 to 40 per cent of people may be interested. [at-home tests]”

“Women who have lost their primary care physician, like my wife, would probably be very interested in this,” he continued, “but women who had a good relationship with their primary care physician and saw them for other things might not be as interested.”

The HPV vaccine is offered to Nova Scotia students through the province's school immunization program, and Grimshaw said the HPV test is “a better test to screen females who have been vaccinated through the school-age program.”

Grimshaw said he hopes the new tests will be done every five years, rather than the three years recommended for Pap tests.

He said the workload of “five or six labs” that currently process 60,000 Pap tests a year would drop to around 3,000 to 4,000 a year. The plan is to process those tests at one testing center.

Grimshaw said one of the reasons for the switch to HPV testing is a growing shortage of technicians who can read Pap tests, noting that there are only two schools left in Canada to train such specialists.

Grimshaw added that machines to carry out HPV tests still needed to be purchased and locations for testing centres selected.

New Democrat commissioner Susan LeBlanc on Tuesday urged the province to make the changes as soon as possible.

“Obviously, we want this program to get underway as soon as possible,” LeBlanc told reporters after the meeting. “We understand that there are many components that have to be put into the program, but we also understand that our money will go where the government decides.”

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