Experts cite accuracy and longer screening intervals as reasons for HPV's growing role in detection
HPV testing is proving more accurate and less frequent than Pap smears, prompting some provinces to shift their cervical cancer screening programs, as reported by Statistics Canada.
According to the Colorectal, cervical and breast cancer screening tests, 2024 report, 33 percent of Canadian women aged 25 to 69 have had an HPV test in their lifetime, with participation higher among those aged 25 to 49 (39 percent) than among those aged 50 to 69 (14 percent).
Prince Edward Island became the first province in 2023 to replace Pap smears with HPV testing, and other jurisdictions have either switched or are in transition.
The same Statistics Canada data shows Pap smear participation has declined nationally — 69 percent of women aged 25 to 69 reported having a Pap test within the past three years in 2024, down from 74 percent in 2017.
Women aged 50 to 69 had the lowest participation rate at 64 percent, compared with 70 percent for those aged 25 to 34 and 75 percent for those aged 35 to 49.
Provincial rates ranged from 60 percent in Prince Edward Island to 75 percent in Saskatchewan and Alberta.
Statistics Canada also found participation gaps by demographic group.
Arab (49 percent), South Asian (55 percent), and Chinese (63 percent) women aged 25 to 69 had lower rates than non-racialized, non-Indigenous women (71 percent).
Non-permanent residents (46 percent) and established immigrants (65 percent) also had lower participation compared with Canadian-born women (71 percent).
Ontario-based gynaecologist Kim Alexander said roughly 95 percent of cervical cancers are caused by HPV, which she described as a sexually transmitted disease.
“If we know your HPV status, we actually know your level of risk,” she said in an interview with Yahoo Canada.
Alexander added that HPV testing is “super powerful” in identifying whether a person has the cancer-causing virus, is more accurate than Pap smears, and can now be done more quickly.
She noted that HPV testing is typically required only every five years, compared with the three-year interval for Pap smears.
The Canadian Medical Association Journal reported Pap testing has a high specificity of 96.8 percent but low sensitivity of 55.4 percent, meaning it can miss nearly half of existing abnormalities.
Alexander said the false rate for Pap smears is between 10 and 20 percent, compared with a near-zero missing rate for HPV testing.
She added that 80 percent of people clear HPV within two years — especially in their 20s — but only 60 percent of people in their 40s do so in the same timeframe.
Diane Francoeur, obstetrician-gynaecologist and CEO for the Society of Obstetricians and Gynaecologists of Canada, told CTV News that the biggest barriers to Pap tests are access and misinformation, citing the doctor shortage as one example.
She said these barriers can affect immigrants and Indigenous women, particularly those who have been mistreated, do not trust the medical system, or are not receiving information in their native language.
Francoeur described cervical cancer as treatable but “really, really, really aggressive” and said HPV tests are more effective in screening for it.
Alexander also told Yahoo Canada that cervical cancer “is a vaccine preventable disease.”
The HPV9 vaccine, Gardasil 9, protects against nine HPV types — seven linked to cancers and two to genital warts.
It is recommended for at-risk groups including people with genital warts, abnormal Pap results, frequent new sexual partners, or midlife relationship changes such as divorce, affairs, or non-monogamous relationships.
