Cervical Cancer

Cervical cancer is cancer of the cervix, which is located at the opening of the uterus. Cervical cancer is almost entirely preventable with regular screening, appropriate and timely follow-up of abnormal results and human papillomavirus (HPV) immunization.

Who is eligible for screening?

The Ontario Cervical Screening Program recommends that women who are or have been sexually active have a Pap test every 3 years starting at age 21. Cancer Care Ontario's cervical cancer screening guidelines provide more details for healthcare providers about when screening should start and how long women should wait between screens.

Special circumstances

  1. These guidelines do not apply to women who have been previously treated for dysplasia. Screening intervals should be individualized and should likely be annual.
  2. Women who are immunocompromised (e.g., HIV-positive or on long-term immunosuppressants) should receive annual screening.
  3. Women who have undergone subtotal hysterectomy and retained their cervix should continue screening according to the guidelines.
  4. Pregnant women should be screened according to the guidelines. Pregnancy does not alter the recommended screening interval. Only conduct Pap tests during pre- and post-natal care if a woman is due for regular screening.
  5. Women who have sex with women should follow the same cervical screening regimen as women who have sex with men.
  6. Women who have received the HPV vaccine should continue with screening. The vaccine may be considered by women who have not received the HPV vaccine according to NACI guidelines
  7. Transgender men who have retained their cervix should be screened according to the guidelines


References

  1. "Screening Guidelines - Cervical Cancer," Cancer Care Ontario, accessed April 20, 2017 from https://www.cancercare.on.ca/cms/One.aspx?portalId=1377&pageId=276792

How is screening performed?

Screening is done using a Pap test. This is a simple screening test that can help prevent cervical cancer. A Pap test looks for abnormal cell changes on the cervix.

Often, abnormal cells naturally return to normal. If they do not return to normal, a Pap test looks for these abnormal cells to determine if treatment is necessary. If left untreated for a number of years, abnormal cells can slowly turn into cervical cancer.

A Pap test does not test for other cancers in the reproductive organs, such as ovarian cancer, or for sexually transmitted infections, such as chlamydia, gonorrhea or human immunodeficiency virus (HIV).

A Pap test is done in a healthcare provider’s office.

What happens during a Pap test?

An instrument called a speculum is inserted into a woman’s vagina so her cervix can be seen. Cells are taken from the cervix and are sent to a laboratory to be examined under a microscope.



References

  1. "Pap Test for Cervical Cancer Screening," Cancer Care Ontario, accessed April 20, 2017 from https://www.cancercare.on.ca/cms/One.aspx?portalId=1377&pageId=329671

How is screening encouraged?

Invitation letters about cervical cancer screening are mailed to eligible women ages 30 to 69 to book a Pap test. Letters are also sent to women ages 21 to 69 to inform them of their test results and remind them when it is time to return for screening.

Learn more about cervical cancer screening letters

How many people get screened?

The visualizations on this page begin by looking at screening rates throughout Ontario. This serves to give an idea of the absolute and relative numbers of people who are overdue for screening, and where they are concentrated.

The later visualizations add context to this data by displaying the incidence and mortality rates of cervical cancer, as well as risk factors divided by regions of Ontario.

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Screening Rates Incidence and Mortality Rates Demographic risk factors


Cervical Cancer Screening Rates

This visualization shows screening rates divided by region of Ontario. The hexbinplot displays regions of Ontario as equally-sized hexagons, where darker colours indicate higher number of people overdue for screening. The stacked bar chart shows the same data, where the grey values are people who have been screened, coloured bars are overdue for screening, and the total length of the bar shows the number of people eligible for screening. Hover over the bars to display more information.



Incidence and Mortality Rates for Cervical Cancer

These graphs display incidence and mortality rates. The hexbinplots show rates from 2010-12 combined, divided by region and age groups. The line graphs indicate changes in rate over a three-year period, divided by age groups.



Demographic information

These graphs show socio-demographic variables and chronic disease risk factors for regions in Ontario. The hexbinplots show the percentage of the population in each region with each risk factor. The heatmaps show the same data as a table, including multiple years when available. To sort the heatmap, click on the rows and columns.

Terminology

  • Region refers to either Ontario or one of the Local Health Integration Networks (LHINs) in Ontario. The Ontario statistics excluded cancer cases of unknown residence. Therefore, provincial statistics may not match the true counts and rates published elsewhere.
  • Age refers to the age at diagnosis for the cancer.
  • Year refers to the calendar year in which a cancer was diagnosed.