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Eligibility

Average Risk

Screening Start Age

People with a cervix who are or have been sexually active should begin screening at age 25. Sexual activity includes intercourse, as well as digital or oral sexual activity involving the genital area with a partner of any gender.

Evidence suggests four well-founded reasons for this start age:

  • Cervical cancer is rare in people under age 25.
  • Cervix screening appears to be less effective in younger people.
  • Abnormalities detected by cervix screening often undergo spontaneous resolution in young people.
  • There are risks associated with unnecessary follow-up and treatments, many of which may have long-term consequences for pregnancy or cause undue anxiety and distress.

Screening Interval

Screening is recommended every three years.

Screening Stop Age

Screening can stop at age 69, provided that there have been at least three negative screening tests in the past ten years and no active surveillance of cervical cancer of pre-cursor abnormalities.

Higher-than-Average Risk

People with a history of previous cytological or histological abnormality and immunosuppression are considered high risk for developing cervical cancer and should be screened annually. People with symptoms or abnormal appearance of the cervix should be referred to a colposcopy clinic for evaluation. A Pap test is not recommended and referral to colposcopy should be arranged as soon as possible, regardless of any Pap test result.

For more information on higher-than-average risk screening recommendations, please refer to the BC Cancer Cervix Screening Program Overview.


Frequently Asked Questions

People who have received the HPV vaccine still require cervical cancer screening because the vaccine does not protect against all types of HPV that can cause cervical cancer. For more information, please refer to the BC Cancer Cervix Screening Program Overview.

 

While cervical cancer screening has proven very effective in decreasing the incidence of pre-cancer and cervical cancer, like any screening test, it isn’t perfect. Women should be aware of the benefits and harms of cervical cancer screening and make an informed decision to screen.

Benefits of Screening

  • Screening where practiced effectively has resulted in decreased cervical cancer incidence and mortality in women. 
  • Cervical cancer is one of the most preventable cancers. Cervical cancer begins as an infection of the uterine cervix with high-risk human papillomavirus (hr-HPV) that needs to persist for many years. The transition from initial HPV infection to invasive cancer seems to take decades in most cases, with a minimal latency period of approximately 7 years.
  • Cervical cancer screening saves lives. Most cervical cancer cases occur among women who have not undergone screening or who have had a long interval between Pap tests. In BC, about 58% of the 178 patients diagnosed with invasive cervical cancer in 2014 were five years or more overdue for screening. The majority of cases are diagnosed in the 30-39 and 40-49 age groups.
  • Women between the ages of 25-69 stand to benefit the most from screening

Harms of Screening

  • Most HPV infections and pre-cancerous lesions resolve spontaneously, particularly among younger women who are of childbearing age.
  • Over-diagnosis and treatment of these transient cervical intraepithelial neoplasia (CIN) are associated with substantial harms, including heightened psychosocial consequences in the women treated, increased risk of pre-term and low-birth-weight babies (especially for women treated with excisional approaches), and unnecessary utilization of health care resources.
  • A 2008 study concluded that in the treatment of CIN, all excisional procedures seem to be associated with adverse obstetric morbidity, but among these, only cold knife conization is associated with a significantly increased rate of severe outcomes.
  • Initiating screening in women under 25 can produce more harm than benefit, as cervical cancer is not common in women under age 25.
For more information, please refer to the BC Cancer Cervix Screening Program Overview.
 

SOURCE: Eligibility ( )
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