POPULATION

Asymptomatic women who are or who have been sexually active. These guidelines do not apply to women with symptoms of cervical cancer (e.g. abnormal vaginal bleeding), previous abnormal screening results (until they have been cleared to resume normal screening), to women who do not have a cervix (due to hysterectomy), or to women who are immunosuppressed.

BURDEN OF ILLNESS

In 2011, the estimated incidence of cervical cancer in Canada was approximately 1,300 new cases while approximately 350 women die each year in Canada from cervical cancer. The incidence of cervical cancer increases significantly after the age of 25 years and peaks during the fifth decade, thus affecting women in their reproductive and productive years.

INTERVENTION: SCREENING FOR CERVICAL CANCER WITH CERVICAL CYTOLOGY

DETAILS OF RECOMMENDED SERVICE

For women aged 25 and over, we recommend triennial screening with a Pap test by a primary care practitioner. Although some evidence suggests that HPV—DNA testing may be appropriate for reducing incidence and mortality from cervical cancer, recommendations on HPV screening will be made when more research is available.

CONSIDERATIONS FOR IMPLEMENTATION

Consider using an electronic health record to flag a screening reminder for women aged 25 or 30 and over.

SPECIAL CONSIDERATION

Screening rates in Aboriginal women are increasing. New immigrants may be less likely to be screened. Women from certain ethnic and sociocultural groups may prefer to be screened by a female health care practitioner. Attention needs to be paid to increasing screening rates of these under screened populations.