HPV testing: A gamechanger in preventing cervical cancer

Why are women in Canada still dying from cervical cancer?

Cervical cancer is almost entirely preventable, and treatable when detected early, yet the rates continue to rise. In fact, according to the Canadian Cancer Society, it is the most rapidly increasing cancer in Canada, with a 3.7% annual increase since 2015.

Dr. Gina Ogilvie is helping to change that. The global and public health physician and clinical researcher at the University of British Columbia is conducting studies focused on the prevention of cervical cancer, its early detection and equitable access to care.

“Our findings will impact every female of reproductive age,” she said.

Most cervical cancers are caused by the human papillomavirus (HPV), a common sexually transmitted infection. The HPV vaccine helps prevent infection, but it is most effective when given before exposure to the virus, ideally at an early age.

Regular screening also reduces the risk of cervical cancer. There are two types of screening, Pap tests which help detect abnormal cells in the cervix, and HPV tests which can detect the presence of high-risk HPV.

In 2007, as part of a team of researchers, Dr. Ogilvie received funding from CIHR to compare the effectiveness of Pap tests and HPV tests for cervical cancer screening. Their findings demonstrated that HPV tests are a more reliable method for detecting at-risk cases than the Pap test.

“The HPV test offers greater protection against cancer,” she said, “and a negative HPV test is more accurate than a negative Pap, which means you have greater comfort in extending the interval, so you can decrease the frequency of screening. Some of our recent analyses show effective protection for up to seven years.”

The research conducted by Dr. Ogilvie and the team was instrumental in changing cervical cancer screening guidelines across the country. All Canadian provinces and territories have or are in the process of including HPV testing as their primary screening method.

Dr. Ogilvie and her team received another CIHR grant in 2019 to research primary and secondary prevention of cervical cancer. One of the areas of interest was looking into the acceptability of self-sampling. The HPV test kit is a quick, painless and convenient way to collect a sample from the vagina in the privacy of one’s home. “This screening tool can help to address equity issues. It puts the power of screening in a woman’s hands,” explained Dr. Ogilvie. “So, if women have a history of trauma, or find going for a pelvic exam difficult, we have self-collection; working women with children who don’t have time to go in for an appointment, and women in small communities who see their physicians socially — at church for example — they may not want to go for testing,” she said.

Self-testing kits will also benefit women living in remote and rural areas with limited access to testing and women in areas with no culturally sensitive screening programs.

“Self-collection allows us to improve coverage, particularly for those who are under-screened,” said Dr. Ogilvie. “It really empowers women to take charge of their health.”

Canada has set a goal to eliminate cervical cancer by 2040. Dr. Ogilvie’s research has contributed significantly to realizing that goal by showing the benefits of HPV vaccination and screening programs. Her findings have guided provinces and territories to transition to HPV primary screening. That, combined with increasing HPV vaccination rates are key to making Canada the first country in the world to eliminate cervical cancer.

At a glance

Issue

Cervical cancer is the fastest growing cancer in Canada. It is more common in people living in rural or remote areas. Cervical cancer is almost entirely preventable, and treatable when detected early.

Research

Dr. Gina Ogilvie is a Tier 1 Canada Research Chair in Global Control of HPV-related diseases and prevention at the University of British Columbia and Investigator at the Women’s Health Research Institute. She and her team have received funding from CIHR to research cervical cancer – how to prevent it, how to detect it and how to treat it, no matter where you live. Their work changed cervical cancer screening guidelines across the country and is helping to eliminate cervical cancer in Canada by 2040.