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B.C. ditching pap tests for Canada's first at-home self-screened cervical cancer plan

VANCOUVER — British Columbia is aiming to eliminate cervical cancer in the province with the launch of Canada's first at-home self-screening program, Premier David Eby said Tuesday. The premier said starting later this month B.C.
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British Columbia Premier David Eby speaks during a news conference in Kamloops, B.C., on Monday, Sept. 11, 2023. British Columbia is phasing out the pap test for cancer screening in favour of mail-in kits collected by the patients. THE CANADIAN PRESS/Darryl Dyck

VANCOUVER — British Columbia is aiming to eliminate cervical cancer in the province with the launch of Canada's first at-home self-screening program, Premier David Eby said Tuesday.

The premier said starting later this month B.C. will begin phasing out the pap test for cancer screening in favour of mail-in kits with tests collected by patients. 

A localized pilot project that started in 2021 has shown that at-home screening for the human papillomavirus, or HPV, is more effective at finding pre-cancerous lesions and provides patients with fewer barriers compared with the pap test, Eby said. 

"Every year about 200 people in our province face the terrifying diagnosis of cervical cancer," he said at a news conference. "Any time we can prevent someone from facing that diagnosis we're one step advanced in our goal of improving the health of the whole population in B.C."

Cervical cancer, preventable through immunization and screening programs, is the fourth most common cancer in women globally and is among the fastest increasing cancers for females in Canada, said a government statement.

Eby said B.C. usually doesn't "get to set a goal as a province to eliminate a form of cancer, a deadly form of cancer, namely cervical cancer right here in our province." 

But this was now a "very real possibility."

There are 15 types of high-risk HPV that can be associated with various cancers if they aren’t cleared by the body, said the government statement. If they persist they can cause cells to change, leading to cervical cancer,.

Starting Jan. 29, the test kits can be ordered online or by phone and can be used at home and mailed in or taken to a health-care provider for screening, Eby said.

The results will be returned within four to six weeks and the patient's health-care provider will also get the information. But people don’t need a doctor to take the test and results will be linked to a community clinic if further care is needed, said the government. 

"This program puts the power to prevent cervical cancer in the hands of ordinary British Columbians," Eby said. "It's quick. It's more accurate than the traditional method of testing and it's good for a longer period of time."

Dr. Gina Ogilvie, a global expert in HPV control at University of B.C., said the province launched the world's first cervical cancer screening program in 1955, but now is embarking on a strategy that moves beyond pap tests to prevent the disease.

"Today, we are taking the next major leap forward with the goal of not just reducing the incidence of cervical cancer, but ultimately eliminating it altogether," she said.

The HPV test looks for the virus that could result in cervical cancer while the pap test screens for abnormal changes in the body that could lead to cancer.

"The transition to HPV testing as a primary screening for cervical cancer is supported by rigorous evidence," said Ogilvie. "Randomized trials, including a very large major trial led here in B.C. with over 20,000 women showed HPV-based screening is more effective at identifying those with pre-cancerous lesions compared to conventional cytology or pap smears."

Eby's wife, Dr. Cailey Lynch, a family doctor, participated in the news conference, congratulating the HPV screening researchers and relating her own experiences with cervical cancer patients.

Lynch said she has had dreams about a 35-year-old woman who died of cervical cancer at Kootenay Lake Hospital in Nelson, B.C., when she was working there as a registered nurse years ago.

"I still have dreams about the patient at the end of the hall who we didn't reach in time," she said.

The at-home screening program comes as the New Democrat government faces political and public concerns about people waiting months for cancer care.

Last year, the government started sending breast and prostate cancer patients to Bellingham, Wash., for treatment at the province's expense to reduce wait times.

The government also announced a 10-year cancer-care program last February that included building cancer treatment centres at Kamloops, Nanaimo, Surrey and Burnaby.

— By Dirk Meissner in Victoria

This report by The Canadian Press was first published Jan. 9, 2024. 

The Canadian Press

Note to readers: This is a corrected story. A previous version incorrectly spelled the name of Dr. Cailey Lynch.

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