Dr. Melissa Bedford, Naturopathic Doctor with Patient at Victoria Clinic

Pap Tests & Cervical Cancer Screening in Victoria

In British Columbia, cervical cancer screening is accomplished with the Papanicolaou (Pap) test/smear (named after its founder, George Nicholas Papanicolaou). Unlike public health screening for breast cancer and colon cancer, which begins at age 50 in healthy individuals, cervical cancer screening begins at a much younger age (25 years old).

This page is going to walk you through all the basics of pap testing and cervical cancer screening, so that you can have a deeper understanding of why this is such an important aspect of preventative health in people with a cervix.

Have questions? As your Naturopathic Doctor in Victoria I am here to support you in your health journey.  Please reach out for a meet & greet to get started.

What causes cervical cancer?

Cervical cancer is caused by infection with human papillomavirus (HPV) that is long term, persistent, and high risk. 

  • Long Term: Cervical cancers develop very slowly, typically taking 10-15 years for invasive cervical cancer to develop following an initial infection with high risk HPV (hrHPV).
  • Persistent: There is an estimated 80% lifetime risk of HPV infection, meaning HPV infection is very common and will affect most people at some point in their lives (often without us ever knowing we have the infection). However, most HPV infections are transient – our body will clear the majority of infections within 2 years, especially in people under age 30. 
  • High Risk: There are different strains (types) of HPV – some are low risk and some are high risk. There are 15 high risk HPV (hrHPV) strains – the two most prevalent are HPV-16 and HPV-18, which are associated with approximately 70% of cervical cancers.

Common questions about cervical cancer screening

PMS support for women - Dr. Melissa Bedford naturopathic doctor

Your doctor will use a small spatula and/or a small brush to take a sample of cells from the surface of your cervix. The sample of cells is sent to the BC Cancer Agency to be examined under a microscope. Your cervix is located at the top of your vagina. There may be some discomfort during the pap test but it should not be painful. Remember, this is YOUR exam – you can ask your doctor to stop the exam at ANY time for ANY reason.

The pap test should not be done while you are on your period – any other time in your menstrual cycle is okay. Your doctor will ask you the first day of your most recent period, so write down that date before your appointment.

HPV is transmitted through sexual contact, including digital sexual contact, oral sexual contact, vaginal intercourse, and anal intercourse. While condom use does reduce the risk of HPV infection, it does not completely prevent transmission.

The early stages are often asymptomatic (without any symptoms). However, if you have any of the following symptoms you should talk with your doctor:

  • Abnormal vaginal bleeding (e.g. bleeding in between periods, bleeding during or after sex, bleeding after menopause)
  • Abnormal or persistent vaginal discharge
  • Pelvic pain, or pain during sex

Screening (via a pap test) is important because the early stages of cervical cancer are often asymptomatic (without any symptoms). Screening allows us to identify abnormalities in cervical cells early on, so that we can monitor their regression back to normal cells, or catch their progression into precancerous abnormalities and treat these before cancer develops.

Cervical cancer screening used to start at 21 years old and take place every two years. In 2016, following two expert reviews, British Columbia aligned their screening recommendations with those from the Canadian Task Force on Preventive Health Care. The expert reviews found that over-diagnosis and unnecessary treatment of transient cervical cell abnormalities was causing substantial harm, including immense psychosocial stress and increased risk of pre-term and low-birth weight babies.

  • Average Risk individuals: Anyone with a cervix between the ages of 25 and 69 who has ever been sexually active should be screened for cervical cancer (via a pap test) every three years.
    • Sexual activity includes digital sexual contact, oral sexual contact, vaginal intercourse, and anal intercourse with a partner of any gender
    • This recommendation is the same whether or not you have received the HPV vaccine
    • Screening can stop at age 69 if you have at least 3 negative screening tests from the past 10 years
  • High Risk individuals (immunocompromised): Screening should be done annually and your doctor may recommend you start screening at age 21 and/or continue screening beyond age 69.
  • Individuals who have had their cervix removed: Screening is not needed.

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