The Invasive Pap Smear Test May Finally Be Replaced For Good

Human papillomavirus testing may soon replace the more invasive, less accurate pap smear test as the de facto cervical cancer check for women in the coming years. Advocates for HPV tests say that the benefits go far beyond just comfortability, as well.

“If we switch [testing] sooner, we potentially save hundreds to thousands of lives every year,” said Michelle Halligan, the director of prevention at the Canadian Partnership Against Cancer. “The longer we put it off, the longer we put off our benefits and put people at risk.”

According to some research, HPV tests are nearly 50 percent more sensitive than the cervical scraping needed for a pap test. This means that pap smears currently miss about half of the abnormalities inside the vagina that HPV tests catch. To mitigate the risks, doctors encourage women to schedule pap smears every two to three years, rather than the five year gaps normally outlined for HPV testing.

“There’s the ability to not have to use a speculum that goes in … no need to scrape cells off your cervix,” Halligan said.

Switching from the pap smear to the HPV test will require joint efforts from multiple government agencies in Canada

Even though the switch from traditional testing to HPV testing sounds like an obvious decision, external factors like cost and implementation still stand in the way.

Moving to a new system is complex and people need steady, bite-sized information so they feel comfortable doing the test, and to tackle stigma as HPV is a sexually transmitted infection, says Dr. Catherine Popadiuk, an associate professor of obstetrics and gynecology and specializes in cervical cancer.

“We have to take away that stigma that there’s something negative about this,” she said, “so that’s part of the concern in having a good strategy to roll this out.”

The incidence of cervical cancer in Canada in 2022 is about 7.5 people per 100,000, according to the Canadian Medical Association Journal. Case numbers have declined from 20.05 per 100,000 in 1978 as screening efforts became more substantial; and then again to 12.6 per 100,000 in 2006, before the introduction of the HPV vaccine in schools.

Advocates for the switch also believe a public health information campaign is also needed so that women and those with female reproductive organs can understand the reason for the switch to HPV tests.