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Cancer screening tests are resuming. Find out more at Cancer Screening During COVID-19.

Cervical Screening

Screening is testing done on people who are at risk of getting cancer, but who have no symptoms and generally feel fine. The cervix is a body part that connects the uterus (womb) to the vagina (genital opening). Cervical cancer is cancer in the cervix. The goal of cervical screening is to find cell changes in the cervix before they become cancer.

Cervical cancer deaths are more frequent in areas of the world where cervical screening is not available. The dramatic decline since the 1980s in the rate at which Ontario women develop and die from cervical cancer is almost entirely due to screening.

A Pap test is a screening test that can detect cell changes in the cervix that may lead to cancer before people feel any symptoms. It is important that these cell changes are found and, if necessary, treated before they can cause cervical cancer.

When to Get Screened

Currently, the Ontario Cervical Screening Program recommends that anyone with a cervix (women, transmasculine and non-binary people) who is or ever has been sexually active have a Pap test every 3 years starting at age 21. But we are in the process of updating this recommendation. If you are under 25, talk to your family doctor or nurse practitioner about whether you should wait until age 25 before starting cervical screening with the Pap test. 

 You can stop regular screening with Pap tests at the age of 70 if you have had 3 or more normal tests in the previous 10 years.

Eligible people need to get cervical screening even if they:

  • feel healthy and have no symptoms
  • are no longer sexually active
  • have only had 1 sexual partner
  • are in a same-sex relationship
  • have been through menopause
  • have no family history of cervical cancer
  • have received the HPV vaccine

People who have had a hysterectomy should talk to their doctor or nurse practitioner to see if they need to continue cervical screening.

Pap Test Screening

The Pap test (also known as the Pap smear) is the most common way to find cell changes in the cervix that may lead to cancer:

  • A Pap test looks for abnormal cells in the cervix. Cervical cells may become abnormal when someone has a human papillomavirus (HPV) infection. Abnormal cells often return to normal on their own but if they do not, they need to be found and, if necessary, treated.  Otherwise, the abnormal cells caused by HPV infection may cause cervical cancer if they stay in someone’s cervix for many years.
  • A Pap test does not test for other cancers in the reproductive organs, such as ovarian cancer, or for sexually transmitted infections, such as chlamydia, gonorrhea or HIV.
  • A Pap test is done by a doctor, nurse practitioner, registered nurse (RN) or midwife.
  • A Pap test only takes a few minutes. For a Pap test, the provider will open a patient’s vagina (genital opening) using a medical tool called a speculum to see their cervix. The provider will use a soft brush to take cells from the surface of the patient’s cervix so the lab can examine the cells under a microscope. Some people may find it uncomfortable or embarrassing but it is important that any cell changes are found and, if necessary, treated before they can cause cervical cancer.
  • The lab sends the test results to the provider who did the test.
  • The provider who did the test will then tell the patient the next steps for follow-up.

To learn more about how to get ready for a Pap test and what happens after your test, see the Cervical Screening FAQs.

Where to Get Screened

Make an appointment with your doctor or nurse practitioner. If you do not have a doctor or nurse practitioner, you can register for Health Care Connect at 1-800-445-1822 or visit the Health Care Connect website.

Some public health units and community health centres also provide Pap tests. People with a cervix (women, transmasculine and nonbinary people) in the North West and Hamilton Niagara Haldimand Brant regions may be eligible for screening in one of our mobile screening coaches.

For information on healthcare services in your community, visit ontario.ca/healthcareoptions.

Ontario Cervical Screening Program

The Ontario Cervical Screening Program is an organized screening program run by Ontario Health (Cancer Care Ontario) and the Government of Ontario. The program’s goal is to reduce the risk of developing or dying from cervical cancer by increasing the percentage of people with a cervix (women, transmasculine and nonbinary people) who get screened regularly and who have timely and appropriate follow-up of abnormal results. The program sends letters to eligible people inviting them for a Pap test, advising them of next steps following a Pap test and reminding them when it is time to return for screening. The program also supports doctors and nurse practitioners so they can provide the best possible cervical screening for their patients.

Screening Letters Sent to the Public

Ontario Health (Cancer Care Ontario) sends eligible people for the Ontario Cervical Screening Program letters inviting them to get screened, informing them of their results, and reminding them when it is time to return for screening.

Letters Eligible People May Receive

  • Correspondence privacy notice
  • Invitation and recall letters
  • Invitation and recall reminder letters
  • Normal result letter
  • Unsatisfactory result letter
  • Abnormal result letter
  • Abnormal result follow-up reminder

A sample of each letter type is available in the Letters to the Public area.