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Screening for Cervical Cancer

Cervical cancer deaths are very 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 Pap testing and screening.

A Pap test is a simple screening test that can detect cell changes in the cervix that may lead to cancer before women feel any symptoms.

When to Get Screened

The Ontario Cervical Screening Program recommends that women who are or have been sexually active have a Pap test every 3 years starting at age 21. Regular screening should continue until at least age 70 or when advised by a doctor or nurse practitioner to stop. Pap tests can stop at the age of 70 if a woman has had 3 or more normal tests in the previous 10 years.

Women ages 21 to 69 still need to be screened for cervical cancer 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

Women who have had a hysterectomy should talk to their doctor or nurse practitioner to see if they need to be screened.

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. Sometimes cervical cells become abnormal over time as they die and then renew. They are also abnormal when a woman 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, slowly over a number of years, they may become cervical cancer.

  • 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 in a healthcare provider’s office, either by a doctor or nurse practitioner. An instrument called a speculum is inserted into a woman’s vagina so her cervix can be seen. Cells are taken from the surface of the cervix and are sent to a laboratory to be examined under a microscope. Some women may find it uncomfortable or embarrassing but it takes only a few minutes.

  • The Pap test is sent to a lab. The results are sent back to the doctor or nurse practitioner who will then advise the patient on appropriate 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. Women 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 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 women who get screened regularly and who have timely and appropriate follow-up of abnormal results. The program sends letters to Ontario women inviting them for Pap testing, advising them of next steps following a Pap test and reminding them when it is time to return for screening. The program supports doctors and nurse practitioners so they can provide the best possible cervical screening for their patients.

Screening Letters Sent to the Public

Cancer Care Ontario sends letters to eligible women ages 30 to 69 to book a Pap test through the Ontario Cervical Screening Program. We also send letters to women ages 21 to 69 to inform them of their test results and remind them when it is time to return for screening.

Letters Women 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.

Resources for Newcomers and Immigrants

When you to move to a new country it’s important to keep your health at its best. For all women who are or have ever been sexually active that includes getting screened for cervical cancer. Find out if you should be screened and how to make an appointment:

Claudia’s Cervical Screening Story (Spanish)

Learn about how Claudia from El Salvador was hesitant to have a Pap test because she heard that they were uncomfortable and painful. She changed her mind when a friend told her about how her doctor discovered early cell changes in her cervix that may lead to cancer. This experience encouraged Claudia to go for a Pap test.

Transcript – Claudia

Hosne Ara’s Cervical Screening Story (Bengali)

Learn about how Hosne Ara, a newcomer to Ontario, overcame her fear of cervical screening and now gets regular Pap tests. Hosne Ara encourages her neighbours and friends to learn about and get Pap tests.

Transcript – Hosne Ara