Cervical Screening Information

About Cervical Cancer

• Cervical cancer is caused by a virus called “HPV” (human papillomavirus). There are over 100 different types of HPV. Most types of HPV are harmless, but 12 to 15 types of HPV infections can cause cervical cancer. The types of HPV infection that may cause cancer are called “high risk HPV.”

• You can get HPV from another person through intimate sexual contact (i.e., having sex with anyone using fingers, genitals or the mouth).
• HPV infections are common. Up to 80% of men and women who are sexually active will have an HPV infection in their lifetime.
• Most HPV infections go away on their own (without treatment), especially if you are younger than 30 years old. If the infection is gone, your Pap test results usually go back to normal.
• If an infection caused by a high risk HPV type does not go away for many years, it can lead to cervical cancer, unless the abnormal cells caused by the infection are found early and treated.
• Most women with an HPV infection do not develop cervical cancer.

• Every year, about 750 women in Ontario will get cervical cancer and about 160  will die from it. Without cervical screening, these numbers would be even higher.

Cervical Screening

• Cervical screening is for most women, and anyone with a cervix.
• Screening is testing done on people who may be at risk of getting cancer, but who have no symptoms and generally feel fine. Cervical screening with the Pap test checks to see whether there are abnormal cells on your cervix that could turn into cancer.
• Cervical screening works very well. Since the 1980s, the percentage of women in Ontario getting or dying from cervical cancer has gone down because more people have been getting screened with Pap tests.
• During a Pap test, your doctor or nurse practitioner gently puts an instrument, called a “speculum,” into your vagina so they can see your cervix. Then they take cells from your cervix and send them to a laboratory to be looked at under a microscope.
• A Pap test does not check for other cancers, such as cancer of the ovaries or uterus. It also does not test for infections you can catch by having sex, such as chlamydia, gonorrhea or HIV.

Why Cervical Screening is Important

• Regular cervical screening with the Pap test is important because it can prevent cervical cancer. Cervical screening does this by finding abnormal cells on the cervix so they can be treated.
• When early cell changes or cancer of the cervix are found early, treatment is almost always successful.
• It is also important to have the right kind of follow-up appointments or tests if your Pap test result is abnormal.
• Screening is the only way to find the abnormal cells that could turn into cervical cancer because abnormal cells do not usually cause symptoms.  

Benefits and Limitations of Cervical Screening

• Pap tests work very well, but no screening test is perfect.
• For example, you can have a false-positive test result, which is when your risk of getting cervical cancer is small, but your Pap test result is abnormal. A Pap test can be abnormal for many reasons, including reasons that are not related to cervical cancer.
• You can also have a false-negative test result, which is when your Pap test result is normal, even if you have cervical cancer or your cervix has abnormal cells that could turn into cancer.

About the Ontario Cervical Screening Program

• The Ontario Cervical Screening Program helps women in Ontario get high-quality cervical screening. The goal of the program is to lower the risk of getting or dying from cervical cancer. The Ontario Cervical Screening Program also helps to make sure women with abnormal screening test results get the right kind of follow-up care, such as more tests or specialist appointments.
• To support you and your primary care provider in staying up to date with cervical screening, the Ontario Cervical Screening Program mails letters inviting you to get screened with the Pap test. The program also sends letters telling you whether your results are normal or abnormal, and reminding you when it is time to get screened again. If you do not want to get letters from the Ontario Cervical Screening Program, please call 1-866-662-9233.
• Cancer Care Ontario’s cervical screening guidelines recommend that you get screened with a Pap test once every 3 years if you are 21 to 69 years old and if you are, or have ever been, sexually active (i.e., had sex with anyone using fingers, genitals or the mouth).
• If you have never been sexually active, you should not have cervical screening, no matter how old you are. You should wait until you become sexually active before getting screened.
• You should get Pap tests regularly until at least 70 years old. Your risk of getting cervical cancer does not go down with age. 
• You can stop getting Pap tests when you turn 70 years old if you have had at least 3 normal tests in the last 10 years.
• If you are 21 to 69 years old, you need to have cervical screening with the Pap test, even if you: 

• feel healthy and have no symptoms
• are no longer sexually active
• have only had sex with 1 person
• are in a same-sex relationship
• have been through menopause (have stopped having periods)
• have no family history of cervical cancer
• have had the HPV vaccine

• If you have had a hysterectomy (your uterus has been removed), talk to your doctor or nurse practitioner to see if you need to keep getting screened.
• If you start to have strange bleeding or discharge from your vagina, see your doctor or nurse practitioner, even if your last Pap test was normal.

Getting Ready for Your Pap Test

• Try to make sure you do not have your period when you go for a Pap test.
• You should also try not to have sex or use tampons, creams or medicines in your vagina for 2 days before your Pap test.
• If you cannot avoid these, you should still go for your test.

Follow-Up Care After an Abnormal Pap Test

• If you have an abnormal Pap test result, it does not necessarily mean you have cervical cancer. 
• If you have an abnormal Pap test result, it is important to get the right kind of follow-up care, such as more tests or specialist appointments, to prevent cervical cancer.
• If your Pap test is abnormal, your doctor or nurse practitioner may send you for another Pap test or to a specially trained doctor who treats abnormal cervical cells, called a “colposcopist.”

Lowering Your Risk of Getting Cervical Cancer

• Go for regular Pap tests.
• Go for follow-up care (i.e., more tests or specialist appointments) if your Pap test result is abnormal.
• Consider getting the HPV vaccine, especially if you have never been sexually active.

• In Ontario, a publicly funded school-based HPV vaccination program offers the Gardasil®9 vaccine free to Grade 7 boys and girls. Outside of the school program, the HPV vaccine is available for a cost. The cost of the vaccine is covered by some private health plans.
• Getting the HPV vaccine before having sex for the first time helps prevent cervical cancer. The benefits of vaccination after you have sex for the first time may help protect you from future infections.
• The vaccine protects you from the most common high risk HPV infections. The HPV vaccine does not protect against all high risk HPV types. Therefore, even if you have had the HPV vaccine, you still need regular cervical screening with the Pap test.
• Your risk of getting an HPV infection starts when you have sex. Your risk goes up each time you have sex with someone new or if your partner has had sex with many other people.

• Use a condom with your partner. Condoms do not fully protect you from getting an HPV infection, but they may lower your risk of getting an infection. Condoms can also protect you from other sexually transmitted infections, such as chlamydia, gonorrhea and HIV.
• Do not smoke cigarettes, and avoid second-hand smoke. Cigarette smoke can weaken your immune system, which makes it hard for your body to fight off an HPV infection.

Where to Get Screened for Cervical Cancer

• You can make an appointment for a Pap test with a doctor or nurse practitioner. If you do not have a doctor or nurse practitioner, you can find one through Health Care Connect at 1-800-445-1822 or Find a doctor.
• Some public health units and community health centres will also do Pap tests.
• For information on healthcare services in your community, visit Health Care Options.

For More Information

• For information about cervical screening or the Ontario Cervical Screening Program, call 1-866-662-9233.
• For general information about health-related programs and services, call Service Ontario at 1-877-234-4343, TTY 1-800-387-5559.

For more information on cancer statistics, please visit the 2018 Ontario Cancer Statistics report.