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Resources for the Public - Cervical Screening
 
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Ontario Cervical Screening Cytology (Pap Test) Guidelines

HPV and HPV Vaccine

Resources for Newcomers and Immigrants

Claudia's cervical cancer 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 the doctor discovered early changes that may lead to cancer. This experience encouraged Claudia to go for a Pap test.


Read text transcript - Claudia

Hosne Ara's cervical cancer screening story (Bengali)

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


Read text transcript - Hosne Ara

Settlement.org: Information for Newcomers

Settlement.org provides comprehensive, up-to-date and trustworthy information to help new immigrants settle in Ontario.


Cervical Cancer Screening - Frequently Asked Questions


Protect yourself with regular Pap tests


What is a Pap test?

A Pap test is a simple screening test that can help prevent cancer of the cervix (cervical cancer). A Pap test looks for abnormal cell changes on the cervix. It does not test for other cancers in the reproductive organs or for chlamydia, gonorrhea, or HIV.

Female reporductive system

A Pap test is done in a healthcare provider’s office. To do a Pap test, you will be asked to lie on your back on an examining table. An instrument, called a speculum, is gently inserted in your vagina so your cervix can be more clearly seen. Cells are taken from the cervix and are sent to a laboratory to be examined under a microscope.

Why are Pap tests needed?

The cells on the cervix are constantly being renewed. Sometimes, these cells become abnormal. A Pap test looks for these abnormal cells. Often, abnormal cells naturally return to normal. 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.

Should I have a Pap test?

  • If you have ever had any sexual skin-to-skin contact, you need to have regular Pap tests starting at age 21. This includes intercourse, intimate touching or oral sexual contact.
  • Pap tests should be a part of your regular health check-up until you are 70 years old. The risk of getting cancer of the cervix does not decrease with age.
  • Pap tests can stop at the age of 70 if you have had three or more normal tests in the prior 10 years.
  • If you have had a hysterectomy, talk to your healthcare provider to see if you still need a Pap test.

Do I still need a Pap test?
Yes
No
I feel healthy and have no symptoms

I have never had intimate sexual contact

I am no longer sexually active

I have had only one partner

I am in a same sex relationship

I have been through menopause

I have no family history of cervical cancer

I am under 21

How often should I have a Pap test?

  • You should have a Pap test every three years.
  • If you are found to have abnormal cells, your cervical cancer screening plan will change.

Are Pap tests effective?

Yes. But, they are not perfect. They can miss some abnormal cells. Be sure that you are going for regular Pap test screening. This decreases the chance of missing important changes. If you have unusual vaginal bleeding or discharge, see your healthcare provider, even if your last Pap test was normal.

Where do I go for a Pap test?

  • Make an appointment with your healthcare provider.
  • If you do not have a healthcare provider, 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.
  • For information on healthcare services in your community, visit ontario.ca/healthcareoptions.

How do I get ready for a Pap test?

It is best to:
  • Try to make the appointment for a day when you do not have your period.
  • Don’t have sex or use tampons, creams or medicines in your vagina for 48 hours before the test.
  • If these can’t be avoided, still go for your test.

What happens after a Pap test?

  • Your healthcare provider will contact you if you have an abnormal test result. In future, the Ontario Cervical Screening Program will also send you a letter telling you if your test result is abnormal or unsatisfactory. If you do not wish to receive letters from the Ontario Cervical Screening Program, please call 1-866-662-9233.
  • Most often, your Pap test result will be normal. If your result is abnormal, it does not mean you have cervical cancer. However, you will need to talk to your healthcare provider about next steps, such as a repeat Pap test in a few months. If needed, you may also have to see a specialist for more tests.

Cervical Cancer


What causes cervical cancer?

Certain types of human papillomavirus (HPV) cause cervical cancer.
  • HPV is a family of viruses commonly found in both men and women.HPV is passed from one person to another through intimate sexual contact.
  • Most people come into contact with HPV at some point in their lifetime. Usually there are no symptoms and often people do not know that they have an HPV infection. The infection usually goes away naturally within two years.
  • Infection with HPV causes cell changes in the cervix. For most women, the cells change back to normal when the infection goes away. Sometimes, for reasons that are not well understood, an HPV infection stays in the body for a long time. Over a number of years, this may slowly lead to cancer if the abnormal cells are not followed appropriately and, if necessary, treated.
  • Most women with HPV infection do not develop cervical cancer.
Pap tests check for cervical cell changes that are caused by HPV infection. Cervical cancer can be prevented by following these cell changes closely and treating them if necessary.

What can I do to reduce my risk of cervical cancer?

  • Go for regular Pap tests.
  • Go for follow-up testing if your Pap test result is abnormal.
  • Consider HPV immunization. The HPV vaccine is available at no charge to all grade 8 girls through Ontario’s publicly funded school-based program. In addition to the publicly funded program, HPV vaccine is available on a user-pay basis (about $500). It is approved for women up to 45 years of age. Women are encouraged to speak to their healthcare provider about getting immunized.
  • It is ideal to have the vaccination before becoming sexually active and possibly exposed to the HPV virus. However, women who are already sexually active can also receive the vaccine. The vaccine prevents most but not all cervical cancers. Therefore, even if you are vaccinated against HPV, you still need regular Pap tests.
  • Be aware that the risks of HPV infection include starting sexual activity at an early age, having multiple sexual partners and having a partner with a number of previous intimate contacts.
  • Use a condom. Condoms do not fully protect you from HPV infection, but they may reduce the risk. Condoms are effective protection against other sexually transmitted infections.
  • Be tobacco-free and avoid second hand smoke. Tobacco use can weaken the immune system, which makes it difficult for your body to fight off an infection.
  • Eat well; follow Canada’s Food Guide. Exercise regularly, manage stress and get enough rest to stay healthy.

Results and Follow-Up


What is an abnormal Pap test result?

Regular Pap tests are designed to find early cell changes in the cervix, before problems develop.

An abnormal Pap test result means that the cells taken from your cervix look different under the microscope than normal cells. Cell changes found through Pap tests are very rarely cancer but do require follow-up testing.

Cancer of the cervix may take a long time to develop, and there are usually no warning signs and symptoms. Fortunately, the regular Pap test can find most abnormal cells on the cervix before they turn into cancer.

What causes an abnormal result?

Usually changes in the cells of the cervix are caused by the human papillomavirus (HPV):
  • HPV is a family of viruses commonly found in both men and women.
  • Most people come into contact with HPV through sexual contact at some point in their lifetime. Usually there are no symptoms and often people do not know that they had an HPV infection.
  • Usually the infection goes away naturally within about two years.
  • Sometimes, for reasons that are not well understood, an HPV infection does not go away. Instead, it stays in the body for a long time. Over a number of years, this may slowly lead to cancer if the abnormal cells are not found and, if necessary, treated.

Why is follow-up so important?

Follow-up of abnormal Pap test results is important because it can help prevent cervical cancer.

Abnormal cells often change back to normal naturally. However, in some women, the abnormal cells do not change back to normal and cancer can develop. It is important to do follow-up tests of these abnormal cells and if necessary treat them to prevent cervical cancer from developing.

What happens after an abnormal Pap test?

Talk to your healthcare provider about your result and the follow-up testing needed. Your follow-up plan depends on the type of cell changes you have:
  • You may be asked to repeat your Pap test more often for a short period of time, for example every six months. This will allow time to see if the abnormal cells will change back to normal on their own.
  • Your healthcare provider may suggest an HPV test.
  • You may be referred for a special examination called colposcopy.

What is colposcopy?

Colposcopy is an exam done in a similar way to a Pap test. It is done by a healthcare provider with special training in this area.

It allows the specialist to look more closely at your cervix with a magnifying lens (colposcope). It helps him/her see your cervix in more detail. You will be asked to lie on your back and, as with a Pap test, an instrument called a speculum will be gently inserted into your vagina to allow the cervix to be clearly seen. A liquid will be applied to the cervix to help highlight any abnormal areas.

If any area of concern is found, the specialist will take a small sample of tissue from your cervix (biopsy) for a closer look under a microscope in a lab. The biopsy can help determine if treatment is needed or not.

What happens after colposcopy?

To ensure the cells return to normal you may need a follow-up Pap test or another colposcopy. You may possibly need treatment. There are many simple methods to successfully remove the abnormal cells.

What else can I do?

Follow-up testing is the most important thing you can do. However, your body will be better able to fight off an HPV infection if you are strong and healthy:
  • Be tobacco-free and avoid secondhand smoke. Tobacco use can weaken the immune system, which makes it difficult for your body to fight off an infection.
  • Eat well; follow Canada’s Food Guide. Exercise regularly, manage stress and get enough rest to stay healthy.

Remember
  • Going for regular Pap tests is an important step to stay healthy. An abnormal Pap test result can be stressful. However, keep in mind that the reason for going for regular Pap tests is to find early changes in the cervix, before problems develop.
  • Following-up on abnormal Pap test results can most often prevent cervical cancer from developing.
  • See your healthcare provider so you can be followed regularly.If you have questions about your clinical care, please speak to your healthcare provider.
Last modified: Thu, May 04, 2017
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