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Screening Guidelines - Cervical Cancer
 


Screening InitiationchevronCervical cytology screening should be initiated at 21 years of age for women who are or have ever been sexually active. This includes intercourse, as well as digital or oral sexual activity involving the genital area with a partner of either gender.
Screening IntervalchevronIf cytology is normal, screening should be done every 3 years. The absence of T zone is not a reason to repeat a Pap test earlier than the recommended interval. See Recommendations for follow-up of abnormal cytology.
Screening CessationchevronScreening may be discontinued at the age of 70 if there is an adequate negative cytology screening history in the previous 10 years (i.e., 3 or more negative cytology tests).
Notes:
  • Any visual cervical abnormalities and/or abnormal symptoms must be investigated regardless of cytology findings.
  • We are working with the Ministry of Health and Long-Term Care to implement HPV testing in the Ontario Cervical Screening Program.

Qualifying Statements

Women who are not sexually active by age 21 should delay cervical cancer screening until sexually active.

Screening Women with Special Circumstances

  • These guidelines do not apply to women who have been previously treated for dysplasia. Screening intervals should be individualized and should likely be annual.
  • Women who are immunocompromised (e.g., HIV-positive or on long-term immunosuppressants) should receive annual screening.
  • Women who have undergone subtotal hysterectomy and retained their cervix should continue screening according to the guidelines.
  • Pregnant women should be screened according to the guidelines. Pregnancy does not alter the recommended screening interval. Only conduct Pap tests during pre- and post-natal care if a woman is due for regular screening.
  • Women who have sex with women should follow the same cervical screening regimen as women who have sex with men.
  • Women who have received the HPV vaccine should continue with screening. The vaccine may be considered by women who have not received the HPV vaccine according to NACI guidelines:
    http://www.healthycanadians.gc.ca/publications/healthy-living-vie-saine/human-papillomavirus-9-valent-vaccine-update-recommendation-mises-a-jour-recommandations-papillome-humain-vaccin-nonavalent/index-eng.php
  • Transgender men who have retained their cervix should be screened according to the guidelines

icon for Cervical Screening appQR code for Cervical Screening appFree App – Guidelines at Your Fingertips!
These guidelines can be accessed in the Ontario Cervical Screening Program's free mobile app. Scan the QR code or search "Ontario Cancer Screening" in your app store to download.


Last modified: Thu, Jan 12, 2017
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