CervixCheck

Most women age 21-69 who have ever had sexual contact should have a Pap test every 3 years.

  • CervixCheck is Manitoba's organized cervical cancer screening program.
  • Sexual contact includes skin-to-skin contact between two people of the oral, genital or rectal areas, or sex with sex toys.
  • Trans men and women may need regular Pap tests.
  • Make a Pap test appointment with your healthcare provider or find a Pap test clinic here.

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Cervical Cancer Prevention: The Pap Test

A Pap test is a test that can find changes on your cervix. During a Pap test, cells are taken from your cervix, and sent to a lab for assessment. In most cases, the cells are normal. Sometimes abnormal changes caused by HPV can become cancerous. A Pap test can find these abnormal changes before they turn into cancer. Regular Pap tests with follow-up for abnormal changes can prevent most cancer of the cervix.

The Pap test does not check for other sexually transmitted infections (STIs) like gonorrhea or chlamydia. Ask your doctor or nurse about testing for STIs.

To find out more about what to expect at a Pap test appointment, click English | French (pdf).

Human Papillomavirus (HPV) & the HPV Vaccine

Human Papillomavirus (HPV) is a very common sexually transmitted virus. Over 80% of Canadians will have at least one HPV infection during their lifetime. HPV is spread easily through past or current sexual contact including oral, genital and/or rectal skin-to-skin contact, or sex with sex toys. Most people show no symptoms of the virus and their body’s immune system will clear the infection. There are more than 100 types of HPV. Some types of HPV cause genital warts. Others may cause abnormal cervical changes including cervical cancer. HPV has also been linked to cancers of the vulva, vagina, penis, anus, mouth and throat. Most HPV infections will not progress to cancer.

You May Be At Risk for HPV

If you have ever had sexual contact, you are at risk for an HPV infection. HPV passes from person-to-person through current or past sexual contact (including sexual abuse). Sexual contact includes:

  • oral, genital or rectal skin-to-skin contact, or
  • sex with sex toys.

HPV can pass to and from people of all genders. HPV infection usually has no signs or symptoms. Most HPV infections will disappear on their own (regress). Sometimes HPV can progress, over time, into abnormal cervical changes including cervical cancer. The Pap test can find abnormal cells before they progress into cancer.

Natural History

90% of HPV infections will regress on their own without any intervention within two years. In rare cases, HPV can persist, and over time, develop into cervical cancer.

What is the HPV vaccine?

The HPV vaccines provide protection against certain types of HPV that can cause genital warts, cervical cancer, as well as cancers of the mouth, throat, anus, vulva, vagina and penis. If an HPV vaccine is received before sexual contact, it will be almost 100% effective in preventing infection (see table below). Studies show that females who have already been sexually active may also benefit from receiving the vaccine.

There are three HPV vaccines approved for use in Canada:

  HPV types covered Protects against:
Cervarix 16, 18 Over 70% of cervical cancers
Gardasil 4 6, 11, 16, 18 Over 70% of cervical cancers & 90% of genital warts
Gardasil 9 6, 11, 16, 18,
31, 33, 45, 52, 58

90% of cervical cancers & 90% of genital warts

Females who receive the HPV vaccine still need to have regular Pap tests because the HPV vaccines do not protect against all HPV types that can cause cervical cancer.

It’s important to know that:

  • None of the HPV vaccines can be used to treat existing HPV infections.
  • Regular cervical cancer screening is important because HPV vaccines do not protect us from all types of HPV that can cause cervical cancer.
  • Click to learn more about the HPV vaccine English | French (pdf).

Should You Get the HPV Vaccine? (Dr. Mike Evans)

Who should Get Checked?

Most women age 21-69, who have ever been sexually active should have a regular Pap test every 3 years. Transgender men and women may also need regular Pap tests.

Sexual activity includes:

  • oral, genital, or rectal skin-to-skin contact, or
  • sex with sex toys.

Having a Pap test every year or two offers very little added benefit over having a Pap test every 3 years and can expose women to unnecessary harms including:

  • discomfort or bleeding from the test,
  • anxiety that may result from abnormal test results,
  • over-diagnosis of abnormal cell changes that would go away on their own, and
  • problems with future pregnancies from some treatments during colposcopy.

CervixCheck Does Not Recommend Screening Women Under 21 Year of Age

The harms of screening under 21 significantly outweigh the benefits.

  • Pap tests and follow-up procedures can expose young women to unnecessary risks including:
    • discomfort or bleeding from the tests,
    • anxiety that may result from abnormal test results,
    • over-diagnosis of abnormal cell changes that would go away on their own, and
    • problems with future pregnancies from some treatments during colposcopy.
  • Cervical cancer is very rare in women younger than 21 years of age.
    • Human papillomavirus (HPV) is a common sexually transmitted virus that can cause abnormal changes on the cervix and cervical cancer.
    • Most HPV infections in young women do not cause cancer and 90% of infections will disappear on their own within 2 years without any treatment.
    • When the infection does not go away, abnormal changes develop that may lead to cervical cancer. These changes take many years to happen.
    • Delaying screening to age 21 will still find abnormal changes - if they happen - before they turn into cancer.

Should I get checked if:

I have never had sexual contact? No
I have only had one partner? Yes
I am a lesbian or am a woman who has had sex with women? Yes
I am post-menopausal? Yes
I have no family history of cervical cancer? Yes
I have had a hysterectomy but I still have my cervix? Yes
I am under 21? No
I have had the HPV vaccine? Yes
I am a trans man who has a cervix? Yes
I am a trans woman who has had bottom surgery to create a cervix? Yes

If you have questions about your screening eligibility, talk to your health care provider or contact CervixCheck.

If you are not sure when you last had a Pap test, you can request your cervical cancer screening history from CervixCheck using the form under the results and further testing tab below.

Benefits & Potential Harms of Cervical Cancer Screening

Benefits

  • Regular Pap tests with follow-up for abnormal changes can prevent up to 80% of cervical cancer
  • Abnormal changes can be removed with procedures during colposcopyDetecting cancer at an early stage can result in simpler treatment, more treatment options, and less need for chemotherapy

Potential Harms

  • Discomfort or bleeding from the Pap test or colposcopy
  • Anxiety that may result from abnormal test results
  • Over-diagnosis of abnormal cell changes that would go away on their own
  • Problems with future pregnancies from some treatment during colposcopy

Results & Follow-Up Testing

Pap test results are usually available 2-6 weeks after the test. You can find out your result in one of two ways:

  1. Contact the doctor or nurse who did your test, or
  2. Request a copy of your results from CervixCheck.

Although most Pap test results are normal (negative for intraepithelial lesion or malignancy), about one in 10 tests come back as abnormal (cervical dysplasia). Most of the time, abnormal changes will disappear on their own without any treatment. You may need a repeat Pap test, or in some cases, you may need colposcopy. Most women who have abnormal Pap test results and who have follow-up test and/or treatment will never get cancer of the cervix. Be sure to keep all appointments after an abnormal Pap test. For more information, see the following resources:

What you need to know about preventing cervical cancer (pdf) English | French

Colposcopy

Return to your doctor or nurse anytime you have abnormal vaginal bleeding (bleeding after menopause, persistent bleeding between periods or with sex), or abnormal vaginal discharge.

Colposcopy

A colposcopy examines the cervix and vagina using a low-powered magnifying instrument known as a colposcope. It is a follow-up test that allows a specially trained gynecologist to get a closer look at your cervix.

To learn more about colposcopy, please find:

What you need to know about preventing cervical cancer (pdf) English | French

If it has been 2-6 weeks since your Pap test, you can request a copy of your Pap test results in 1 of 2 ways:

1. Call CervixCheck toll-free at 1-855-95-CHECK. 
2. Email your request to CervixCheck@cancercare.mb.ca

Registry

The registry is a confidential record of Pap tests and follow-up test results for all Manitobans. The registry contains:

  • your name, address and date of birth,
  • your Personal Health Identification Number (PHIN) and your Manitoba Medical Number (MHSC),
  • the date(s) of your test(s) and results,
  • the name, address and number of the health care provider who did your test(s), and
  • the name of the laboratory where each test was read.
The registry is accessed by:
  • The health care provider who takes your Pap test,
  • The laboratory that reads your Pap test, and
  • CervixCheck staff involved in the registry.

Everyone who has access to your information is bound by the Personal Health Information Act (PHIA) and has signed a pledge of confidentiality.

Your personal health information is collected according to a regulation of the Public Health Act. For more information about your rights under the Personal Health Information Act, contact the Privacy Officer for CancerCare Manitoba at (204) 787-2266 or the Manitoba Health Legislative Unit at (204) 788-6612.

 The Registry:
  • keeps a record of all Pap tests and follow-up tests done for you after April 27, 2001,
  • allows you to obtain your own test results,
  • sends your health care provider a letter if you fail to get recommended follow-up testing when an abnormality has been found,
  • sends you a letter if follow-up is outstanding for an abnormal Pap test or if you are overdue for a Pap test,
  • collects information to improve our understanding of cancer of the cervix, and
  • helps us to improve Pap test services across Manitoba.

Keeping records becomes important if you move or change health care providers, or if your health care provider moves or changes laboratories. When looking at test results, medical staff should take your past history into account.

Opting In/Out of Registry

To opt out, indicate this in this form (EnglishFrench pdf) below and return it to CervixCheck. We encourage you to discuss your decision with your health care provider or with CervixCheck. To opt back into the registry, please call our office. Your test results will be available to the registry from the date that you reenter the program.

 

Pap Test Clinics

To book a Pap test appointment:

  1. contact your regular health care provider, or
  2. enter your postal code in the search box below and click the search icon to find a Pap test clinic near you.

Call ahead to the site to ensure the clinic will meet your Pap test needs.

For help, call CervixCheck at 1-855-95-CHECK.

Screening for Other Cancers

To learn more about screening for cancers other than breast, cervical, or colorectal, click here.