Cervical cancer is caused by human papillomavirus (HPV). Over 80% of Canadians will have at least one HPV infection in their lifetime.
Most women age 21 to 69 who have ever had sexual contact should have a Pap test every 3 years. Trans, non-binary, and gender diverse people with a cervix should have a Pap test every 3 years.
Cancer is a serious illness in the body. Cervical cancer can occur when there is uncontrolled growth of cells on the cervix.
Cervical cancer is caused by high-risk human papillomavirus (hrHPV). HrHPV can cause abnormal cells to develop on the cervix. If the abnormal cells do not go away on their own, and/or if left untreated, they can become cancer.
Most people are at average risk of cervical cancer and should have a Pap test every 3 years.
Some people are at increased risk for cervical cancer and may need to be screened more frequently. Factors you cannot change that can increase your risk for cervical cancer include having a personal history of:
A Pap test is a test that can find abnormal changes on the cervix before they turn into cancer. 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 human papillomavirus (HPV) can become cancerous. Regular Pap tests with follow-up with abnormal changes can prevent most cancer of the cervix.
You will be asked to undress from the waist down and lie on an exam table with your feet resting in the foot rests. Allow your knees to fall away from each other.
A speculum is used to open the vagina and examine the cervix. Breathe deeply to help calm your muscles. This allows the speculum to be inserted more easily. You may feel some discomfort, but you should not feel pain. If you feel pain, be sure to let your doctor or nurse know.
A small broom-like device is used to collect cells from the cervix.
Cells are dropped into a vial and sent to a laboratory to be examined.
The speculum will be removed.
You can get dressed.
Cervical cancer screening results are usually available 2-6 weeks after the test. You can find out your result in one of two ways:
Although most cervical cancer screening test results are normal, about one in 10 tests come back as abnormal. Most of the time, abnormal changes will disappear on their own without any treatment.
Your cervical cancer screening result will include a Pap test result and, depending on your age, may also include an HPV test result.
Normal: No abnormal cells were found. Nine out of ten times, Pap test results are normal.
Abnormal: Abnormal cells were found. This result does not mean you have cancer or will get cancer. It means that more testing is needed to understand and possibly treat the abnormal cells. Please see this brochure (PDF) to review different abnormal results.
A hrHPV test looks for high-risk types of HPV that may increase a woman’s risk of developing cervical cancer in the future. Your Pap test sample will be automatically tested for HPV if you are:
HPV testing is not useful for women under the age of 30 because:
High-risk HPV negative – means that you do not have an HPV type that can cause cervical cancer.
High-risk HPV positive – means that you do have an HPV type that can cause cervical cancer. This result does not mean you have or will get cervical cancer. It means that more treatment is needed to prevent cervical cancer from starting.
Depending on your age, Pap, and HPV test result, follow-up tests for cervical cancer screening may include:
You may need a colposcopy if you have:
Be sure to keep all appointments after an abnormal Pap test. For more information, see the following resources:
Colposcopy - see video below
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.
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. The process is like a Pap test.
Tell the nurse or doctor if you are allergic to iodine or shellfish.
A biopsy removes a tissue sample. The sample is sent to the laboratory.
The doctor will remove the tissue sample during the colposcopy. The sample is smaller than a ¼ of the size of a pencil eraser. It is gently removed with an instrument like a pair of tweezers.
A biopsy usually takes less than a minute. Some women feel nothing. Others describe a pinching feeling or cramps. This usually stops within a few minutes. Your doctor may suggest a pain reliever.
You may have spotting for a few days. If so, use pads, not tampons.
For at least two days after your biopsy, do not:
A cold knife conization removes a cone shaped piece of tissue. It is done as a day surgery procedure and requires anesthetic. If cancer cells have been found, it will also determine whether or not these cells have spread to other tissues.
LEEP is short for loop electrosurgical excision procedure. After freezing the area with local anesthetic, an electrical wire loop is inserted into the opening of the cervix and the abnormal tissue is removed.
Laser surgery is a treatment that uses an intense narrow beam of light (called a laser beam) to remove abnormal cervical cells. A local anesthetic is used. A watery discharge is a common side effect that may last up to two weeks.
The registry is a confidential record of cervical cancer screening tests and follow-up test results for all Manitobans. The registry contains:
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.
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.
To opt out, indicate this in this form (English | French pdf) below and return it to CervixCheck. We encourage you to discuss your decision with your healthcare 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.
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 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:
Contact your health care provider if you experience any signs or symptoms of cervical cancer and they last for 3 or more months.
To book a Pap test appointment:
Call ahead to the site to ensure the clinic will meet your Pap test needs. If you would like to promote a Pap test clinic in your community, we invite you to use our Cervical Cancer Screening Test Clinic Posters.
For help, call CervixCheck at 1-855-95-CHECK.
Bring your Manitoba Health Card to all your CancerCare Manitoba Screening appointments. Keep the information on your Manitoba Health card current. This will enable us to send you letters to remind you to get screened for cancer. To learn more, visit the Manitoba Health Card website.