From The Industry: Ending cervical cancer in Canada is within reach

Human papillomavirus (HPV) vaccines make eradicating cervical cancer by 2040 an achievable goal, but there 's still more work to be done.

Douglas Donovan 4 minute read March 4, 2022
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Governments are investing in screening and diagnostics to help cervical cancer prevention. GETTY

What better day than International HPV Awareness Day to touch on Canada’s  ambitious, but achievable goal: to eradicate cervical cancer by 2040. With the advent of human papillomavirus (HPV) vaccines, this goal seems more within our reach than ever, but there are still miles to go — and we need to take advantage of technological advances to get us across the finish line.  

Cervical cancer is primarily caused by persistent genital infection with high-risk HPV. The arrival of HPV vaccines 15 years ago was a game-changer, and of course, vaccines are an enormous part of the solution to changing the course of cervical and other genital cancers — the next generation of Canadian women could be cervical cancer-free. But for many women, it is too late for prevention. HPV prevalence has historically been 70 per cent — prior to the introduction of HPV vaccines, three out of four sexually active Canadians would have contracted a form of HPV at some point in their lives.  

The health of millions of women depends on screening

It’s still critical that we are aggressively rooting out HPV wherever possible for early detection and treatment — the health of millions of women in Canada still depend on it. Not only is there a large population that needs regular screening, but during the COVID-19 pandemic, screening rates have dropped precipitously, increasing the likelihood of undiagnosed cervical cancer. The Hologic Global Women’s Health Index found that only 24 per cent of Canadian women aged 50 to 74 say they have been tested for any type of cancer in the past year — lower than the 33 per cent to 50 per cent range that would be expected if they adhered to the national guidelines for breast and cervical cancer screenings. Health care professionals have raised the alarm that many cancers may be going undetected due to lack of screening and diagnosis. 

Governments have also recognized this backlog and are investing in screening and diagnostics to help make up for lost time, but it’s a good opportunity to pause and ask how effective our cervical cancer screening methods truly are, and what more we could be doing to end this disease.  

We continue to rely on the Pap smear, a nearly 100-year-old technology that has seen little innovation despite its near-ubiquitous use. And while it has been one of the most successful cancer screening tools, there are newer approaches that could be more broadly adopted in Canada to help us reach our goal.  

Liquid-based cytology pap tests are a more recent innovation that can provide sensitive testing of the cervix cells and can more accurately identify abnormal cells that may lead to cervical cancer. It produces fewer false-negatives and false-positives, reducing the need for repeat testing and allows for easy HPV reflex testing. Yet across Canada, only a handful of provinces have implemented liquid-based cytology to improve their cervical cancer screening programs, including Saskatchewan, that made the switch right in the middle of a pandemic. 

And when it comes to HPV testing, new technologies can also help to root out the main cause of cervical cancer. As recently as just two years ago, mRNA was a little-known method of fighting disease. Now thanks to the widespread adoption of mRNA vaccines to fight COVID-19, we know it’s capable of carrying important information to the body. This technology can also be used to identify HPV.  

In fact, a new health economic model developed by Aquarius Population Health and recently published in Preventive Medicine Reports, shows that if an mRNA HPV test was implemented in Ontario as part of a cervical cancer screening program in place of a DNA test, it could save the province over $4 million annually and avoid unnecessary colposcopies and additional screening tests. 

This kind of program could be implemented to similar effect in provinces across the country and save scarce health care dollars overall while reducing the burden of screening on both Canadian women and the time spent by overworked health professionals. 

As women start to return to regular testing and screening for cervical cancer, we have the opportunity to take advantage of these technological advances. Ending cervical cancer is within our grasp — now let’s finish the job. 

Douglas Donovan is the VP and general manager of Canada and Latin America, Hologic Inc., an innovative medical technology company primarily focused on improving women’s health and well-being through early detection and treatment. For more information on Hologic, visit www.hologic.com. 

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