Cervical Cancer Rates Are Rising in Canadian Women Aged 35 to 54

Medicine can stop this cancer. A vaccine prevents most cases, a routine test catches trouble years early, and for decades the numbers only went down, yet in one group of Canadian women those numbers are climbing again.

Cervical cancer rates are increasing among Canadian women aged 35 to 54 despite major advances in screening and vaccination, CTV News reported on October 31. Experts are urging women not to put off getting checked. The Canadian Cancer Society estimates that about 1,700 women will be diagnosed with cervical cancer this year and 450 will die from it. A study using Canadian Cancer Registry data shows the shape of the trend, with rates falling among women 25 to 34 and those 65 and older, while they climb in the two middle-aged groups.

Key takeaways

The Canadian Cancer Society estimates about 1,700 cervical cancer diagnoses and 450 deaths in Canada this year.

Rates have risen about 1.1 per cent a year among women 35 to 44 since 2001, and about 1.6 per cent a year among women 45 to 54 since 2012.

In 2022, women aged 35 to 44 had the highest rate of any age group, at 18.1 per 100,000, close to where it stood in 1992.

A gynecologic oncologist told CTV that one of the biggest gaps is women who never return for follow-up after an abnormal result.

The vaccine is approved in Canada up to age 45, and walk-in and community clinics can screen women who do not have a family doctor.

Why is a prevention gap opening up in this age group?

The frustrating part is that cervical cancer rates are climbing at a time when the tools have never been better. Screening has moved well beyond the Pap test of a generation ago, and HPV testing can now detect the virus that causes nearly all cervical cancers before abnormal cells ever appear. Dr. Julie Anne Francis, a gynecologic oncologist at Lakeridge Health in Ontario, described it to CTV as a huge change in technology.

The researchers behind the registry study described women aged 35 to 54 as a cohort that may be falling into a prevention gap. Canada's school-based HPV vaccination programs rolled out across the provinces between 2007 and 2010, after most of these women had already left school, so this group carries less vaccine protection than the women behind them. Experts quoted by CTV also pointed to slowing vaccine uptake. Our guide to the cancer risk factors you can change covers what else moves the needle.

What happens if you never followed up on an abnormal result?

Screening only prevents cancer when the follow-up happens too. Francis told CTV that one of the biggest gaps lies in losing women once they have an abnormal result, and that there are many reasons people skip the next step. Some do not realize the test was abnormal, some are afraid of what the follow-up might find, and some assume an abnormal result means cancer when it usually does not.

An abnormal result is often the opportunity to prevent a cancer before it starts, she said, since cell changes caught early can be treated with a simple procedure. If you ever received an abnormal result and did not go back, that follow-up is still worth doing now, and no one at the clinic will scold you for the gap.

Can you get screened without a family doctor?

Experts also pointed CTV to a simpler problem, which is that many Canadians do not have a family doctor, who is usually the person offering and performing Pap and HPV tests. Without one, screening can lapse for years without anyone noticing. The good part is that a family doctor is not the only route, since walk-in clinics, community health centres, and many sexual health clinics can screen you, and some provincial programs let you book directly.

Screening is also getting easier. Provinces are moving from the Pap test to more sensitive HPV testing, and B.C. offers a self-screening kit you can use at home for people aged 25 to 69. Canada has committed to eliminating cervical cancer as a public health problem by 2040, and closing these gaps is how that target gets met. Our guide to how to prevent heart disease, cancer, and more covers the other screening tests worth booking.

Is it too late for the vaccine?

If you never received the HPV vaccine, it is not necessarily too late for the vaccine. Health Canada has approved it for people up to age 45, and whether it makes sense for you is a short conversation with a doctor or pharmacist. Research on young women vaccinated through school programs shows how powerful it can be, as our report on the drop in cervical cancer deaths in vaccinated women explains.

Find your last test date. Check your provincial health records or ask your clinic when your last Pap or HPV test was done.

Book the screening if you are due. If it has been more than three to five years, or you cannot remember, book with a family doctor, walk-in clinic, or community health centre. If you are over 40, our guide to mammogram screening in Canada is worth reading at the same time.

Check for a self-screening option. Ask your provincial screening program whether an at-home kit is available where you live.

Finish any unfinished follow-up. If you ever had an abnormal result and did not go back, call the clinic and pick up where you left off.

Ask about the vaccine. If you are 45 or younger and never vaccinated, ask a doctor or pharmacist whether it makes sense for you.

Frequently asked questions

How often should women aged 35 to 54 be screened?

The schedule depends on your province and the test used. Pap tests have usually been repeated about every three years, while programs that use HPV testing often space screening about five years apart when results are normal. If your last test was more than three to five years ago, or you cannot remember it, you are probably due.

Does an abnormal screening result mean something serious?

An abnormal result usually means there are cell changes or a high-risk virus that need a closer look, and most abnormal results are not cancer. Follow-up testing finds changes early, when they can be treated with a simple procedure. Skipping that follow-up is one of the biggest reasons cervical cancer rates are rising in women aged 35 to 54.

Can adults over 26 still get the vaccine in Canada?

Health Canada has approved the HPV vaccine for people aged 9 to 45, so many adults can still receive it. Public funding for adults varies by province, and the benefit is usually greatest before exposure to the virus. A doctor or pharmacist can tell you whether it makes sense for you and what it would cost.

Your next step

A cancer this preventable should not be gaining ground on anyone. If you are overdue for screening or want to talk through the vaccine, the Medimap Health Hub has more on staying ahead of cancer. You can also find a family doctor or compare walk-in clinics near you and book this week.

Disclaimer: This article is for general information only and is not medical advice. It does not replace a conversation with a doctor or other qualified health professional who knows your history. If you think you are having a medical emergency, call 911 or go to the nearest emergency department.