Eliminating cervical cancer in Canada
Cervical screening in Canada
Key takeaways
- In 2024, cervical screening participation for women 25 to 69 years of age in Canada was 69 per cent, down from 74 per cent in 2017.(1)
- In the same year, cervical screening participation was lower among females from racialized groups (49 per cent — 63 per cent), immigrants (65 per cent) and non-permanent residents (46 per cent) and those who identified as a person with a disability (58 per cent), compared to females who identified as non-racialized (71 per cent), Canadian-born (71 per cent), or did not identify as having a disability (70 per cent), demonstrating more work is needed to improve access for people who face barriers to screening and care. Females living in rural areas had similar participation rates to those living in urban areas.(1)
- Among females aged 25 to 69, participation rates among First Nations living off reserve (70 per cent), and Métis (71 per cent) were similar to non-Indigenous populations (69 per cent).(1)
Cervical screening is available across all provinces and territories in Canada. Since it was first introduced, significantly fewer people have been diagnosed with or have died from cervical cancer.(2) Organized cervical screening programs coordinate the delivery of services, which can increase participation, support timely follow-up and retention, and limit the harms of screening. As of January 2024, organized cervical screening programs exist in nine provinces, with additional provinces and territories actively working to implement their own programs.
Updates to cervical screening guidelines and processes are underway across Canada. Provincial and territorial guidelines for cervical screening, including start/stop ages and frequency, are outlined in the Cervical screening in Canada: 2023-24 report. Where organized screening programs are not available, individuals may request screening directly from a primary care provider as part of their regular care.
Provinces and territories are in various stages of planning for the transition to HPV primary screening, which is superior to Pap tests and offers the opportunity for self-screening, where people can collect a screening sample themselves. A few provinces have already made the switch and recommend HPV primary screening for eligible people aged 25 to 69, once every five years.(3,4)
Story of progress
Introducing organized cervical screening in the territories
Northwest Territories will be piloting an organized cervical screening program using HPV self-screening as the primary test. This will be the first organized cervical screening program to roll out in the territories. About half of the population of Northwest Territories is First Nations, Inuit or Métis, and the majority (86 per cent) live in smaller communities with multiple barriers to accessing screening. Currently, the onus is on individuals to request cervical screening from a primary care provider, which can lead to some people being missed. The creation of a culturally safe, organized cervical screening program will support territorial access to screening, build relationships and improve health outcomes across Northwest Territories, with HPV primary screening at the forefront.
Cervical screening coverage and program status
Hover over each province and territory for cervical cancer screening coverage and program status.
Legend
● Organized population based screening
● Program announced or planned
● Opportunistic screening
Percentage of women (aged 21-69) reporting at least one Pap test in the past three years, 2017
Canada has a target that no less then 80% of eligible individuals in any identifiable group are up to date with cervical screening.
Legend
● Coverage target
● Immigration status
● Location
● Age group
● Indigenous identity
Data table and footnotes
Screening uptake is critical to the elimination of cervical cancer
Recent data shows a decline in screening participation rates, highlighting the urgent need to strengthen efforts to expand screening accessibility and implement HPV primary screening, including self-screening.(1) Optimizing screening uptake is essential to achieve cervical cancer elimination. Canada has set a target of 90 per cent of eligible individuals being up to date with cervical screening by 2030. In 2024, cervical screening participation for women 25 to 69 years of age, ranged from 60.4 per cent in Prince Edward Island to 74.9 per cent in Saskatchewan.
In addition to the overall target of 90 per cent, Canada has a target of at least 80 per cent of eligible individuals in every identifiable group being up to date with cervical screening. Several strategies are being used to increase and improve screening participation among identifiable groups. For example, after an Afrocentric screening program was implemented for newcomers to Ontario, cervical screening rates among those eligible increased from 59 per cent to 70 per cent between 2011 and 2018.(5)
For additional information on screening participation across Canada, please consult Health Fact Sheets: Colorectal, cervical and breast cancer screening tests, 2024.
First Nations-, Inuit- and Métis-governed research and data systems
To further support closing gaps in care, health system partners are prioritizing First Nations-, Inuit- and Métis-governed research and data systems and collaborating with First Nations, Inuit and Métis communities to co-design tailored solutions.
Efforts are also needed to enhance linkages across cancer data and fill data gaps, including collecting data on equity identifiers, to better understand who experiences disparities and report on screening participation data among those who experience barriers to screening, including members of racialized communities and 2SLGBTQIA+ individuals. This reporting will provide actionable insights to support program improvement and further understanding of screening uptake and inform strategies to enable reach.
Story of progress
Equity in cervical screening participation in Manitoba
Bringing care closer to home, introducing easy-to-use tools and resources, and embedding culturally safe approaches to care makes it easier for people to access screening. In Manitoba, HPV self-screening is being offered as a key strategy to support screening participation in general, but especially among equity-denied groups.
CancerCare Manitoba conducted a pilot from April 2021 to March 2023 to provide at-home HPV test kits to people who had never participated in cervical screening, were overdue for screening and/or faced specific barriers to screening. Early results show that at least 90 per cent of participants found the kits easy to use, would choose the HPV at-home kits for future testing and would recommend a kit to their friends.(6)
- Government of Canada, Statistics Canada. Health Fact Sheets: Colorectal, cervical and breast cancer screening tests, 2024. 2025.
- Caird H, Simkin J, Smith L, Van Niekerk D, Ogilvie G. The Path to Eliminating Cervical Cancer in Canada: Past, Present and Future Directions. Curr Oncol. 2022;29(2):1117-22. Epub 2022/02/25. doi: 10.3390/curroncol29020095. PubMed PMID: 35200594; PubMed Central PMCID: PMCPMC8870792.
- BC Cancer. Cervix Self-Screening Pilot Project [Internet]. 2023. Available from: http://www.bccancer.bc.ca/screening/Documents/cervix-self-screening-provider-guide.pdf.
- Government of Prince Edward Island. HPV Screening and Cervical Cancer Prevention [Internet]. 2023. Available from: https://www.princeedwardisland.ca/en/information/health-pei/hpv-screening-and-cervical-cancer-prevention.
- Nnorom O, Sappong-Kumankumah A, Olaiya OR, Burnett M, Akor N, Shi N, et al. Afrocentric screening program for breast, colorectal, and cervical cancer among immigrant patients in Ontario. Can Fam Physician. 2021;67(11):843-9. Epub 2021/11/14. doi: 10.46747/cfp.6711843. PubMed PMID: 34772714; PubMed Central PMCID: PMCPMC8589122.
- Fernandes B, Dworkin S, Bunzeluk K, Turner D, Baldry L, Coulter L, et al., editors. Elimination of Cervical Cancer in Canada: Exploring invitation strategies for HPV self-sampling among under screened women ICSN; 2023; Turin, Italy.