Canada is moving away from Pap tests. Here's what you need to know

Getting a Pap test can be an uncomfortable experience. 

For people who have undergone sexual trauma or experienced discrimination in a doctor's office, putting their feet into stirrups for a pelvic exam is likely even worse. 

Some relief could be coming as Canada moves away from Pap smears for cervical cancer screening in favour of testing for the human papillomavirus (HPV), which causes the vast majority of cervical cancers. The HPV test has been shown to be safe and effective — plus, people can do the swab test at home.

It's a small but mighty change that experts say will help Canada meet its goal to eliminate cervical cancer by 2040. 

"HPV testing is well-proven to be an enormous improvement in terms of detection of pre-cancers over Pap testing," said Dr. Kim Alexander, a gynecologist in Brampton, Ont., whose expertise is in cervical cancer screening.  

"Screening with Pap testing misses almost half of existing abnormalities on the cervix," Alexander told Dr. Brian Goldman, host of CBC's The Dose. 

The HPV test, however, identifies pre-cancer cells earlier, studies have shown. That means a negative result can be trusted, Alexander said. 

"If you have a single negative HPV test, the probability of finding a pre-cancer 10 years later is less than one per cent."

Most jurisdictions across Canada are moving to HPV testing as primary screening.

One of the biggest advantages to the switch is the improved efficacy of the test. Because it detects cervical precancers earlier and more accurately, the test only needs to be done every five years.

In comparison, it's recommended that women aged 30 to 69 get a Pap test at least every three years. 

If an HPV test is positive, a Pap smear is done to collect a specimen from the cervix for further testing. 

If you're going to a medical office for HPV screening, the doctor or nurse practitioner may still do a pelvic exam with a speculum, said Alexander. 

"If we can collect that primary HPV sample in the doctor's office with a speculum, then if your HPV test shows up positive in the lab, they can automatically run the Pap test from the same specimen," she said.