Salvador poses barriers to access, such as the lack of primary care physicians, meaning people are not consistently monitored and have to keep up to date with screenings themselves.
However, when informed, the advancement of self-testing with HPV smears instead of conventional Pap smears has improved access to testing for rural and marginalized populations for people with a cervix aged 25 to 69 years. Most provinces are in the process of transitioning to HPV screening, which is usually done every five years.
Experts would like to see provincial databases that track who has and who has not been screened so that reminders can be sent to people. British Columbia is leading the way in Canada with such a system. outlined by BC Cancer.
“Nobody goes to the doctor unless there’s a problem. They’re not reminded. You have to get your screening done and find the resources,” says Salvador, noting that medical information privacy laws in many provinces are blocking progress on the databases needed to set up an outreach program.
But there is hope. She points to progress in Australia, where challenges are similar to those in Canada:
“They have very remote populations that don’t have easy access to a center, and they also have marginalized communities. We need to look at what the self-collection of HPV has done for them. And what it did, especially during COVID, is it allowed people to continue to get screened because they could do the collection themselves at home. They also have the same problems that Canada did during the pandemic, where they lost primary care physicians, nurses, and people who were supervising. But with the addition of self-collection, their screening numbers have increased again.”
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