Screening for cervical cancer

Cervical cancer is a preventable disease. Screening with a Pap test has been shown to reduce mortality from cervical cancer.

Nearly all cervical cancer cases are caused by high-risk Human Papillomavirus (HPV) infection. 

Women, trans men, or gender-diverse people aged 25-69 who have a cervix and have ever been sexually active (including any type of genital contact, with or without vaginal penetration) should have a cervical screening test (Pap test) every three years after three consecutive negative results.

Those who have received the HPV vaccine or who are menopausal should also participate in cervical screening. 

However, some people with special circumstances should be screened with Pap tests more frequently. These include:

• people who have been treated for abnormal Pap tests or an invasive cervical cancer 
• people who have conditions that lower their immune response. For example, transplant recipients, HIV positive people and those treated with chemotherapy

A Papanicolaou test, known as a Pap test, is the main tool used to screen for cervical cancer that checks the cells from your cervix for any abnormal changes. Cervical cancer can be prevented by finding these cells and removing them.

A health-care provider will perform this test in their office or at a clinic.

First, the health-care provider will talk to you about Pap test and how it will be done and then they will collect the cells from the cervix. It only takes a few minutes to perform a Pap test.

The sample will be sent to the lab to be examined under a microscope for any abnormal changes.

You will be contacted by your healthcare provider with your results. 

More information on collecting a Pap test is available at Paptestinfo.ca.

If you have ever been sexually intimate (meaning intercourse, oral or touching of the genital area), you can begin having Pap tests at the age of 25.

(Example: First sexual encounter at age 16 = first Pap test at age 25)

If you are not sexually active at 25, you can wait three years after your first sexual encounter before having your first Pap test.

(Example: First sexual encounter at age 25 = first Pap test at age 28) 

If you are over the age of 69 and in the past ten years have had regular Pap tests with no abnormal results, you can probably stop having Pap tests.

However, if you are over 69 and have never had a Pap test, do not remember when you had your last Pap test, or have any symptoms such as abnormal bleeding, talk to a primary health-care provider about cervical cancer screening.

If you are younger than 69 years of age and have stopped having your periods (menstrual cycles), then you should still have Pap tests. Statistics show that cervical cancer cases occur more frequently in women over 50 years of age.

A Pap test is normally performed by a physician, nurse practitioner or trained nurse.

If you do not have a primary health-care provider, most communities in New Brunswick have clinics where trained health-care professionals do Pap tests.

New Brunswick Pap test clinics

A normal or negative Pap test means the cells taken from your cervix show no signs of abnormal cell changes. Usually, routine screening according to your screening history will be recommended.

It is important to contact the health-care provider who collected your Pap test to discuss your test results and when your next Pap test will be due.

An abnormal Pap test result means the cells taken from your cervix look different than normal cells when seen under a microscope. Cell changes found through Pap tests are very rarely cancer. When these changes are caught early, they can be watched closely and treated so that cancer doesn’t develop. 

It is important to contact the health-care provider who collected your Pap test to discuss your test results and the follow up testing required.

Follow up often requires returning for another Pap test. Sometimes you may be referred to a specialist (gynecologist) who may perform further tests or treatment. 

Learn more about abnormal Pap test results.

The New Brunswick Cervical Cancer Prevention and Screening Program is dedicated to making sure that New Brunswick women, trans men and gender diverse people with an intact cervix aged 25 to 69 participate in regular cervical cancer screening, with a Pap test. This program is managed by the New Brunswick Cancer Network at the Department of Health, in partnership with health-care providers and the regional health authorities. Its purpose is to lower the rates of cervical cancer in New Brunswick by improving prevention, early detection and screening of this preventable disease.

The Cervical Program monitors screening activity (Pap and HPV tests) to determine who is screened and who is not screened within the province.

The program sends letters to individuals and health-care providers when screening or follow-up is overdue. This is to make sure that those who have not been participating in screening are invited or reminded and that those with significantly abnormal test results get the follow-up they need.

The program is an active member of the Pan-Canadian Cervical Cancer Screening Network, facilitated by the Canadian Partnership Against Cancer.

• People getting Pap tests are automatically participants of the program.
• You continue to get Pap tests from your primary health-care provider as usual.
• The lab sends your test results to your primary health-care provider. They advise you of your test results.
• The labs also securely transfer the results of Pap or Human Papillomavirus (HPV) tests to a provincial database for the program.
• The program tracks screening activity based on recommendations of the New Brunswick Cervical Cancer Prevention and Screening Program Clinical Practice Guidelines.
• People between the ages of 25 to 69 with no record of having had a Pap test will be invited by the program.
• The program may send letters to individuals and to primary health-care providers when screening or follow-up is overdue.
• People who get Pap tests regularly may never receive a letter.
• The New Brunswick Cancer Screening Programs collect, use and disclose participants’ name, address, birth date and Health Care Number, along with the necessary clinical screening information, to monitor screening activity, determine eligibility and invite New Brunswickers to participate in cancer screening programs and services. If you want more information about your privacy rights, please send an email to [email protected].

As part of the New Brunswick Cervical Cancer Prevention and Screening Program, letters will be sent to eligible New Brunswickers (age 25 to 69) and to primary health-care providers according to clinical practice guidelines.

The program will send:

• invitation letters to newly eligible people (25 years of age or older or relocated to New Brunswick) or any eligible person between 25 to 69 years of age who has not had cervical screening (no record of a Pap test since 2011 or no record of a total hysterectomy since 2002 in New Brunswick)
• recall letters to eligible people who have been screened in the past but are overdue for routine cervical screening
• reminder letters to the health-care provider associated to an abnormal Pap test result in cases when follow up is overdue; and six months later, a reminder letter to the program participant and a copy to the associated health-care provider if follow up has not happened

The program does not send letters to people or healthcare providers when:

• the Pap test result is negative
• the follow-up is done according to the Clinical Practice Guidelines for normal or abnormal results
• a person is outside the target age group of 25 to 69, without a cervix, already had a cervical cancer or choose to not participate (opt out) in the cervical program

By choosing to not participate, the program will no longer send you letters to invite, remind, or advise you of when you are overdue for cervical screening tests.

You can continue to get Pap tests for cervical cancer screening with your doctor or nurse practitioner even though you have chosen not to participate in the program.

To learn more about the NB Cervical Cancer Screening program, to opt out of the program or to return to the program, call 1-844-777-3443.

Follow up after an abnormal Pap test often requires returning for another (repeat) Pap test.

Sometimes, you may be referred to a specialist (gynecologist) who may perform further tests and/or treatment such as a colposcopy. 

A colposcopy is done much the same way as a Pap test.

A speculum is inserted into the vagina to hold it open so the cervix can be clearly seen and examined. 

The colposcopy doctor (gynecologist) uses a special instrument called a colposcope. It has a light and magnifying lens (much like binoculars) on the end, which allows the inside surface of the cervix and the vagina to be seen more clearly under high magnification. The colposcope itself isn't inserted – it is positioned outside the opening of the vagina.

The area may be swabbed with solutions that help the doctor see the tissues better.

Biopsies may be taken from any suspicious areas using forceps or a scoop called a curette.

Once the biopsy specimens (when taken) have been examined by the lab, the colposcopy doctor will contact you with the results or an appointment. 

The colposcopy doctor will return you to your primary health care provider for Pap tests when they feel comfortable that your colposcopy examination is complete.

Your health-care provider (doctor or nurse practitioner) will refer you to a specialist (gynecologist) for colposcopy testing. Colposcopies are usually done in an outpatient clinic at one of the regional hospitals closest to your home. The gynecologist’s office or colposcopy clinic will send instructions to you on how to prepare for a colposcopy.

After colposcopy, the specialist (gynecologist) will talk to you about your results.

They will let you know if another colposcopy visit or a treatment is needed. 

The most common treatments used for colposcopy are cryotherapy, laser and loop electrosurgical excision procedure (LEEP). All of these treatments remove the abnormal area of cells. Speak to your colposcopy doctor for more information.

The doctor will also let you know when you can return to your family doctor for routine cervical screening. 

HPV (Human Papillomavirus) is the most common sexually transmitted infection that is spread through skin-to-skin contact during sex. Around 75% of sexually active people will get at least one HPV infection in their lifetime.

HPV infections often have no symptoms and most infections go away by themselves within two years. But sometimes, HPV infections can lead to several types of cancers, including cervical, oral pharyngeal, anal and penile. One way to lower your risk and protect yourself from HPV infections and related cancers is to get vaccinated for HPV. 

More information about the HPV vaccination is available through Public Health.

The HPV test checks for the presence of high-risk HPV types. Research shows that HPV testing can help identify people who have cervical lesions or are most likely to have precancerous changes and are at risk of developing cervical cancer.

In New Brunswick, the HPV test is only used for those 30 years of age and older as a follow-up to specific abnormal Pap test results. An HPV test is usually completed from a Pap test specimen. The HPV test is not currently used as a replacement for the Pap test.

The New Brunswick Cervical Cancer Prevention and Screening Program is working with stakeholders to transition from Pap to HPV testing soon in line with Canada's Action Plan to Eliminate Cervical Cancer .

More information on HPV testing is available at the Canadian Cancer Society.