For decades, British Columbia has been at the forefront of cervical cancer prevention, screening and treatment. BC has one of the longest-standing screening programs in the world, operating since the mid-1950s. With the commencement of population-based screening, the morbidity and mortality associated to cervical cancer has dramatically declined. BC also implemented school-based HPV vaccination in 2008, one of the most important components of cervical cancer prevention. And now, with the financial assistance of Scotiabank and BC Women’s Health Foundation, a new milestone is about to be achieved in the fight to eliminate cervical cancer.
All screening is not equal
Screening is vital to reduce the risk of cervical cancer. In 2017, about half of those diagnosed with cervical cancer had no history or screening or were more than five years overdue. In the Fraser Valley region, only 63.3 per cent of women and individuals with a cervix (WIC) are up to date with cervical screening, the lowest rate in the province. Fraser Valley has a high population of WIC of South Asian origin, and across Canada, WIC of South Asian origin have significantly lower screening attendance for a variety of reasons – discomfort with pelvic exams, embarrassment, male health centre providers, lack of knowledge about cervical screening and time constraints.
New program addresses barriers to traditional screening
To address the barriers associated with low cervical screening attendance among South Asian and immigrant populations in the Fraser Valley region, a project was launched in April 2019. This initiative was made possible thanks to generous funding from donors like Scotiabank. In collaboration with UBC and BC Cancer, a unique online service was designed called CervixCheck. Patients of partnering family physicians in the Fraser Region registered online through CervixCheck to receive a cervix self-screening kit mailed to their home. After the kit was received, WIC could safely, easily and painlessly collect a vaginal self-screening sample that was then sent to the provincial laboratory where it received HPV testing. Results were then made available to the patient online through the CervixCheck website.
HPV testing (testing for cancer-causing strains of the human papillomavirus) is improved technology for cervical cancer screening, detecting cervical pre-cancer earlier and more accurately than traditional pap screening. In addition, HPV testing allows for new and innovative approaches to cervical screening, which includes the opportunity for patients to vaginally collect samples themselves.
Scotiabank’s commitment is helping those in underserved regions of BC
Thanks to Scotiabank, in the five years since the launch of CervixCheck, many communities in BC with limited access who had previously been overdue or never been screened have now had easier access to screening. Many of the barriers that existed with the traditional approach to screening have been reduced or eliminated, including more than 200 WIC in the Fraser Valley and self-screening has been positively received by patients and providers.
As one CervixCheck participant said, “I think this is a brilliant idea and more women will get screened when they can do so from the comfort of their own homes for whatever reasons they may have”. This was reinforced by one of the collaborating physicians: “Having had the opportunity to offer [self-collection] to my patients has allowed me to extend the reach to women who hold off sensitive examination because of cultural reasons, women who do not have a family physician or cannot access cervical cancer screening due to life constraints.”
Cervical screening goes provincewide.
Through their ScotiaRISE program, Scotiabank committed $125,000 in funding for the CervixCheck project in 2021, the findings of which have helped inform for the provincial rollout of HPV primary screening in January 2024.
Scotiabank’s involvement in the CervixCheck project was significant. Without this funding, CervixCheck would not have been possible, and this contribution to research will continue to inform the future of HPV primary screening in BC and have a critical impact on the ultimate goal of eliminating cervical cancer in BC.
