Canada has tools to end cervical cancer but lags

Canadian health officials are facing a difficult reality: women are still dying from cervical cancer after receiving normal Pap test results, despite the existence of a more accurate screening method that could prevent those deaths.

Recent research from Eastern Ontario found that 132 women were diagnosed with cervical cancer over a two-year period. Eighteen of them died. The study’s authors argue these deaths were preventable, pointing to a screening system that has been slow to adopt newer technology.

The issue isn’t a lack of tools. Human Papillomavirus (HPV)-based screening detects the virus that causes cervical cancer before abnormal cells even appear. Pap tests, by contrast, only catch changes after they’ve already started. Evidence has consistently shown HPV testing is more accurate, yet much of Canada still relies on the older method. In the Eastern Ontario study, the Pap test came back falsely negative for one in five women who were later diagnosed with cervical cancer.

Some provinces have made the switch to HPV-based screening, but adoption across the country has been uneven. The authors say this inconsistency is part of the problem. Cervical cancer rates are rising even as the medical community knows how to prevent the disease.

The disease develops slowly, which means effective screening creates a window for intervention years before cancer takes hold. That window closes when the wrong test is used or when women don’t get screened at all. More than half of the cases in the study involved women who weren’t adequately screened, often because they lacked a primary care provider. For those who did get tested, the false negatives are particularly troubling. A normal result can create a false sense of security, delaying diagnosis until the cancer has progressed. That’s not a regional quirk — it’s a systemic flaw that plays out across the country.

Australia is on track to eliminate cervical cancer by 2035 using the same tools and evidence available to Canada. They’ve done it through widespread HPV vaccination, full adoption of HPV-based screening, and national support for self-testing. None of this is experimental. The technology exists, and the clinical experience is there.

Canada’s path forward, according to the study’s authors, involves three practical steps. First, HPV-based screening needs to be implemented consistently nationwide instead of province by province. Second, screening programs should be designed around the barriers that keep people from participating — trauma, discomfort, geography, and lack of access to care. HPV self-collection addresses all of these, but it still isn’t recommended nationally. Third, the system needs to modernize how it reminds people to get screened. Mailed paper reminders are still the standard, even though text or email alerts are more effective at turning awareness into completed tests.

The gap between what’s possible and what’s happening is a matter of implementation, not knowledge. Public and political will are the missing pieces. Until those change, the study suggests, women will continue to die from a disease the country knows how to prevent.