Canada Faces Setback in Goal to Eliminate Cervical Cancer by 2040

The recent Canadian Cancer Statistics report indicates that Canada may not achieve its goal of eliminating cervical cancer by 2040. Shannon Pethick, a survivor who was diagnosed at age 32, expressed her disappointment, stating, “It hurts my heart because we should be past this.” Her sentiments reflect a growing concern among health professionals about stagnating cervical cancer rates in the country.

Worrying Trends in Cervical Cancer Rates

According to the CCS Advisory Committee, cervical cancer rates in Canada have reached a “concerning plateau.” The report forecasts that 430 individuals are expected to die from cervical cancer in 2025, a small fraction of the 87,400 cancer-related deaths anticipated this year. Importantly, all these deaths are potentially preventable due to the availability of a vaccine against the human papillomavirus (HPV), which is a leading cause of cervical cancer.

Canada had seen a steady decline in cervical cancer rates from 1984 to 2005, but progress has since fluctuated. The World Health Organization (WHO) established a global target in 2018 to reduce cervical cancer cases to fewer than four per 100,000 females. The current trajectory suggests that Canada may not meet this significant public health goal.

Barriers to Screening and Vaccination

Pethick’s personal experience underscores the challenges many face in accessing preventive care. She delayed routine Pap tests for seven years, leading to a diagnosis that required aggressive treatment, including two months of radiation and chemotherapy. Now cancer-free, she reflects on her struggles with infertility caused by treatment decisions made during a critical time.

Many women are deterred from undergoing Pap tests due to their invasive nature. Pethick believes that if self-testing for HPV had been available, she would have taken action sooner. Currently, self-testing is implemented in British Columbia and is seen as equally effective as tests conducted by health professionals. Similar initiatives are being developed in New Brunswick, Nova Scotia, and Prince Edward Island.

Jennifer Gillis, the director of surveillance at the Canadian Cancer Society, noted several factors contributing to the stagnation of cervical cancer rates. These include lower HPV vaccination rates, decreased screening participation, and gaps in follow-up care. She emphasized the potential benefits of shifting from Pap tests to HPV tests and advocated for making the HPV vaccine free for those who missed vaccination opportunities during school, as the costs—$215 per shot for three doses—can be prohibitive.

Canada’s plan to eliminate cervical cancer aims for 90 percent of 17-year-olds to be fully immunized with the HPV vaccine by 2025. However, the Canadian Partnership Against Cancer reports that only three provinces—Prince Edward Island, Newfoundland and Labrador, and Quebec—currently exceed an 80 percent vaccination rate. Alarmingly, a report by the Federation of Medical Women of Canada revealed that less than 20 percent of Canadians have received the HPV vaccine.

Dr. Milena Forte, a family doctor in Toronto and a member of the Federation, highlighted the misconceptions surrounding the HPV vaccine, which often lead to its lower uptake compared to other routine vaccines. “We have a free way to decrease rates of cervical cancer. Everybody should be lining up for this,” she stated.

As Canada grapples with these challenges, the urgency for effective public health strategies becomes increasingly clear. The need for improved access to screening and vaccination, combined with robust public awareness campaigns, is essential to reverse the current trends and work towards the elimination of cervical cancer.