Photo: Dr. Robert Di Cecco, Regional Lead for Cervical Screening, South West Regional Cancer Program
Photo credit: St. Joseph’s Health Care London
March 10, 2025
As of Monday, March 3, 2025, Ontario has adopted the HPV test as the new standard for cervical cancer screening, replacing the traditional pap smear.
The HPV test sample is collected using a similar method as the pap smear and is available at all the same places the pap smear was available. If you have a cervix, the starting age for screening eligibility is 25 years old and the frequency of testing will depend on the test results.
“If the result of the test is negative for HPV, then your next screening test would be in five years. But if the result is abnormal, then next steps could include more frequent testing, or a referral to a colposcopy clinic for follow-up,” explains Dr. Robert Di Cecco, Regional Lead for Cervical Screening for the South West Regional Cancer Program (SWRCP).
What is the difference between a pap smear and the HPV test?
For patients the process of having the HPV test will be the same as that of the traditional pap smear, as both involve the collection of cells on the cervix. However, the difference is in what the test actually looks for at a cellular level.
The pap smear looks for cell abnormalities and is not as sensitive or specific as the HPV test. The pap smear also requires a subjective interpretation of someone looking at the cells in the sample and determining whether they are abnormal or not.
The HPV test specifically detects evidence of cancer-causing strains of HPV in the sample, providing a more accurate assessment of cervical cancer risk.
“The HPV test is objective and doesn’t require someone’s interpretation of whether there is an abnormality,” says Dr. Di Cecco. “The test identifies a patient’s risk of developing cervical cancer by looking at whether there is evidence of cancer-causing strains of HPV in the sample. The test helps determine a person’s risk of developing something or changes to the cervix that need to be followed.”
Why is the test changing?
“We have seen that the HPV test is more sensitive and specific than the pap smear. From that standpoint, the results are more accurate to what an individual’s actual risk of abnormality is,” Dr. Di Cecco says.
The HPV test identifies those cancer-causing strains and as a result, helps better identify those patients more at risk and that need to be followed more closely by health care providers.
“The HPV test is a better test than the pap smear and it avoids subjecting people to the anxiety of an abnormal test that may be a false positive. We are better able to streamline patients who are at risk and those not at risk of developing an abnormality with the HPV test,” shares Dr. Di Cecco.
Other countries have implemented this test for many years and now Ontario is using it as the primary screening test.
Dr. Di Cecco notes that while regular HPV testing is key to early identification of cervical abnormalities, the HPV vaccine can help to fight many of the major cancer-causing strains of HPV which can decrease the incidence of abnormalities developing on the cervix. “Getting the HPV vaccine is an intervention that might decrease the incidence of cervical abnormalities because it can help an individual to fight an HPV infection in the first place,” Dr. Di Cecco says.
“We are always acquiring new information as time goes on and that may modify how we do things for the better,” says Dr. Di Cecco. “The hope with implementing the HPV test as the primary screening test is it will allow us to more accurately identify those at risk of developing abnormalities and therefore, allow us to intervene before they can develop into an actual cancer.”
If you would like more information about cervical screening and the HPV test, please visit see the HPV testing fact sheet from Ontario Health (Cancer Care Ontario).