Ontario Cervical Screening Program

• As of March 3, 2025, the HPV test will replace cytology as the primary test for cervical screening and will also be used for follow-up testing in colposcopy.
• The HPV test is more sensitive than cytology and when combined with reflex cytology assessment, will improve detection of cervical pre-cancer. The improved sensitivity of HPV testing allows for longer intervals between screens for people who test negative for HPV. In addition, new guidance for management and follow-up will minimize repeat testing and support timely discharge from colposcopy.

• People are eligible for cervical screening if they:
  - have a cervix*, and
  - are at least 25 years old, and
  - have ever been sexually active, and
  - do not have symptoms suggestive of cervical cancer (such as abnormal vaginal bleeding or discharge, bleeding after sexual activity and pelvic pain).
• Most eligible people should get screened with the HPV test every 5 years. Some eligible people may need to get screened more often based on their medical or screening history.
• Some eligible people may need to get screened more often based on their immune status, screening results history or colposcopy results.
• Most people can stop cervical screening from ages 65 to 69. Some people may get cervical screening tests after age 69 based on their medical history or screening results history.

* Including women, Two-Spirit people, transmasculine people, nonbinary people, pregnant people, post-menopausal people, people who have undergone a subtotal hysterectomy and retained their cervix, and people who have had the HPV vaccine.

• Healthcare providers can order the HPV test for eligible people by completing one of the following requisitions:
  - The HPV and cytology tests requisition - for cervical screening, or
  - The HPV and cytology tests requisition - colposcopy for follow-up of cervical screening-related abnormalities
• The appropriate OCSP requisition must be used for ordering a screening or colposcopy related test.
• HPV testing cannot be ordered using the Ministry of Health and Long Term Care Laboratory Requisition or a hospital laboratory requisition.

To register: If you have not ordered lab tests through Dynacare previously or are unsure if you are in the Dynacare database, call our Customer Care Centre at 800.565.5721 to register for HPV testing. Please provide the following information:

• Physician billing number (must be an Ontario billing number only)
• Indicate whether you are a doctor, nurse practitioner, or midwife
• Last name
• First name
• Full address including – Suite number/Address number/Street/City/Province(ON)/Postal code
• Phone number
• Fax number

Laboratory reports to providers include standard messaging for HPV test results and recommended next steps.

• If the result is HPV positive, it means the test detected a high-risk HPV type.
• HPV positive (types 16, 18/45): Should be referred to colposcopy, even if the reflex cytology test (also known as a Pap test) result is normal.
• HPV positive (other high-risk types): Reflex cytology testing will be performed on the samples automatically by the laboratories. The results of cytology will determine the most appropriate follow up recommendation.
• If the result is HPV negative it means the test did not detect a high risk HPV type and can return to routine screening.
• Invalid results: In a small number of cases, a result may be invalid (meaning that the test didn’t provide a clear negative or positive result or there were not enough cells present in the sample, or the sample was contaminated) and may require a new sample or further follow up.

• For more information on screening with the HPV test, visit ontariohealth.ca/OCSP-recommendations