SOMBA K'E/YELLOWKNIFE - Women won't need to undergo as many intrusive Pap smear tests under new guidelines introduced by the Department of Health and Social Services last week.

Dr. Andrew Kotaska, clinical director of obstetrics at Stanton Territorial Hospital, authored new cervical cancer screening recommendations for the Department of Health and Social Services. - Photo courtesy of Dorothy Westerman New cervical cancer guidelines Pap smear screening at a later age; now three years after first intimate sexual contact or age 21, whichever is sooner. Decreased frequency of Pap smear screening for women with three consecutive normal tests – to every two years instead of annually. Simpler follow-up of low-grade Pap smear abnormalities: a. Fewer colposcopies (the diagnostic examination to confirm or refute abnormal Pap smears), and In certain specific circumstances, testing for human papillomavirus (HPV) instead of colposcopy or repeat Pap smears. No need for Pap smears after age 69 if prior Pap history has been normal. No need for Pap smears after total hysterectomy (with the cervix removed, but not necessarily ovaries) if prior Pap smear history has been normal.

"The new guidelines (were) written to help women avoid unnecessary Pap smears and unnecessary colposcopy examinations," said Dr. Andrew Kotaska, clinical director of obstetrics at Stanton Territorial Hospital and the author of the new guidelines.

"This will lessen the inconvenience to (women) and the cost to the health care system."

He said cervical cancer, caused by certain strains of the human papillomavirus (HPV), grows at a slow rate and thus, does not needed to be tested at the rate it has been occurring at in the NWT.

Since the introduction of Pap smear screening in Canada in the 1960s, the occurrence of cervical cancer has decreased by 80 per cent. The NWT has the highest Pap smear coverage rate in Canada.

According to the new guidelines, women should start cervical cancer screening at the age of 21, or three years after their first sexual contact.

Prior to this, women were recommended to have their first screening at the age they first became sexually active.

The guidelines also call for Pap smears to be conducted only once every two years instead of every year, providing the patient hasn't been experiencing any abnormalities.

According to Kotaska, there were approximately 26,000 Pap smears conducted in the NWT and Nunavut last year.

"If the guidelines are followed closely, I would expect a reduction of up to half the overall volume of Pap smears," said Kotaska.

"Mostly because women with normal Paps will only need to go every two years instead of annually.

"I spend a significant amount of my time performing colposcopy, which is inconvenient and uncomfortable for women."

A colposcopy is a medical diagnostic procedure to examine the cervix and the tissues of the vagina and vulva to detect precancerous lesions.

"HPV is the main risk factor for developing cervical cancer and it can be spread through any sexual activity," said Kotaska.

The virus is a sexually-transmitted infection and can cause cancer of the cervix, abnormal cervical cells, abnormal vulva cells and genital warts.

Schools in Yk Education District No. 1 will be starting a HPV vaccination campaign this spring for any students who missed it in the fall.

The vaccine is being offered to girls in Grade 4, 5 or 6 with a catch-up program to be implemented at Sir John Franklin High School over a five-year period. Kotaska recommends parents ensure their daughters are vaccinated with the HPV vaccine before they become sexually active.

"The vaccine is safe and prevents both abnormal Pap smears and cervical cancer," he said.

Kotaska said Yellowknife has one of the poorest participation rates in Canada for the vaccine due to the refusal of the Yellowknife Catholic school district to inoculate its students for HPV.

The Yellowknife Catholic school board voted against offering the vaccine to its students last September. Board trustees stated they did not trust the vaccine (Gardasil) had been properly tested before it was released to the public.