{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:07:28Z","timestamp":1792523248955,"version":"4.5.0"},"reference-count":42,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>This white paper, prepared by a consortium of Canadian national and provincial organizations and experts, outlines urgent strategies to curb the rising incidence of HPV-related cancers, of which, cervical cancer is currently the fastest-growing cancer in Canada. Despite school-based vaccination programs, the national HPV vaccine uptake remains suboptimal at about 64%, far below the 90% coverage target by 2025 necessary to eliminate cervical cancer by 2040. The report emphasizes a multi-pronged approach: support access to HPV vaccination with expanded funding policies and education around school-based programs while addressing inequities in underserved populations. HPV testing is highlighted as the preferred method for cervical cancer screening, offering higher sensitivity than Pap smears. Self-collection is presented as an innovative strategy to reduce barriers, particularly for marginalized groups, with promising evidence from Canadian pilots and international models. Crucially, we call for investment in comprehensive, population-based databases to track vaccination, screening participation, and follow-up care. Robust registries would allow targeted outreach to under- or never-screened individuals, ensure timely follow-up of abnormal results, and measure the impact of prevention programs across Canada. With vaccination, equitable access to HPV testing, integration of self-collection, and strong data systems, Canada can achieve its goal of eliminating cervical cancer within two decades.<\/jats:p>","DOI":"10.3390\/curroncol32110594","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T01:35:11Z","timestamp":1761269711000},"page":"594","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["HPV Testing, Self-Collection, and Vaccination: A Comprehensive Approach to Cervical Cancer Prevention"],"prefix":"10.3390","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8061-375X","authenticated-orcid":false,"given":"Shannon","family":"Salvador","sequence":"first","affiliation":[{"name":"Jewish General Hospital, McGill University, Montreal, QC H3T 1E2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"ref_1","unstructured":"Canadian Cancer Statistics Advisory Committee, Canadian Cancer Society, Statistics Canada, Public Health Agency of Canada (2025, April 18). Canadian Cancer Statistics 2023. Available online: https:\/\/cancer.ca\/Canadian-Cancer-Statistics-2023-EN."},{"key":"ref_2","unstructured":"CDC (2025, April 18). Cancers Caused by HPV. Human Papillomavirus (HPV), Available online: https:\/\/www.cdc.gov\/hpv\/about\/cancers-caused-by-hpv.html."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"E419","DOI":"10.1503\/cmaj.109-5347","article-title":"Mouth and throat cancers from HPV on rise in men","volume":"188","author":"Collier","year":"2016","journal-title":"Can. Med. Assoc. J."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Maldonado, I., Plata, M., Gonzalez, M., Correa, A., Nossa, C., Giuliano, A.R., Joura, E.A., Ferenczy, A., Ronnett, B.M., and Stoler, M.H. (2022). Effectiveness, immunogenicity, and safety of the quadrivalent HPV vaccine in women and men aged 27\u201345 years. Hum. Vaccines Immunother., 18.","DOI":"10.1080\/21645515.2022.2078626"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Saraiya, M., Unger, E.R., Thompson, T.D., Lynch, C.F., Hernandez, B.Y., Lyu, C.W., Steinau, M., Watson, M., Wilkinson, E.J., and Hopenhayn, C. (2015). US assessment of HPV types in cancers: Implications for current and 9-valent HPV vaccines. J. Natl. Cancer Inst., 107.","DOI":"10.1093\/jnci\/djv086"},{"key":"ref_6","unstructured":"Canadian Partnership Against Cancer (2019). Action Plan for the Elimination of Cervical Cancer in Canada 2020\u20132030, Canadian Partnership Against Cancer."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/978-981-10-5765-6_3","article-title":"Human Papillomavirus-Related Cancers","volume":"1018","author":"Li","year":"2017","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_8","unstructured":"Government of Canada, Public Health Agency (2025, April 19). Updated Recommendations on Human Papillomavirus Vaccines. Available online: https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/vaccines-immunization\/national-advisory-committee-immunization-updated-recommendations-hpv-vaccines.html."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1080\/21645515.2018.1564440","article-title":"Challenges and opportunities of school-based HPV vaccination in Canada","volume":"15","author":"Gagnon","year":"2019","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Sharma, S., Chauhan, D., Kumar, S., and Kumar, R. (2024). Impact of HPV strains on molecular mechanisms of cervix cancer. Microb. Pathog., 186.","DOI":"10.1016\/j.micpath.2023.106465"},{"key":"ref_11","unstructured":"Government of Canada, Public Health Agency (2025, April 19). Human Papillomavirus (HPV) Vaccines: Canadian Immunization Guide. Available online: https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/healthy-living\/canadian-immunization-guide-part-4-active-vaccines\/page-9-human-papillomavirus-vaccine.html."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1503\/cmaj.150451","article-title":"Including males in Canadian human papillomavirus vaccination programs: A policy analysis","volume":"188","author":"Shapiro","year":"2016","journal-title":"Can. Med. Assoc. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"672","DOI":"10.17772\/gp\/1790","article-title":"Vertical transmission of HPV in pregnancy. A prospective clinical study of HPV-positive pregnant women","volume":"85","author":"Jach","year":"2014","journal-title":"Ginekol. Pol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Petca, A., Borislavschi, A., Zvanca, M.E., Petca, R.-C., Sandru, F., and Dumitrascu, M.C. (2020). Non-sexual HPV transmission and role of vaccination for a better future (Review). Exp. Ther. Med., 20.","DOI":"10.3892\/etm.2020.9316"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"E416","DOI":"10.1503\/cmaj.1095398","article-title":"HPV not just a young woman\u2019s problem","volume":"189","author":"Vogel","year":"2017","journal-title":"Can. Med. Assoc. J."},{"key":"ref_16","unstructured":"Canadian Partnership Against Cancer Data Tables for the Eliminating Cervical Cancer in Canada Digital Report, Canadian Partnership Against Cancer. Available online: https:\/\/www.partnershipagainstcancer.ca\/ecc-data\/."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"5850","DOI":"10.3390\/curroncol31100435","article-title":"Progress and Challenges in Canada\u2019s Path Toward the Elimination of Cervical Cancer","volume":"31","author":"Perez","year":"2024","journal-title":"Curr. Oncol."},{"key":"ref_18","unstructured":"Canadian Partnership Against Cancer (2022). HPV Vaccine Access in Canada, 2022, Canadian Partnership Against Cancer. Available online: https:\/\/www.partnershipagainstcancer.ca\/topics\/hpv-vaccine-access-2022\/."},{"key":"ref_19","unstructured":"Government of Canada, Public Health Agency (2025, April 19). Adult National Immunization Coverage Survey (aNICS): 2023 Results. Available online: https:\/\/www.canada.ca\/en\/public-health\/services\/immunization-vaccines\/vaccination-coverage\/adult-national-immunization-coverage-survey-2023-results.html."},{"key":"ref_20","unstructured":"Government of Canada, Public Health Agency (2025, April 28). Provincial and Territorial Routine and Catch-Up Vaccination Schedule for Infants and Children in Canada. Available online: https:\/\/www.canada.ca\/en\/public-health\/services\/provincial-territorial-immunization-information\/provincial-territorial-routine-vaccination-programs-infants-children.html."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(19)30298-3","article-title":"HPV Vaccination Impact Study Group. Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes: Updated systematic review and meta-analysis","volume":"394","author":"Drolet","year":"2019","journal-title":"Lancet"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1002\/ijc.33513","article-title":"Declining rates of cervical intraepithelial neoplasia in British Columbia, Canada: An ecological analysis on the effects of the school-based human papillomavirus vaccination program","volume":"149","author":"Donken","year":"2021","journal-title":"Int. J. Cancer"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2084","DOI":"10.1016\/S0140-6736(21)02178-4","article-title":"The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: A register-based observational study","volume":"398","author":"Falcaro","year":"2021","journal-title":"Lancet"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1056\/NEJMoa1917338","article-title":"HPV Vaccination and the Risk of Invasive Cervical Cancer","volume":"383","author":"Lei","year":"2020","journal-title":"N. Eng. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"419","DOI":"10.14745\/ccdr.v50i12da01","article-title":"Summary of the National Advisory Committee on Immunization (NACI) Statement: Updated guidance on human papillomavirus (HPV) vaccines","volume":"50","author":"Forbes","year":"2024","journal-title":"Can. Commun. Dis. Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"E1136","DOI":"10.1503\/cmaj.240787","article-title":"Switching from a 2-dose to a 1-dose program of gender-neutral routine vaccination against human papillomavirus in Canada: A mathematical modelling analysis","volume":"196","author":"Drolet","year":"2024","journal-title":"Can. Med. Assoc. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"700","DOI":"10.17269\/s41997-018-0091-0","article-title":"Cancer incidence among First Nations adults in Canada: Follow-up of the 1991 Census Mortality Cohort (1992\u20132009)","volume":"109","author":"Mazereeuw","year":"2018","journal-title":"Can. J. Public Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"E320","DOI":"10.1503\/cmaj.170272","article-title":"Cancer incidence and survival among M\u00e9tis adults in Canada: Results from the Canadian census follow-up cohort (1992\u20132009)","volume":"190","author":"Mazereeuw","year":"2018","journal-title":"Can. Med. Assoc. J."},{"key":"ref_29","first-page":"E424","article-title":"Sociodemographic characteristics of women with invasive cervical cancer in British Columbia, 2004\u20132013: A descriptive study","volume":"9","author":"Simkin","year":"2021","journal-title":"Can. Med. Assoc. J. Open."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"E1416","DOI":"10.1503\/cmaj.212076","article-title":"Ensuring equitable access to cancer care for Black patients in Canada","volume":"194","author":"Ezeife","year":"2022","journal-title":"Can. Med. Assoc. J."},{"key":"ref_31","unstructured":"Canadian Cancer Society (2025, April 19). Human Papillomavirus; Canadian Cancer Society. Available online: https:\/\/cancer.ca\/en\/cancer-information\/reduce-your-risk\/get-vaccinated\/human-papillomavirus-hpv."},{"key":"ref_32","unstructured":"Canadian Cancer Society (2025, April 19). Canadian Cancer Statistics: A 2024 Special Report on the Economic Impact of Cancer in Canada; Canadian Cancer Society. 12 December 2024. Available online: https:\/\/cancer.ca\/en\/cancer-information\/resources\/publications\/canadian-cancer-statistics-a-2024-special-report-on-the-economic-impact-of-cancer-in-canada."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Fleider, L.A., Tinnirello, M.d.L.\u00c1., Cherey, F.G., Garc\u00eda, M.G., Cardinal, L.H., Kamermann, F.G., and Tatti, S.A. (2023). High sensitivity and specificity rates of cobas\u00ae HPV test as a primary screening test for cervical intraepithelial lesions in a real-world setting. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0279728"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1001\/jama.2018.7464","article-title":"Effect of Screening With Primary Cervical HPV Testing vs Cytology Testing on High-grade Cervical Intraepithelial Neoplasia at 48 Months: The HPV FOCAL Randomized Clinical Trial","volume":"320","author":"Ogilvie","year":"2018","journal-title":"JAMA"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/ijgo.15600","article-title":"Turning the tide\u2014Recommendations to increase cervical cancer screening among women who are underscreened","volume":"166","author":"Descamps","year":"2024","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_36","first-page":"375","article-title":"Implementation of human papillomavirus primary screening for cervical cancer in BC","volume":"66","author":"Gentile","year":"2024","journal-title":"Br. Columbia Med. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1158\/1055-9965.EPI-14-0998","article-title":"Offering Self-Sampling to Non-Attendees of Organized Primary HPV Screening: When Do Harms Outweigh the Benefits?","volume":"24","author":"Rozemeijer","year":"2015","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Saville, M., Hawkes, D., Keung, M., Ip, E., Silvers, J., Sultana, F., Malloy, M., Velentzis, L., Canfel, K., and Wrede, C. (2020). Analytical performance of HPV assays on vaginal self-collected vs practitioner-collected cervical samples: The SCoPE study. J. Clin. Virol., 127.","DOI":"10.1016\/j.jcv.2020.104375"},{"key":"ref_39","unstructured":"(2025, October 17). Available online: https:\/\/src.healthpei.ca\/cervical-cancer-screening."},{"key":"ref_40","unstructured":"Australian Government, and Department of Health D and A (2025, July 15). Update on Cervical Screening Self-Collection Uptake, Available online: https:\/\/www.health.gov.au\/resources\/publications\/update-on-cervical-screening-self-collection-uptake?language=en."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"7055","DOI":"10.3390\/curroncol30070512","article-title":"Are Canadian Women Prepared for the Transition to Primary HPV Testing in Cervical Screening? A National Survey of Knowledge, Attitudes, and Beliefs","volume":"30","author":"Haward","year":"2023","journal-title":"Curr. Oncol."},{"key":"ref_42","unstructured":"Canadian Partnership Against Cancer Colposcopy services in Canada 2023\u201324, Canadian Partnership Against Cancer. Available online: https:\/\/www.partnershipagainstcancer.ca\/topics\/cervical-screening-canada-2023\u20132024\/colposcopy-services\/."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/11\/594\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T09:13:29Z","timestamp":1761297209000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/11\/594"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,23]]},"references-count":42,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["curroncol32110594"],"URL":"https:\/\/doi.org\/10.3390\/curroncol32110594","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,23]]}}}