Starting cervical cancer screening at 25 years of age: the time has come

In 2013, the Canadian Task Force on Preventive Health Care updated its recommendations for cervical cancer screening, which included increasing the age to start screening to 25 years. Six years on, with only 2 provinces updating their guidelines accordingly, it is timely to review the relevance of these recommendations, as incidence of cervical cancer in women under 25 years of age continues to be low and vaccination levels for human papillomavirus (HPV) are relatively high. Indeed, an important consideration in adopting the 2013 task force recommendations is the successful implementation of the 2007 federal HPV vaccination strategy. More than 10 years have passed since the provinces and territories started their respective HPV vaccination programs, and the first cohort of girls who were vaccinated will be 25 years old in 2019. The effect of vaccination is evident from data collected by provincial screening programs for all women screened, regardless of age, including those younger than 21 years of age.