Long waits expected for Pap test results in B.C.

It took just a few minutes for Jennifer Strangeway to get her Pap test done in July. 

But it took six months to get the results — and they weren't good.

"I've got abnormal cervical cells," said the Vancouver woman, who has now been waiting a month for more test results.

Strangeway is one of many B.C. women facing the stress of long waits — in some cases six months or longer — for results of their Pap tests, which screen for cervical cancer.

Pap tests, also known as Pap smears, are cervical screening tests done in the vaginal area to test for cancerous or abnormal cells. B.C. Cancer recommends people with a cervix between the ages of 25 and 69 should book a test once every three years.

Abnormal cervical cells can potentially signal the onset of human papillomavirus (HPV), a common virus spread through sex, serious forms of which can lead to cervical cancer.

According to B.C. Cancer, the return to in-person health care resulted in a backlog of 110,000 screening samples. 

It says typically 20,000 tests are processed in four weeks, and that these standards are not anticipated to return until the end of March. 

There is a current backlog of 60,000 tests waiting to be processed, B.C. Cancer said. 

Pandemic backlog

Lily Proctor, medical director for B.C. Cancer's cervical cancer screening program, said the backlog is from a shortage of trained lab technologists and the return to in-person health care since the start of the pandemic. 

"The people who weren't able to see their primary care physicians for the Pap smear in 2020 all went in 2021 and that caused an increase in volume," she said. 

Proctor says results are delayed up to 140 days, despite women, like Strangeway, saying they've waited much longer.

"I'm shocked it's taking over six months ... a lot can happen in those months," said Strangeway. 

Iris Gorfinkel, an Ontario family doctor, said the wait for test results is hard on patients.

"There's tremendous anxiety," she said. "It does cause women to be worried about what's going on in [their] bodies in the meantime."

Gorfinkel added patients shouldn't worry about developing cervical cancer while waiting for results. 

Cervical cancer "is a very, very slow-growing disease," she said, adding that abnormalities are monitored over time. 

Series of solutions

Proctor said B.C. Cancer is working on dealing with the delays and, in the short-term, doctors have been asked to triage Pap smears.

"So if there's anything abnormal, if there's anything they're worried about, they just have to mark on their requisition that it's urgent," Proctor said, adding those tests would be put to the front of the line. 

People experiencing symptoms like abnormal bleeding, pelvic pain or changes in discharge should consult a specialized gynecologist for a diagnostic test, she said, noting that Pap tests are recommended for asymptomatic patients.

B.C. Cancer has been introducing a new liquid-based test, which "can be processed faster than conventional Pap tests."

It's currently being used in 86 per cent of the province, with full conversion expected in two to three months, according to Proctor. 

As a mitigation strategy to handle the ongoing surge in Pap tests, the new tests are being processed by a third party supplier while B.C. labs clear the backlog in results, B.C. Cancer said in a statement.

Gorfinkel said the current system is not efficient enough and that cervical cancer screening should be done at home by patients themselves.

"The overarching goal is getting [all these tests] out of the family doctor's office," she said, adding this will allow doctors to focus on patients with a history of HPV. 

B.C. Cancer has been running an at-home pilot project since December 2021 with 67,000 subjects.