The Leeds, Grenville and Lanark District Health Unit (LGLDHU) says it’s no longer offering Pap smears at its sexual health clinics in order to focus more on services that prevent the spread of sexually transmitted infections (STIs).
The change took effect on Monday, the health unit announced last week.
It comes as some Canadian health providers move away from Pap smears for cervical cancer screening in favour of testing for the human papillomavirus (HPV), which causes the vast majority of cervical cancers.
Ontario currently recommends women age 21 and over get a Pap test every three years if they are or have been sexually active, though the provincial guidelines are in the process of being updated. Guidelines differ in other provinces.
Cervical cells may become abnormal when someone has an HPV infection, according to Cancer Care Ontario, the provincial government’s principal cancer advisor.
LGLDHU Medical Officer of Health Dr. Linna Li said local STI rates are on the rise and the health unit needed to pivot.
“Because of that [rise] and also because of our organizational capacity only being what it is, we are moving away from certain services in order to focus on others,” Li told CBC’s All In A Day on Monday.
Li said the health unit’s sexual health clinics did not provide a huge number of Pap smears, and they were never a part of the health unit’s “core mandate.”
The tests are available elsewhere, such as from primary-care doctors and walk-in clinics, she added.
Ottawa Public Health’s website, for example, does not list Pap tests among its offerings but tells visitors that their family physicians, nurse practitioners, walk-in clinics and university or college health services can provide Pap tests.
‘They’re under strain’
Dr. Lesley Spencer, a family physician focused on women’s health, said she gets a fair number of referrals from walk-in clinics that do not offer Pap tests.
She said she feels for anyone who might not have a family doctor and now has one less option when it comes to getting a Pap smear.
Spencer sympathized with the health unit, too.
“It’s a lot of administration work to have make sure [the tests] are done on a regular basis, follow up on the results and, like everything else in health care, they’re under stress, they’re under strain,” she said.
LGLDHU is primary funded through provincial grants and while it has received an increase in funding, that increase has not kept pace with inflation, Li said.
“What that has led to is a de facto erosion of the resources,” she said.