High-risk B.C. patients waiting months or paying U.S. clinics for cervical cancer test

The BC Cancer Foundation's Vancouver office is seen in this undated image. (BCCancerFoundation.com)

Patients who’ve tested positive for a high-risk strain of HPV are waiting up to nine months for follow-up testing to determine if they have cervical cancer, with some paying $1,100 for the diagnostics at U.S. clinics, CTV News has learned.

The B.C. Cancer Agency’s benchmark is for patients who’ve tested positive for HPV-16 or -18, for example, to see a specialist for a colposcopy within eight weeks, but the medical director of the Cervix Screening Program acknowledged patients are now waiting far longer than they should.

“We don’t want patients waiting six to nine months, and B.C. Cancer is working really hard with health authorities to increase capacity across the province,” said Dr. Emily Proctor, who performs the high-specialized diagnostic exam herself. “It causes me a significant amount of moral distress, causes my patients distress.”

Last year, B.C. became the first province to move from pap smears, which have to be performed in a doctors’ office, to a home-testing kit with a swab that a patient can easily collect and mail to a lab to determine whether they have the human papilloma virus, a precursor to cervical cancer.

Officials expect the current surge in early detection will lead to longer waits for colposcopy screening for up to five years.

Anxious patients left in limbo

B.C. Cancer said half of the screening in the province is now done via the self-screening swab. Some of those who test positive for HPV via the highly-sensitive test are simply notified of the result and told no follow-up is required.

For “high-risk” patients, a letter in the mail notifies them they need the colposcopy exam, but their primary care providers are often surprised to find not only are they unable to get their patient an appointment, there’s no waitlist or even an estimated timeframe for the exam to rule out cervical cancer.

“It’s unacceptable that B.C. would introduce new screening measures without adequate mechanisms to carry them out,” one such patient told CTV News. “It creates anxiety in a patient to be told, ‘Your case is urgent enough to require further action – but we’re not able to schedule you within the recommended timeframe.’”

She was able to book an appointment with a Bellingham medical clinic, but is frustrated to be paying $1,100 out-of-pocket to get the exam within the recommended national guidelines.

CTV News asked the B.C. Cancer Agency if patients would be reimbursed, considering the exceptional delays, but was told they would not.

Cancer agency blames health authorities, system

Provincial health officials had expected an increase in patients needing the microscopic examination and potential biopsy as part of the colposcopy procedure, and Proctor said it was the health authorities’ responsibility to ensure adequate staffing.

Medical journals and the B.C. Cancer Agency had also raised the likelihood of a surge in demand, but a national, system-wide shortage of health professionals isn’t easy to address in the short- to medium-term.

“Although it does feel terrible to have to wait, and I appreciate it, when we’re catching things earlier and better with a new test, it often means that we’re catching them faster and smaller, and that what we do find can be highly treatable,” insisted Proctor, who added that symptomatic patients are seen much faster and that cervical cancer is a slow-moving illness.

When detected in its early stages, cervical cancer can be treated in a gynecologists’ clinic during an hour-long procedure with local anesthetic.

British Columbia is aiming to eradicate cervical cancer with a combination of the HPV screening and a free, voluntary HPV vaccination program for teens and young adults. The sexually transmitted virus is the precursor to a number of cancers below the belt, mouth, and throat,