Eliminating cervical cancer in Canada

Cervical cancer rates in Canada

Key takeaways

  • In recent years, cervical cancer incidence has increased in Canada and was cited as the fastest increasing cancer among females.1
  • An estimated 1,550 people in Canada were diagnosed with cervical cancer and 400 people died from it in 2023.1
  • Canada’s cervical cancer incidence and mortality rates are comparable to those in other high-income countries including the United States, United Kingdom, France and Germany, but lag behind several others such as Australia, New Zealand, Italy and Switzerland.2
  • Cervical cancer elimination is defined as reaching and maintaining fewer than four cervical cancer cases per 100,000 women.3
  • There were 8.3 cervical cancer cases per 100,000 females in 2018.1 With intensified efforts, Canada can achieve the goal to eliminate cervical cancer by 2040.
  • Cervical cancer cases per 100,000 females ranged from 6.4 in Nova Scotia to 10.1 in Manitoba in 2020.4
  • Cervical cancer incidence rates are higher among equity-denied communities including those in lower-income neighbourhoods and rural locations.4

Age-standardized incidence rate (per 100,000) for cervical cancer, Canada†, 1994 to 2018

Legend

● Actual ● Elimination threshold

† Based on trends in age-standardized incidence rates per 100,000 for cervical cancer (females only) from 1994 to 2018, Canada.
Data table and footnotes

Age-standardized incidence rate (per 100,000) for cervical cancer, by jurisdiction†, 2020

Legend 
● Elimination threshold
†Data for Canada includes all provinces/territories. Quebec 2020 data was carried forward from 2017 data, Nova Scotia 2020 data was carried forward from 2018 data. Cervical cancer cases in Northwest Territories, Yukon and Nunavut were suppressed due to small numbers.
Data table and footnotes

Age-standardized incidence rate (per 100,000) for cervical cancer, by neighbourhood income quintile and residence location, Canada†, 2016 to 2018 combined

Legend
● Elimination threshold
†Data for Canada includes all provinces/territories except Quebec.
Data table and footnotes

The importance of accelerating cervical cancer elimination

Women and individuals with a cervix between the ages of 30 and 50 carry the greatest burden of the disease.4 This is an age range that includes many people who are significant social and economic contributors to society while also fulfilling caregiving roles.

Cervical cancer rates are especially high among people living in rural or remote areas and people with low income.4 Despite limited data in Canada, rates are also likely to be higher among 2SLGBTQIA+ individuals and people of certain races or ethnicities, such as women who identify as a visible minority, Indigenous or Black.5,6,7,8,9,10

These differences are often due to structural and systemic factors, including racism and discrimination in the health system, which create barriers to accessing vaccination, screening and care. People who hold multiple intersecting equity-denied social identities—including identities related to race, class, age, gender, sexuality, disability, immigration status, religion or language—may experience complex and unique incremental barriers to access. Addressing these inequities is critical.

Data doesn’t tell the whole story

In Canada, there is very limited data to describe how race and ethnicity affect risk for cervical cancer. Data for specific populations, including First Nations, Inuit and Métis, is limited to single studies.6,7,8,9,10

By contrast, the United States systematically collects data on cervical cancer incidence and mortality by race and ethnicity. Its data reveals that Hispanic, Indigenous and Black women have significantly higher rates of new cervical cancer cases than women of other races or ethnicities.11 It is likely that similar trends exist in Canada.

The safe collection and use of data on race, education, geographic location and other social determinants of health, as well as information based on other ways of knowing, are needed to identify the populations most affected by cervical cancer in Canada and inform efforts to close health equity gaps.

In addition, the need for Peoples-specific and self-governed data is recognized by First Nations, Inuit and Métis partners as a priority in the Canadian Strategy for Cancer Control and the Action Plan for the Elimination of Cervical Cancer in Canada, 2020–2030 (Action Plan). The pan-Canadian Cancer Data Strategy guides efforts to enhance the collection, integration and use of cancer data including race, ethnicity and Indigenous identity data. It also highlights First Nations, Inuit and Métis-led efforts to advance data and data governance, such as the First Nations Data Governance Strategy.

Hear from Dr. Gina Ogilvie, Canada Research Chair in Global Control of HPV-related Diseases and Prevention, and Dr. Onye Nnorom, Public Health and Preventive Medicine Specialist (Black Health focus), on the importance of population-specific data:

First Nations-, Inuit- and Métis-governed research and data systems 

The Action Plan calls for enhanced measurement and standardized reporting to identify disparities and provide actionable insights for program improvement, including the prioritization of First Nations-, Inuit- and Métis-governed research and data systems. With access to Peoples-specific data and knowledge about HPV vaccination, more culturally safe and appropriate vaccination programs can be delivered.12

Getting to elimination by 2040 

OncoSim modelling shows that Canada can eliminate cervical cancer by 2040 through intensified efforts to bolster HPV vaccination programs within and beyond school-based programs and by transitioning to HPV primary screening as soon as possible. 

Projected age-standardized incidence rate (per 100,000) for cervical cancer by intervention type, 2018 to 2051

Legend
● 50% of people in universal school-based vaccination programs vaccinated from 2026 onwards + implementation of HPV primary screening from 2025 onwards*
● 70% of people in universal school-based vaccination programs vaccinated from 2026 onwards + implementation of HPV primary screening from 2025 onwards*
● 90% of people in universal school-based vaccination programs vaccinated from 2026 onwards + 90% of people outside school-based vaccination programs vaccinated up to age 45 by 2025 + implementation of HPV primary screening from 2025 onwards*
● Elimination threshold
*Increasing HPV vaccination must be combined with the implementation of HPV primary screening and improved follow-up of screening results to eliminate cervical cancer.
Data table and footnotes

  1. Canadian Cancer Statistics Advisory Committee, Canadian Cancer Society, Statistics Canada, Public Health Agency of Canada. Canadian cancer statistics 2023 [Internet]. Canadian Cancer Society: 2023 [cited 2024 Feb 6]. Available from: https://cancer.ca/Canadian-Cancer-Statistics-2023-EN.
  2. International Agency for Research on Cancer. Global cancer observatory [Internet]. Geneva: International Agency for Research on Cancer; 2022 [cited 2024 Mar 22]. Available from: https://gco.iarc.fr/en.
  3. World Health Organization. Cervical cancer elimination initiative [Internet]. Geneva: World Health Organization; 2022 [cited 2024 Mar 8]. Available from: https://www.who.int/initiatives/cervical-cancer-elimination-initiative
  4. Statistics Canada. Canadian cancer registry. 2023 [Internet]. Ottawa, ON: Statistics Canada; 2018 [cited 2024 Jan 12]. Available from: https://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=3207.
  5. Comeau D, Johnson C, Bouhamdani Review of current 2SLGBTQIA+ inequities in the Canadian health care system. Front Public Health. 2023 Jul 18;11:1183284. doi: 10.3389/fpubh.2023.
  6. Mazereeuw MV, Withrow DR, Nishri ED, Tjepkema M, Marrett LD. Cancer incidence among First Nations adults in Canada: follow-up of the 1991 Census Mortality Cohort (1992-2009). Can J Public Health. 2018 Dec;109(5-6):700-709. doi: 10.17269/s41997-018-0091-0.
  7. Mazereeuw MV, Withrow DR, Nishri ED, Tjepkema M, Marrett Cancer incidence and survival among Metis adults in Canada: results from the Canadian census follow-up cohort (1992-2009). CMAJ. 2018;190(11):e320-e6.
  8. Inuit Tapiriit Kanatami. Inuit and cancer fact sheets [Internet]. Ottawa, ON: Inuit Tapiriit Kanatami; 2012 [cited 2024 Mar 8]. Available from: https://www.itk.ca/inuit-cancer-fact-sheets.
  9. Simkin J, Smith L, van Niekerk D, Caird H, Dearden T, van der Hoek K, et al. Sociodemographic characteristics of women with invasive cervical cancer in British Columbia, 2004-2013: a descriptive study. CMAJ Open. 2021 Apr 22;9(2):E424-E432. doi: 10.9778/cmajo.20200139. 
  10. Ezefie DA, Padmore G, Vaska M, Truong TH. Ensuring equitable access to cancer care for Black patients in Canada. CMAJ. 2022 Oct 24;194(41):E1416-E1419. doi: 1503/cmaj.212076.
  11. U.S. Cancer Statistics Working Group. U.S. cancer statistics data visualizations tool, based on 2022 submission data (1999-2020) [Internet]. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Cancer Institute: 2023 [cited 2024 Feb 6]. Available from: https://gis.cdc.gov/Cancer/USCS/?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcancer%2Fdataviz%2Findex.htm%22%20%5Cl%20%22/AtAGlance/#/AtAGlance.
  12. MacDonald SE, Kenzie L, Letendre A, Bill L, Shea-Budgell M, Henderson R, et al. Barriers and supports for uptake of human papillomavirus vaccination in Indigenous people globally: a systematic review. PLOS Global Public Health. 2023;3(1):e
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