It could have changed the course of her life, but instead of looking back with regret, Alicia Hilderley is celebrating a new screening test that can help “change the narrative” when it comes to cervical cancer.
The new test screens directly for HPV, the virus that is the leading cause of cervical cancer. It replaces the long-used Pap test in Ontario as of this month.
Hilderley, who has late-stage cervical cancer, has become an advocate for the new screening tool to help others avoid a similar diagnosis. She is a member of The Ottawa Hospital’s cancer program patient and family advisory council.
“My story doesn’t have to be your story.”
Hilderley, now 37, was diagnosed with Stage 4 cervical cancer months after the birth of her daughter five years ago. Her doctor discovered a tumour on her cervix. A CT scan confirmed the cancer had spread.
“It was quite a shock. It came out of nowhere.”
The diagnosis of incurable cancer was devastating for the new mother who had been undergoing regular Pap tests that had always been normal. She had never had an HPV test, though, and soon learned that she had two strains of HPV linked to cervical cancer.
“If I had had an HPV test, it would have been found.”
HPV is ubiquitous, said Dr. Anna Wilkinson, a family physician and general practitioner-oncologist at The Ottawa Hospital. In most cases, people clear the virus and it is harmless, but a small subset don’t and it can cause cancer over the course of years.
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The new screening tool, which is administered similarly to a Pap test, is significantly more effective at preventing and finding cancers early than the previous test that looked for changes at the cellular level, said Wilkinson.
“It is a better test than the Pap test,” she said, and has the ability to more effectively rule out cancer.
Cervical cancer is essentially preventable. There is now a vaccine, and the new screening test can more effectively catch it before it develops or becomes more severe.
Since the advent of vaccines and better screening tools, some countries are close to eradicating cervical cancer, said Wilkinson. But Canada has a way to go.
As of 2023, it was the fastest-growing cancer in Canadian women.
“We are really falling behind the curve. We should not be seeing rates climbing.”
Wilkinson noted that the controversial Canadian Task Force on Preventative Health Care ruled against HPV screening in 2013 and has not reviewed the guidelines since. Earlier this year, the federal government put the task force’s work on pause while a review is underway.
Despite the task force recommendations, some Canadian provinces adopted the HPV screening test earlier.
Wilkinson said eradicating cervical cancer in Canada is “very doable” between the screening test and the vaccine, which is given to middle school-aged children but can be administered to anyone.
Routine screening is usually done by primary care providers, but people who don’t have one can book an appointment through the Champlain Screening Outreach Program.
Hilderley, meanwhile, has been part of a clinical trial that has helped extend her life. The median life expectancy after a Stage 4 diagnosis of cervical cancer is 16 months, she said. She has also undergone a hysterectomy.
“The only reason I am still alive is because of the clinical trial.”
Still, she said she is doing well and being closely monitored for any progression of the disease. So far, there is no evidence of any.
Although she is normally a private person, Hilderley said she wanted to be an advocate to help people better understand the value of the new test.
“It is incredible that we are at a point with science and health care that no other person with a cervix needs to go through what I went through. This is truly a positive change.”
HPV is responsible for about 99 per cent of cervical cancer cases and a significant proportion of other cancers including vaginal, vulvar, anal, penile and some head and neck cancers.
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