CervixCheck Information for Healthcare Providers

Provider Resources

Cervical Cancer Screening Learning Module for Healthcare Providers

Colposcopy Services in Manitoba (pdf)

Clinical Practice Change - Implementation of HPV triage for cervical cancer screening (pdf) effective March 14, 2022

HPV Triage: Information for Healthcare Providers (pdf)

Pap Test Procedure: Liquid Based Cytology (LBC) (pdf)

HPV FAQ (pdf)

FAQ (pdf) 

Clinic Resources

Vaccine and Screening Video

Patient Resources:

What you need to know to prevent cervical cancer (pdf)

Cervical cancer screening results(pdf)

HPV: Frequently asked questions – English (pdf)

HPV: Frequently asked questions - French (pdf)

Human Papillomavirus Manitoba Public Health Fact Sheet - English (pdf)

Human Papillomavirus Manitoba Public Health Fact Sheet - French (pdf)

Forms 

Request for Cervical Cancer Screening Histories  (pdf) 

Cervical Cytology Request (pdf)

CervixCheck Provider Number Request (pdf)

Cervical Cancer Screening Clinic Registration

Colposcopy Report  (pdf)

The results from cervical cancer screening are reported by the laboratory to the healthcare provider who collected the sample. The report will include:

• Specimen adequacy (satisfactory or unsatisfactory)
• High-risk human papilloma virus (hrHPV) result, if applicable
• Screening recommendations in alignment with the CervixCheck Screening Guidelines (pdf)
• Educational note

Healthcare providers are responsible for reporting all cervical cancer screening test results to their patients, and managing the required follow-up after an abnormal result. Follow-up can include making a referral to a colposcopy clinic or repeating the Pap test.

Colposcopy Services in Manitoba

Colposcopy has been used for several decades to identify sub-clinical abnormalities of the cervix. The cervix is magnified through a binocular scope with a high intensity light. Colposcopy referrals are required in patients with:

1. a visually abnormal cervix.
2. persistent low-grade results.
3. a high-grade cytology interpretation.
4. a high-risk human papilloma virus (hrHPV) result.
5. persistent unsatisfactory results due to obscuring blood or inflammation.

Abnormalities of the cervix are identified based on:

• Epithelial density (white epithelium)
• Vascular patterns (punctation, etc.)

Using these parameters, an area of abnormality can be identified to direct a tissue biopsy.

If a high-grade lesion is identified involving the cervix, it can be treated in a separate appointment with one of the following methods:

1. Laser surgery (uses an intense, narrow beam of light to remove abnormal cells),
2. LEEP (loop electro surgical excision procedure; an electrical wire loop is inserted into the vagina where abnormal tissue is removed), or
3. Cone biopsy (the removal of a cone-shaped piece of tissue).

Colposcopy referrals should include:

• patient demographic information
• referring provider information
• reason for referral
• lab report for the most recent Pap test indicating colposcopy is needed
• CervixCheck screening history – Complete histories can be obtained from CervixCheck using the Cervical Cancer Screening History Request form (pdf). 

See the Colposcopy Services in Manitoba (pdf) for a list of colposcopists to whom you can refer.

Resources to support result delivery and management:

• CervixCheck Screening Guidelines (pdf)
• Chapter 10 Cervical Cancer Screening Test Results (pdf) from the Cervical Cancer Screening Learning Module for Health Care Providers
• Cervical cancer screening test result brochure*  English/French (pdf) - This resource can be ordered from our resources page. 
• HPV: Frequently asked questions – English (pdf)
• HPV: Frequently asked questions - French (pdf)

People with a cervix, a neo-cervix, or removal of a cervix with a history of high-grade dysplasia, between the ages of 21-69 who have had sexual contact. Sexual contact refers to:

• skin-to-skin genital to oral, genital, or anal, or
• sex with shared sex toys.

A neo-cervix can be created during bottom surgery (vaginoplasty).

For more information, see chapter 3 of the Cervical Cancer Screening Learning Module (pdf).

CervixCheck partners with health care providers across Manitoba to offer increased access to cervical cancer screening. Clinics may offer service by appointment, walk-in, or both, and are encouraged to do so as frequently as their resources allow.

By registering your Cervical Cancer Screening Clinic with CervixCheck, your clinic's cervical cancer screening services will be listed on our website. Your cervical cancer screening clinic helps increase cervical cancer screening access for eligible Manitobans. To view a list of our current partner clinics, click here to access our Pap test clinic map. 

To support your clinic, we have a variety of resources for download/order. To view a complete list of resources, click here. 

Cervical cancer screening clinic posters (editable) - English/French (pdf)

Pap Test Procedure (pdf)

HPV FAQ (pdf)

Cervical cancer screening history request form (pdf)

Cervical cytology request form (pdf)

The following outlines patient characteristics that warrant increased surveillance and provides management recommendations for each of these characteristics.

Recent abnormal Pap test result

Follow up as per the CervixCheck Screening Guidelines “Management of Results”

Previous high-grade cervical pathology result (greater than or equal to HSIL/CIN2/moderate dysplasia)

Screen every year once discharged from colposcopy. Screen annually until client meets the criteria to discontinue as per the CervixCheck Screening Guidelines.

Immunosuppression

Immunosuppression includes individuals with:

• a CD4 count of less than 400 in HIV positive people with a cervix, or
• transplantation with immunosuppressive therapy of more than 3 years.

Screen every year.

All cytological abnormalities (including low grade lesions) should be referred to colposcopy.

Exposure to diethylstilbestrol (DES) in utero

Screen every year with cytology and colposcopy of cervix and vagina.

Previous endometrial or ovarian cancer

Screening can be discontinued following a complete hysterectomy if patient has no history of high-grade cervical histopathology prior to cancer

Previous cervical or vaginal cancer

Continue screening annually for as long as the client is biologically healthy

Resources to support individuals requiring increased cervical cancer screening surveillance:

• Chapter 3  Cervical Cancer Screening Guidelines (pdf)
• CervixCheck Screening Guidelines (pdf)

If you are new to practicing colposcopy in Manitoba, use the form below to register with CervixCheck. 

CervixCheck Colposcopist Registration Form (pdf)

As per the Public Health Act, Cervical Cancer Screening Registry Regulation (31/2009), colposcopy reports must be submitted to CervixCheck CancerCare Manitoba within 30 days of the result of the colposcopy being known.

Colposcopy report form (pdf)

Cervical cytology request form (pdf)

Screening history request form (pdf)

To view past and upcoming education training opportunities, click here.

To be informed of upcoming education opportunities, we invite you to sign-up for our e-news.

CancerCare Manitoba Health Educators are trained professionals in a variety of disciplines including public health, education, and marketing. They provide education to the general public, underserved community groups, and training for community educators, and healthcare providers, about:

• Eligibility criteria for participating in breast, colorectal, or cervical cancer screening.
• How to access the various cancer screening tests.
• The potential benefits and harms of participating in cancer screening.
• Education, health promotion, and recruitment strategies for cancer screening.

Contact us at [email protected] if you have questions about cancer screening, resources, health promotion in your community, or education opportunities.