Health committee  Cervix cancer has some of the potentially largest impacts on that. Most women who are diagnosed with a cervix cancer are usually between the ages of 45 to 55. These women are in the prime of their lives. They're also launching their children, highlighting their careers and trying to take care of older family members, and then they are struck down by what can be quite a devastating cancer.

Health committee  That would be me.

Health committee  Actually, no. The nice thing about a salpingectomy—Dr. McAlpine can definitely speak to this, as well, as they did large educational programs on it—is it's actually a fairly easy thing to add to a surgery that's being done anywhere near the pelvis. That's why they're branching out in their colorectal and general surgery teams, because if you're there to take out an appendix, it's a pretty easy thing to also pop out a couple of Fallopian tubes while you're down there.

Health committee  I would definitely agree with Dr. McAlpine.

Health committee  Thank you. I think the issue is that other countries might have more equal access across their entire country, whereas Canada has disparities, depending on where you are. We're quite ahead in some locations and maybe not so much in others, based on where you might be.

Health committee  When it comes to training gynecologic oncologists, quite frankly, we are an incredibly tight community. There are not many of us in Canada. I don't think people quite understand. We're talking about 250 gynecologic oncologists serving the entire population of Canada. We're training probably about anywhere from five to 10 per year.

Health committee  I think the most important thing you can do is ensure that you're educated about your own health and what's available for you, and also what should be available for you, because sometimes what you don't know is what you should know. What can you do to improve your health? What is up and coming in the world?

Health committee  I can field that question. I actually sat in with a breast cancer group just at the beginning of the year as they were starting to really ramp up their BRCA testing programs. It's becoming much more permissible to get BRCA testing in breast cancer. It actually used to be fairly strict, and now they realize they should really be augmenting who can get tested.

Health committee  What a Pap test looks for are changes that the HPV virus has caused in the cervix, so it looks for an active lesion. What the HPV tests looks for is an active virus, so it can be more specific and sensitive to be able to identify someone who has an active HPV virus. Not only that, but there are different subtypes of HPV.

Health committee  In Canada we are all doing a massive changeover right now. Each province has a plan for rollout. It's supposed to be going on, and I do believe that various provinces are at various stages right now.

Health committee  Absolutely.

Health committee  Most cancer agencies in the individual provinces can run genetic testing within their own cancer agency. What we would really like to see is family physicians being educated and having access and the ability to send them. That would be the best place be able to go to say, “I really need genetic testing.

Health committee  That's actually a very good question. We don't have research trials per se to say whether you actually mount an immune response over the age of 45. I can definitely respond because I'm also the head of colposcopy in my hospital. If a woman comes to me because she has a precancerous lesion due to an HPV virus, whether it be cervix or vulva, I absolutely offer her the HPV vaccine if she would like to receive it, no matter what her age.

Health committee  I think one thing we're experiencing is that as people are becoming more sexually free and with divorce rates being what they are, people are re-entering sexual debut in an older generation. These are women who may not have actually had the vaccine or who had the opportunity to have the vaccine earlier.

Health committee  I think a bit has to do with the culture that may be present in each province and perhaps even the lack of education about HPV at this current time. When I was growing up and HPV was first discovered, and then the vaccinations first came out, there were massive nationwide campaigns.