Absolutely.
For HPV testing, we are currently going to be recommending that women get swabbed once every five years by whatever method that they do it. That's different from Pap testing. That has to be more frequent at that point in time.
If someone has a negative result, great: The next time they need to get swabbed is in five years. If someone has a positive, we do the subtyping on it. If it's one of the higher-risk subtypes, the 16 and 18, which are the high-risk subtypes, then those patients go directly to colposcopy.
If you had a national program that was reviewing these results, you could offer the patient the ability, if they wanted, to discuss it with a local health care professional, who would have to be employed by the province, and they could get that done if they have done self-testing. They could even be offered a virtual consult about that. They wouldn't necessarily have to physically come in; they could be offered a virtual consult. As we have seen with COVID, we managed quite nicely with a lot of virtual consults.
They could be given the information, and then they could be directed to the nearest colposcopy centre, which could, again, just be handled through a paper means of getting the consult, and they could be seen in colposcopy and then dealt with via the guidelines on what we recommend.
If it's someone who has one of the other subtypes that can be high risk, at that point in time we do offer reflex Pap testing to see if there's any development of a lesion.
If someone has had the HPV test in a clinician's office, it's often liquid-based, which means they can automatically do that cytology, the Pap test, on the liquid. It does not require someone to come in. However, if someone is self-testing at home, that is actually a dry swab. It is a different type of swab. They would then be required to come in for a visit.
Each of those things needs to be addressed in whatever area you are setting this up to make sure that all of those different components are covered.