Evidence of meeting #101 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was women.
A video is available from Parliament.
5:45 p.m.
Liberal
5:45 p.m.
Conservative
Stephen Ellis Conservative Cumberland—Colchester, NS
Thank you very much, Chair.
I don't think I'm belabouring this point, but I do believe that this novel screening program is the future and is where we need to go. I think we need to be clear to Canadians about a couple of things.
One is those routine immunizations. They need to get them. We're falling behind on everything. I think that's incredibly important. These are well-proven immunizations, and they work. I think that's one important point.
The second point is this: What would the best program look like? Perhaps you could walk us through the steps. You do self-screening. I assume you do a swab at home. You send it in. Then what? If it's positive, do you end up going directly to colposcopy? Do you have a Pap test after that? Perhaps you could give us a very brief outline.
5:45 p.m.
President-Elect, The Society of Gynecologic Oncology of Canada
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.
5:45 p.m.
Conservative
Stephen Ellis Conservative Cumberland—Colchester, NS
Great. Thank you very much.
I do apologize, but there is one thing that I would like. Hopefully, we can take of it very simply. It's seeking the unanimous consent, Chair, of the committee for this motion:
That, given the recent situation in Belleville, Ontario, which had to declare a state of emergency after responding to 23 overdose incidents in the span of less than two days, the committee call the mayor of Belleville, Neil Ellis; the Belleville chief of police, Mike Callaghan; and other experts to appear before the committee at the earliest convenience, no later than Friday, February 23, 2024, and express its concern to the House.
Again, I apologize for that, but it needed to be said. It's an urgent situation.
Thank you all.
5:45 p.m.
Conservative
5:50 p.m.
Liberal
5:50 p.m.
Liberal
The Chair Liberal Sean Casey
Do we have unanimous consent to adopt the motion presented by Dr. Ellis?
We do not.
Dr. Ellis, you still have about a minute and a half.
5:50 p.m.
Conservative
Stephen Ellis Conservative Cumberland—Colchester, NS
Great. Thank you very much.
When we begin to look at systems here, obviously we know that there are incredible ideas that exist. This is something that I think all of us around the table suffer with, which is that the provinces are practising in silos.
Is there anybody around the table who has an idea of how we get this information out? We don't have a lot of leverage here at the federal level, but how do we encourage provinces to say, “Let's work together on this and let's make it happen.”?
I'd be happy to hear those ideas, because there's a significant difficulty.
Don't everybody raise their hand at once. I get that.
5:50 p.m.
President-Elect, The Society of Gynecologic Oncology of Canada
I think it's a matter of knowing the champions in each province.
I collect names. I know people. It's a big part of what I do. It's making sure I know who the champion is in each of the provinces to reach out to because they know the issues in their province and they can bring them forward to the table.
That is how you have to break down silos.
5:50 p.m.
Conservative
5:50 p.m.
Liberal
The Chair Liberal Sean Casey
Thank you, Dr. Ellis.
The last round of questions for this panel will be posed by Dr. Powlowski for the next five minutes.
5:50 p.m.
Liberal
Marcus Powlowski Liberal Thunder Bay—Rainy River, ON
Why don't we start with Dr. Salvador, who didn't really have a chance to address this question on ovarian cancer and salpingectomies. Should the Canadian Task Force on Preventive Health Care make a recommendation with respect to this? How much would this help to address the fact that people aren't doing them as much as perhaps they ought to be?
5:50 p.m.
President-Elect, The Society of Gynecologic Oncology of Canada
I think it would absolutely be useful.
Our society of obstetricians and gynecologists, as well as the societies in the United States and most of the societies in Europe, have all come forward to make statements saying that we should be doing this, so having the Canadian task force also come forward would be useful.
5:50 p.m.
Liberal
Marcus Powlowski Liberal Thunder Bay—Rainy River, ON
Just for the record, Dr. Hanley and Dr. McAlpine, since this would go into our recommendations, do you recommend the same thing?
5:50 p.m.
Associate Professor, Department of Obstetrics and Gynaecology, University of British Columbia, As an Individual
Yes.
5:50 p.m.
Professor and Division Head, Division of Gynecologic Oncology, University of British Columbia, As an Individual
Yes.
5:50 p.m.
Liberal
Marcus Powlowski Liberal Thunder Bay—Rainy River, ON
Thank you.
I want to switch over to cervical cancer and our backsliding on this issue. Believe it or not, I hate to actually get into the politics of it, but why are we seeing decreased vaccination rates?
Maybe I'll just limit it to you, Dr. Salvador, since you're kind of the generic expert on it and the lead with the Canadian gynecological cancer association.