Health committee  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.

Health committee  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.

Health committee  I think a lot of it has to do with how strong the provincial message has been about cervical cancer. When you have a province has a very strong database, moms are watching themselves getting called to come and get their pap test—“Come for this, come for this, come for this.” If they themselves have then ever had to go for a colposcopy, it's really at the forefront of their brain when they're making decisions about vaccinating their own children.

Health committee  It's actually related to two things. It's not just related to herd immunity, which is obviously beneficial; you're also preventing the other cancers. Men have a high risk for anal cancer and throat cancer. Yes, they don't come until much later in life and are usually things that are now happening in their 60s and 70s, but if you ask any of the ear, nose and throat doctors, the ENTs, they'll say that because smoking has dropped so significantly, they're no longer seeing throat cancers due to smoking causes.

Health committee  If someone has not been vaccinated as a child, then once they're past the age of 18, they will incur those costs themselves in most of our provinces. There are some provinces that will help to cover the vaccination for people who have already been diagnosed with a lesion. That's a little bit of a backstep—just because they have been diagnosed with a lesion, you don't want them to miss the boat.

Health committee  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.

Health committee  That's a very good question. Under the CPAC there is a very distinct guide and layout on Canadian goals on how to eliminate cervical cancer and meet our World Health Organization goals. Currently, if you go through year by year, you see we've fallen behind on those goals that were laid out in that very distinct and quite comprehensive document because this was first created as COVID struck.

Health committee  That is related to the cervix cancer issues. When you look at the numbers pre-2015, you'll see that our cervical cancer rate was actually dropping very nicely. It was going down right on track and in the way that we were expecting it. If you look at the projected numbers that were going out from the previous cancer report, you'll see that they were expecting it to continue to drop.

Health committee  That is obviously a very huge challenge. Currently it obviously falls under each province's responsibility to create its own program. The big issue, again, with it being just provincial is that people move. When someone crosses a provincial border, it's a little bit like starting all over again in terms of their medical health.

Health committee  That's definitely a challenge. We are currently vaccinating the majority of children across the province with something called Gardasil 9, which protects against nine types of HPV. They get two vaccinations six months apart. When someone is outside of that young children's program, then yes, the cost falls upon the individual.

Health committee  Some of the groups that we are bringing to the table are the family medicine practitioner national societies so that they can help distribute the information to their bodies as well. Obviously, these physicians have to go through continuous medical education. We all do. It's a requirement as part of our practice.

Health committee  In terms of salpingectomies, Dr. McAlpine, did they actually come out with a statement directly on that?

Health committee  I absolutely think so. That's actually one of my desired mandates when I take over as president of GOC. I want to get all the partners at the table to talk about how to bring HPV self-testing to this entire country. As you mentioned, it really requires a strong provincial program of database collection, and again British Columbia has among the strongest programs in the country.

Health committee  I think the thing that also disturbed me the most when that data came out is that the data collection ends at 2019, and we all know what happened in 2020 and the years thereafter. If we thought there was a problem with screening going up to 2019—because I think the majority of the issue was probably that women were not getting screened or were being screened late—we're going to have a major uptick, I think, once we get the 2020 to 2024 data, because the screening dropped off drastically.

Health committee  That's one of the things we've debated in discussing how to a create a program and whether you create an opt-in program or an opt-out program. As you can imagine, an opt-out program would be incredibly expensive. That would involve mailing a self-testing kit to every person who was available and then seeing who mailed it back.