By Ajit Johal, BSc (Pharm), RPh, MEd, CTH
Clinical Director, Immunize.io Health Association
“This is a moment for B.C. pharmacists to demonstrate leadership, advance provincial and national cancer-care priorities, and contribute to a global movement to end a cancer that should no longer exist.”
Introduction
British Columbia pharmacists have delivered nearly one million highly accessible primary care interventions under the Minor Ailments and Contraception (MACS) program since its launch in June 2023. According to the Pharmacist Prescribing for Minor Ailments and Contraception (PPMAC) Two-Year Report, contraception prescribing ranked among the top six pharmacist-delivered services, tied with uncomplicated UTIs — each representing 20 per cent of all prescribing encounters.
This expanded scope has demonstrated clear public‑health value: improved access to contraception, prevention of unintended pregnancies, and reduced burden on primary care. Yet a recent survey of nearly 3,000 British Columbians showed that for those accessing contraception visits, 75% were unsure whether broader sexual and reproductive health topics were discussed. Only a minority recalled discussion on barrier methods (14%), STI prevention/testing (13%), or cervical cancer screening (11%).
Pharmacists cited two consistent barriers: patients’ urgency and the volume of potential counselling topics. Within this crowded clinical context, a critically important intervention is often missed: cervical cancer prevention.
BC’s Cancer Action Plan: A Provincial Commitment to Eliminate Cervical Cancer
BC’s Cancer Care You Can Count On: BC’s 10‑Year Cancer Action Plan identifies cervical cancer elimination as a core provincial priority and emphasizes two essential strategies: expanded HPV immunization and province‑wide adoption of HPV‑based cervical screening, including at‑home HPV self‑sampling.
What sets British Columbia apart — and places pharmacists at the forefront of elimination — is the alignment of pharmacy scope, provincial infrastructure and accessible prevention tools. Pharmacists in B.C. have access to every key component required for cervical cancer elimination:
- Publicly funded HPV9 vaccine (expanded in July 2025)
- Private‑supply HPV vaccine for patients outside public eligibility
- A Provincial Immunization Registry (PIR) and CareConnect access for reviewing vaccination history and documenting doses
- A province‑wide HPV self‑sampling program that enables accurate, convenient, no‑cost screening
Very few jurisdictions globally have this complete suite of tools — and none have them as integrated into pharmacy practice as British Columbia.
1. B.C.’s Expanded HPV9 Immunization Program (July 31, 2025)
British Columbia expanded its publicly funded HPV9 program as of 31 July 2025. Key eligibility includes:
- All individuals up to 26 years of age (inclusive)
- Individuals 9–45 years with HIV infection (three‑dose series)
- Individuals 27–45 years who self‑identify as GBMSM, including Two‑Spirit, transgender and non‑binary individuals
- Individuals of any age who receive post‑colposcopy treatment for CIN2+
The immunization schedule was simplified to support streamlined delivery across settings. For pharmacists, this expansion makes gap‑identification and vaccine offering much easier during MACS contraception encounters.
2. B.C.’s HPV Self‑Sampling Program
BC Cancer’s Cervix Screening Program allows eligible individuals to order a free HPV self‑screening kit, complete it at home and return it by prepaid mail. HPV self‑screening is available for most people aged 25–69, is highly accurate, and removes many of the barriers associated with traditional Pap screening.
Together, the expanded HPV9 immunization program and self‑sampling initiative establish community pharmacies as central access points for primary and secondary cervical cancer prevention.
Making Every Contraception Encounter Count
Contraception visits often involve patients who may not regularly use primary care services. This makes the pharmacy encounter a uniquely impactful opportunity in the prevention continuum. Yet tools like MedSask contraception templates are long, dense and checklist‑heavy, making cervical cancer prevention messages easy to overlook.
This leads to two predictable outcomes:
- Pharmacists feel pressured to address too many topics
- Patients leave without retaining a single powerful cancer‑prevention message
A streamlined approach allows cervical cancer prevention to fit naturally within the MACS workflow:
- Review HPV vaccination status in CareConnect
- Identify missed or incomplete HPV9 doses; offer vaccination when eligible
- Ask one focused question:
“When was your last cervical cancer screening test (Pap or HPV self‑screening)?” - Refer patients to BC Cancer’s HPV self‑screening program:
https://www.bccancer.bc.ca/screening/cervix
This concise structure transforms contraception services into high‑impact cancer‑prevention interventions — without extending visit time.
Conclusion
Cervical cancer elimination is now a global health priority, recognized through the United Nations’ declaration of Cervical Cancer Elimination Day of Action. British Columbia pharmacists have the tools and authority necessary to accelerate progress.
By incorporating HPV vaccination assessment and HPV self‑sampling referrals into contraception visits — supported by public funding, private supply, centralized registries and universal screening options — pharmacists can close one of the most urgent gaps in women’s health.
This is not only a practical clinical opportunity but a pivotal moment to advance provincial and national cancer‑care objectives and contribute to a global movement to permanently eliminate a preventable cancer.
About the author
Ajit Johal, BSc(Pharm), RPh, MEd, CTH, is a Vancouver‑based pharmacist and Clinical Director of Immunize.io Health Association. He is an active educator and advocate in HPV prevention, delivering training to clinicians and communities locally, nationally and internationally. Ajit has contributed to global platforms, including the International Papillomavirus Society (IPVS), and continues to advance pharmacist‑led vaccination efforts that improve access, reduce inequities and accelerate cervical cancer elimination.