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Cases were classified as screen-detected, inadequately screened, or attributed to healthcare system failure. 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Wilkinson 1, *, Kristin Wright 2, Colleen Savage 3, Dana Pearl 1, Elena Park 4, Wilma Hopman 5,6 and Tara Baetz 7  \nReceived: 8 December 2025  \nRevised: 7 January 2026  \nAccepted: 13 January 2026  \nPublished: 16 January 2026  \nCopyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Family Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada  \n2 Department of Oncology, Queen’s University, Kingston, ON K7L 2V7, Canada; [kristin.wright@kingstonhsc.ca](kristin.wright@kingstonhsc.ca)  \n3 Research Security and Compliance Advisor, Queen’s University, Kingston, ON K7L 2V7, Canada  \n4 Obstetrics and Gynecology, Queen’s University, Kingston, ON K7L 2V7, Canada  \n5 Kingston Health Sciences Centre Research Institute, Kingston, ON K7L 2V7, Canada; [wilma.hopman@kingstonhsc.ca](wilma.hopman@kingstonhsc.ca)  \n6 Department of Public Health Sciences, Queen’s University, Kingston, ON K7L 2V7, Canada  \n7 Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada  \n* Correspondence: [anwilkinson@toh.ca](anwilkinson@toh.ca)  \nSimple Summary  \nCervical cancer is largely preventable, yet rates in Canada continue to rise. This study explores cervical cancer cases that were diagnosed in a two-year period in Eastern Ontario to better understand the factors leading to their development and identify opportunities to improve prevention. Cervical cancers were partitioned into three categories: cancers found through screening, cancers in people who were not adequately screened, and cancers linked to failures in the health care system. Of the 132 cervical cancers diagnosed during this two-year period, only about one in six were detected through screening. Nearly one quarter of the cases were incurable, and more than 13% of individuals died within two and a half years of diagnosis. Over half of the cases occurred in individuals who were inadequately screened. Lack of screening was more common among people living in rural areas, those experiencing social or economic disadvantage, and those without a regular primary care provider. System issues included false-negative Pap tests, loss to follow-up, and misapplication of screening guidelines. Overall, this study shows that gaps in access, follow-up, and screening quality continue to drive preventable cervical cancer in Canada and highlights clear opportunities to improve prevention and care.  \nAbstract  \nCervical cancer is a largely preventable disease, with over 90% of cases caused by persistent infection with human papillomavirus (HPV) . Despite the availability of HPV vaccination and cervical screening, incidence rates in Canada have been rising since 2015, particularly among underserved populations. This study investigates contributing factors behind cervical cancer diagnoses in Eastern Ontario over a two-year period to identify gaps leading to failures in prevention and screening. A retrospective chart review was conducted for cervical cancer cases diagnosed between January 2022 and December 2023 at two regional cancer centres in Eastern Ontario. Cases were categorized as screen-detected, inadequately screened, or system failure, based on prior screening history and care processes. Data was collected on patient, screening, and cancer characteristics. Of 132 cases, 22 (16.7%) were screen-detected, 73 (55.3%) were inadequately screened, and 37 (28.0%) were attributed to healthcare system failure. Later-stage disease was significantly more common in the latter two groups. Thirty-one (23.5%) cases presented with palliative diagnoses, and 18 (13.6%) individuals died within 2.5 years. Inadequate screening was associated with  \nrurality, deprivation, and lack of a primary care provider. Sys","cbCaify7kmcHvioP","https://ap.wps.com/l/cbCaify7kmcHvioP","pdf",352062,"English","# Simple Summary\n## Study objective and context\n## Case classification approach\n## Key findings on detection, stage, and outcomes\n# Abstract\n## Background and prevention framework\n## Methods\n## Results\n## Conclusions and implications","[{\"question\":\"What prevention measures are central to cervical cancer elimination in this study?\",\"answer\":\"The study emphasizes primary prevention through HPV vaccination and secondary prevention through cervical screening and prompt management of precancerous changes.\"},{\"question\":\"How were cervical cancer cases categorized for analysis?\",\"answer\":\"Cases were grouped into screen-detected, inadequately screened, or healthcare system failure categories based on prior screening history and care processes.\"},{\"question\":\"Which factors were most associated with inadequate screening in Eastern Ontario?\",\"answer\":\"Inadequate screening was associated with rurality, deprivation, and lack of a primary care provider.\"}]","Towards Cervical Cancer Elimination - Insights from an In-Depth Regional Review of Patients with Cervical Cancer - Simple summary | PDF",1790134034,25]