Women who want an annual Pap test now have to pay for the screening under new rules that took effect Jan. 1.

The Ontario Health Insurance Program (OHIP) previously covered one Papanicolaou (Pap) stain a year, but in an effort to cut costs the province now only covers the cost of a test once every three years.  The change saves the government $1.5 million for 2012/13 and $6.1 million for 2013/14.

The move also aligns provincial and recently updated Cancer Care Ontario guidelines.

Pap tests are used to test women for cervical cancer.

“It makes sure that we are making the best use of the limited health care dollars that we have,” Ontario Medication Association (OMA) president Dr. Doug Weir said.

If women want a Pap test more frequently than every three years, they’ll have to pay for the lab analysis, which costs about $20, Weir said, adding most physicians will likely charge the fee to perform the test.

Women who have had abnormal Pap results, or whose doctors have ordered the exam, do not have to pay for the additional exams.

Cancer Care Ontario updated its recommendations on cervical cancer screening last year. It now says women should start the test at the age of 21 and be screened every three years until the age of 70 if their results are normal.

Stephanie Rose recently moved to Toronto from the United States and said she’s disappointed by the change and didn’t expect she’d ever have to pay out of pocket for the test.

“I really think that’s something we can’t take lightly,” she said. “I think regular Pap smears are really important for general population well-being.”

Kirsten Goodland said her family has a history of cancer, and that the cost would affect her. She works part-time and is a full-time student.

“You should never feel scared to go and test for something that could potentially kill you.”

“This isn’t America.”

The Canadian Cancer Society estimated that 1,350 Canadian women were diagnosed with cervical cancer and 390 died from the disease in 2012,.

Research shows most of the benefit of cervical cancer screening occurs for women in their 40s and older, the point at which most cervical cancer cases are diagnosed.

However, abnormal test results are not uncommon in younger women because the Pap tests pick up lesions caused by infections with the human papillomaviruses (HPV), which can cause cervical cancer.

With files from The Canadian Press