Neither country has been able to win two in a row against the other over the last three years. If one wins in the preliminary round at an international competition, the other prevails in the final.
So host Canada's goal at the 2013 women's world hockey championship in Ottawa is to defeat their rival to open the tournament Tuesday and again in a likely meeting between them in the April 9 final.
"The key is to find ways to beat the U.S. two games in a row," head coach Dan Church says.
The International Ice Hockey Federation's women's world championship returns to the city where it was first held in 1990. Canada last hosted the tournament in 2007 in Winnipeg.
Canada and the U.S. have met in all 14 previous finals with Canada winning 10, but the Americans taking three of the last four world titles.
Canada is the defending world champion after beating the U.S. on their home ice in Burlington, Vt., in 2012. Caroline Ouellette of Montreal scored the overtime winner in a 5-4 victory in the final.
But the Canadians also opened last year's world championship with a shocking 9-2 loss to the Americans, which was Canada's most lopsided loss to them ever. At the 2012 Four Nations Cup in Finland, Canada beat the Americans 3-1 in the preliminary round, but fell 3-0 to them in the final.
"The reality is we know the U.S. and us are really evenly matched," Ouellette says. "On any given day, it can go one way or the other. We all have the responsibility to be as good as we can be on that day.
"I don't think we can say anymore that we have more depth or more talent or more speed. They are as good as we are. Last year's final at world championships was one of the fastest, most physical games I've been part of in my career. I do not expect anything less from this year."
Canada's world championship roster is the same as the 2012 lineup except for the return of forward Sarah Vaillancourt of Sherbrooke, Que. The two-time Olympic gold medallist hasn't played for the national team since the 2011 world championship because of injuries.
Shortly after this year's world championship concludes, Church is expected to invite these 23 players plus another five to try out for his 2014 Winter Olympic team. Those players will congregate in Calgary this summer and train full time until the Games in Sochi, Russia.
The IIHF instituted a new world championship format for the women last year with the top four seeds in one pool and the bottom four in the other.
The top two teams in Pool A get byes to the semifinals. The bottom two in A meet the top two from Pool B in the quarter-finals, with those winners advancing to the semifinals.
The bottom two teams in B play to avoid relegation and won't face the best teams in the tournament at all.
While the format alteration allows the U.S. and Canada to meet earlier in the tournament, the change was also done to reduce embarrassing scores.
So Canada and the U.S. are joined by Switzerland, winner of bronze for the first time last year, and Finland. Sweden, Russia, Germany and the Czech Republic are in the second group.
Russia's performance in Burlington exposed a flaw in the new format. The Russians didn't win a single game in the tournament, yet because they were the fourth seed in the first group, they could finish no worse than sixth and avoided the relegation round.
Russia, whose stated goal is to win women's hockey bronze in Sochi, recently named former NHL player Alexei Yashin as their new general manager.
Their star player is Iya Gravrilova, a teammate of Canadian captain Hayley Wickenheiser on the University of Calgary Dinos.
Other international players to watch include U.S. forward Amanda Kessel, a University of Minnesota star named the NCAA's top player this year. She is the sister of Toronto Maple Leafs forward Phil Kessel.
Kessel beat out Minnesota teammate and Finland goaltender Noora Raty for the NCAA award. The Finns will rely heavily on Raty to pull off an upset of Canada at the world championship, as will the Swiss on their goaltender Florence Schelling.
Canada is led by Wickenheiser and Jayna Hefford, both playing in their 12th world championship, and Ouellette in her 11th.
Meghan Agosta-Marciano of Ruthven, Ont., and Ouellette were standouts for Canada in Burlington. Edmonton's Shannon Szabados has been Canada's starting goaltender in big international games since her standout performance helped Canada win gold at the 2010 Winter Games in Vancouver.
The national women's team has experienced unprecedented turnover since 2010. With nine players in this world championship lineup who didn't win gold in Vancouver, learning how to beat the U.S. when it counts at this world championship sets the tone for Canada's Olympic preparation.
"For us, it's about continuing to have that emotional maturity in big games," Church said. "I think we have learned a lot from the last few events we've played together.
"Our biggest challenge as we move into Ottawa is to be prepared to win the first game of the round robin and hopefully go into a gold-medal game and if it's against the U.S., we can play our best game there as well."