The cervix is the lower, narrow end of the uterus (the hollow, pear-shaped organ where a foetus can grow). The cervix leads from the uterus to the vagina (birth canal) below.

Cervical cancer is the 2nd most common cancer among South African women, after breast cancer. Women in South Africa have a 1 in 41 lifetime risk of cervical cancer (NCR 2023).

Both breast and cervical cancer have been identified as a national priority with increasing incidences occurring. Both cancers can be successfully treated if detected in the early stages, so it is important that women are aware of symptoms and what is normal for their bodies and go for regular cancer screening.

Did You Know?

  • Cervical cancer is the leading cause of cancer related deaths, and the second most common diagnosed cancer (excluding basal cell carcinoma) among South African women.
  • The Human Papilloma Virus (HPV) is the primary cause of cervical cancer in women, resulting in 300 000 deaths due to cervical cancer globally per annum
  • HPV strains 16 and 18 are most frequently associated with the development of cervical cancer
  • HIV infected women are at an increased risk for HPV infection at an earlier age (13-18 years) due to a suppressed immune system and are diagnosed with cervical cancer at an earlier age (15-49 years)

Symptoms include: abnormal bleeding between periods, heavier and longer menstrual period, vaginal discharge, vaginal bleeding or pain during intercourse / after menopause, increased urinary frequency.

Risk factors: Cervical cancer is mainly caused by the Human Papilloma Virus (HPV), a common virus spread through skin-to-skin contact, body fluids and sexual intercourse. Failure to use protection during sexual intercourse, sexually transmitted infections (STIs), multiple sexual partners, early sexual debut, and use of oral contraceptives increases risk.

Women with HIV infection also have a higher risk of developing cervical cancer. Furthermore, being overweight, inactive, consuming alcohol, poor dietary habits, smoking and exposure to chemicals increases risk.

Reduce Risk Through Pap smears

Having regular Pap smears can detect abnormal cells in the cervix (lower part or mouth of the womb), that could develop into cervical cancer. Screening involves taking a swab of the cervical cells. It is uncomfortable, but painless.

When abnormal cells are identified and removed, in many cases it is prior to cancer cells developing.

Early diagnosis and treatment of pre-cancerous lesions prevents up to 80% of cervical cancers, in high resource countries, where cervical cancer screening is routine.

Pap smears help us identify abnormal cells on the cervix (lower womb) caused by HPV which can lead to cancer. It’s very important that women do not stay away when they receive abnormal results. Cervical cancer is highly treatable if caught in the early stages and treatment should start as soon as possible for optimum results.

WHAT IS HPV?

HPV stands for Human Papillomavirus and is a very common virus. There are more than 100 strains of the virus, most of them do not cause cancer. About 7 in every 10 people will have HPV infection at some point in their lifetime – the virus lives on your skin and can be transmitted through skin-to-skin or sexual contact. Over 100 types of HPV have been identified, and more than 30 of these infect the genital mucosa, 15 of which are cancer causing. HPV 16 and HPV 18 are the highest-risk types known to cause about 70% of all cervical cancers.

Other strains of HPV are known as high risk. In women, these strains can cause cancers of the cervix, vagina, vulva, and anus, as well as head and neck cancers. About 70% of cervical cancers are caused by HPV. In men, high risk strains of HPV can cause penile, anal and head and neck cancers. The HPV vaccination protects girls from being infected by HPV and thus reduces the risk of developing HPV related cervical cancer later in life.

HIV positive women are eligible for a Pap smear at diagnosis and every three years thereafter if negative for cervical cancer (yearly if screening is positive).

Who should have a Pap smear?

  • all women who have been sexually active, should start having Pap smears between ages 18 to 20 years
  • every eligible woman should preferably have a Pap smear at least every 3 years

Note:

  • It is better to have a Pap smear at a less optimal time, than not at all
  • Routine cervical screening is not required for women under the age of 18 years, even if they are sexually active
  • If a woman is 70 years old and, within the last 5 years, had two normal Pap Smears, she need not continue with Pap smears

Source:

Cervical Cancer – CANSA (https://cansa.org.za/cervical-cancer/)
Find more information in CANSA’s Cervical Cancer Position Statement & Fact Sheet.