Cervical cancer remains one of the most preventable cancers when detected early. In South Africa, it is the second most common cancer among women, yet regular screening can reduce mortality by up to 80%. This article explains what you need to know about screening and why it matters.

What is Cervical Cancer Screening?

Cervical cancer screening involves testing for precancerous or cancerous cells on the cervix before symptoms develop. The two main screening methods are:

• Pap smear (Papanicolaou test): Collects cells from the cervix to examine for abnormalities
• HPV test: Checks for high-risk strains of human papillomavirus that can cause cervical cancer

Both tests are performed during a pelvic examination and take only a few minutes. While the procedure may feel uncomfortable, it should not be painful.

Who Should Be Screened?

Current South African guidelines recommend:

• Women aged 30 and older should have a Pap smear every 10 years if results are normal
• Women living with HIV should be screened at diagnosis and annually thereafter
• Women with previous abnormal results may need more frequent screening

However, many healthcare providers, myself included, recommend more frequent screening—typically every three years for women aged 21-65, or as clinically indicated based on individual risk factors.

What Happens During a Pap Smear?

During the procedure:

1. You will lie on an examination bed with your feet in stirrups
2. A speculum is inserted to allow visualisation of the cervix
3. A small brush or spatula collects cells from the cervix
4. The sample is sent to a laboratory for analysis

The entire process takes approximately five minutes. You may experience light spotting afterward, which is normal.

Understanding Your Results

Results typically take 1-2 weeks and fall into several categories:

• Normal: No abnormal cells detected. Continue routine screening.
• ASCUS (Atypical Squamous Cells of Undetermined Significance): Minor cell changes that often resolve on their own. May require repeat testing.
• LSIL/HSIL: Low-grade or high-grade changes that require further investigation, usually colposcopy.
• Abnormal glandular cells: Requires further evaluation.

An abnormal result does not mean you have cancer. Most abnormalities are precancerous changes that can be monitored or treated before cancer develops.

The Role of HPV Vaccination

The HPV vaccine protects against the strains of human papillomavirus responsible for most cervical cancers. In South Africa, the vaccine is offered to Grade 4 girls through the school health programme. However, vaccination does not eliminate the need for screening—vaccinated women should still follow recommended screening schedules.

When to Seek Medical Attention

While cervical cancer often has no early symptoms, consult your doctor if you experience:

• Bleeding between periods or after menopause
• Bleeding after sexual intercourse
• Unusual vaginal discharge
• Pelvic pain unrelated to your menstrual cycle

Taking Action

Cervical cancer screening saves lives. If you are due for a Pap smear, or if you have never had one, I encourage you to schedule an appointment. The few minutes of discomfort are a small investment in your long-term health.

At our practice, we provide cervical cancer screening in a comfortable, private environment. If you have concerns or questions about the procedure, please don't hesitate to discuss them during your consultation.