Let’s start at the very beginning, by answering the question: ‘what is a Pap smear?’ :

A Pap smear (sometimes called a “Pap test”) is a test that doctors use to check the cervix for early signs of cancer. The cervix is the part of a woman’s body where the uterus and the vagina meet. It is the bottom part of the uterus.

To do a Pap test, your doctor or nurse will push apart the walls of your vagina using a device that looks like a duck beak (called a speculum). Then, he or she will use a small tool, usually a brush, to collect cells from your cervix. The staff at a lab will look at those cells under a microscope to see if they are abnormal.

Do not assume that you are having a Pap test every time the doctor or nurse uses a speculum. That device is used for other reasons, too. If the doctor or nurses uses a speculum, ask whether you are being checked for cervical cancer.

Pap tests can find cancer cells or cells that could turn into cancer, called “pre-cancer.” The test can usually find cancer in the early stages, when it can be treated or even cure

So what is cervical cancer?

The cervix is the lower part of your uterus (womb). Cancer of the cervix (cervical cancer) is a serious but preventable disease. Screening tests can find changes in cervical cells before cancer develops. These include a Pap smear and screening for the presence of the virus HPV, but more on that later. Changes in cervical cells before cancer develops are called dysplasia and removing cells that have dysplasia can prevent cervical cancer. If left untreated, dysplasia can lead to cervical cancer. So screening tests can help prevent cervical cancer.

What causes cervical cancer?

Cervical cancer is almost always caused by a virus called human papillomavirus (HPV).

  • HPV is not the same as human immunodeficiency virus (HIV, which causes AIDS) or herpes simplex virus (HSV, which causes cold sores and genital herpes).
  • Infection with HPV is very common among adults. In fact, most people will have HPV at some point in their lives. Up to 80% of women would have had HPV by the age of 50 years.
  • Usually, your body’s immune system fights off the infection, and HPV goes away on its own.

Is HPV infection serious?

  • There are many types of HPV.
  • The types that can lead to cervical cancer are called high-risk types. The two main culprits are number 16 and 18.
  • Other types, called low-risk types, may cause genital warts but do not cause cervical cancer.
  • High-risk HPV is a problem only when it doesn’t go away. If it stays in your body for a long time, it can lead to cervical cancer.

Are there symptoms of HPV?

  • No, HPV infection doesn’t cause symptoms, so most people don’t know they have it.
  • A person can have HPV for a very long time before it’s found.


How does a person get HPV?

  • HPV is highly contagious
  • HPV is spread from one person to another by skin-to-skin contact in the genital area.
  • HPV can be spread even if there is no intercourse.
  • HPV can be spread by vaginal, anal, and possibly oral sex.

Talking with Your Partner About HPV

Finding out you have HPV can be disturbing. You may be concerned that your partner was unfaithful. Your partner may think that you were. It’s really important to make sure you both have the facts about HPV:

  • Most adults have HPV at some time during their lives.
  • HPV doesn’t cause symptoms and usually goes away on its own.
  • Most people with HPV don’t know they have it.
  • Usually it is impossible to know which partner gave a person HPV.
  • HPV is not a sign that you or your partner was unfaithful.
  • It is not helpful or fair to blame your partner if you have HPV.

Having an open conversation with your partner about HPV is important, so you are both informed and can both make safe decisions about your health.

Are there any ways to avoid getting HPV?

Four things can reduce your risk for getting HPV:

  • Get vaccinated. The HPV vaccine is safe and effective in preventing the majority of cervical cancers, precancer, and abnormal Paps. It can also prevent the majority of genital warts.
  • Avoid sexual contact. By abstaining from sexual intercourse and any skin-to-skin contact in the genital area, you can avoid getting HPV.
  • Limit your sexual partners. Have sex with just one person, who has sex only with you.
  • Use condoms. Condoms don’t fully protect from HPV, but they can lower the chance you’ll get it. Condoms also help prevent HIV, herpes, and other sexually transmitted infections.

Making Sense of Cervical Cancer Screening

What screening tests are done for cervical cancer?

There are two main kinds of screening tests:

  • The Pap test
  • The HPV test

We’ve spoken about the Pap smear, so

What is the HPV test?

  • The HPV test is a very accurate way to tell if high-risk HPV is present in a woman’s cervix.
  • This test can use the same sample of cells taken for the Pap test or a separate sample taken right after the Pap.
  • A positive test result means a woman has high-risk HPV. She should be followed closely to make sure the infection goes away and that she does not develop abnormal cells.
  • A positive HPV test result does not mean that a woman has cancer.
  • Also, a positive HPV test result is not a sign that you or your partner had sex outside the relationship. A person can have HPV for a long time before it’s found.

When would an HPV test be done?

  • The HPV test is used in two ways:
    • To see if a woman with a borderline Pap test result (one that shows unusual cells but not dysplasia) needs additional tests.
    • To screen for cervical cancer, along with the Pap test, in women aged 25 or older. Women 25 or older who have HPV are more likely to have had it a long time. That means they have a greater risk of developing cervical cancer.
  • Women under 25 don’t need an HPV test in addition to the Pap test. HPV infection is very common in this age group and usually goes away.
  • The HPV test is not used for men. Most of the time, men don’t develop health problems from HPV.

When should you be screened for cervical cancer?

  • Experts recommend that a woman’s first Pap test be done by age 21 or three years after she becomes sexually active with vaginal intercourse—whichever is first.
  • Women under age 30 should speak to their health care provider about how often to have a Pap test.
  • Women age 25 or older can have an HPV test along with the Pap test. Women who have a normal Pap test result and a negative HPV test result should have both tests repeated in three years.
  • Women age 65 or older should discuss with their health care provider whether or not to continue cervical cancer screening.
  • Women who have had a total hysterectomy (surgery to remove the uterus and cervix) that was not performed to treat cancer or dysplasia don’t need to be screened


Yours in health
Dr Leneque Lindeque (MBChB, FCOG(SA), Mmed (O&G)
Obstetrician and Gynaecologist
Netcare Alberlito Hospital
Tel: (032) 586 0723