Cervical Cancer: The Screening and Warning Signs Every Woman Should Know
Cervical cancer is one of the cancers where prevention and early detection can make a significant difference.
Yet because the early stages may cause few or no noticeable symptoms, routine cervical screening remains an important part of women’s healthcare.
During Cervical Cancer Awareness Month this September, it is a good opportunity to understand what causes cervical cancer, which symptoms should not be ignored and why screening matters — even when you feel perfectly healthy.
What is cervical cancer?
Cervical cancer develops in the cells of the cervix, which is the lower part of the uterus that connects to the vagina.
Most cervical cancers are linked to persistent infection with certain high-risk types of the human papillomavirus, or HPV.
HPV is extremely common and is spread mainly through intimate skin-to-skin and sexual contact. Many HPV infections clear naturally without causing any health problems. However, in some people, a high-risk HPV infection persists and may gradually cause abnormal changes in the cells of the cervix.
If these abnormal cells are not identified and managed, they can potentially develop into cervical cancer over time.
HPV does not automatically mean cancer
Receiving a positive HPV result can understandably be worrying, but having HPV does not mean that you have cervical cancer.
Most people who become infected with HPV will never develop cancer.
The concern is primarily persistent infection with particular high-risk strains of HPV. This is why cervical screening is so valuable — it gives healthcare professionals an opportunity to identify HPV infection or abnormal cervical cells before they progress.
Why cervical screening matters
One of the challenges with cervical cancer is that precancerous changes and early cancer may not cause noticeable symptoms.
A person can therefore feel completely well while abnormal cells are developing.
Depending on your age, medical history and the screening programme being followed, cervical screening may involve a Pap smear, HPV test or both.
A Pap smear examines cells collected from the cervix for abnormal changes, while an HPV test looks for high-risk forms of the virus associated with cervical cancer.
South Africa’s public health cervical cancer screening programme provides routine screening for eligible women, while women with particular risk factors — including women living with HIV — may require more frequent screening.
Your healthcare professional can advise you on the screening schedule most appropriate for you.
Warning signs that should not be ignored
Although early cervical cancer may cause no symptoms, certain changes should always be discussed with a healthcare professional.
These may include:
- Vaginal bleeding between periods
- Bleeding after sexual intercourse
- Bleeding after menopause
- Periods that suddenly become unusually heavy or prolonged
- Unusual or persistent vaginal discharge
- Pain or discomfort during sexual intercourse
- Persistent pelvic or lower abdominal pain
These symptoms do not necessarily mean cervical cancer is present. Infections, hormonal changes, fibroids and several other conditions can cause similar symptoms.
However, unusual vaginal bleeding or persistent changes should not simply be ignored or assumed to be normal.
Who may have a higher risk?
Persistent infection with high-risk HPV is the primary cause of cervical cancer, but several factors may increase the likelihood of developing persistent HPV infection or cervical cell changes.
These include:
- A weakened immune system
- Living with HIV
- Smoking
- Previous abnormal cervical screening results
- Not attending recommended cervical screening
- Persistent infection with high-risk HPV
Women living with HIV have a higher risk of persistent HPV infection and cervical cancer and may therefore require a different screening schedule.
If you are unsure how frequently you should be screened, speak to your healthcare provider rather than waiting for symptoms to appear.
What about the HPV vaccine?
HPV vaccination is one of the most effective tools available for reducing the risk of cervical cancer.
The vaccine protects against important high-risk HPV types responsible for many cervical cancers.
South Africa has an HPV vaccination programme aimed particularly at protecting girls before they are likely to be exposed to HPV. In 2026, South Africa adopted a WHO-supported single-dose schedule for eligible immunocompetent girls aged 9–14 as part of the national programme.
However, receiving the HPV vaccine does not mean cervical screening can be forgotten later in life.
No vaccine protects against every HPV type capable of causing cervical cancer, which means vaccination and screening work together as complementary forms of prevention.
Can cervical cancer be prevented?
Not every case can be prevented, but cervical cancer is considered highly preventable because there are effective ways to reduce risk and identify precancerous changes early.
Important preventative measures include:
- HPV vaccination
- Attending recommended cervical screening
- Following up promptly after an abnormal screening result
- Not smoking
- Practising safer sex
- Managing conditions that affect your immune system
- Seeking medical advice when unusual symptoms develop
The key is not to wait until something feels wrong before thinking about cervical health.
When should you speak to a healthcare professional?
You should consider discussing cervical screening with a healthcare professional if:
- You are unsure when you last had a Pap smear or cervical screening test
- You have previously had an abnormal screening result
- You are living with HIV or another condition that affects your immune system
- You experience unusual vaginal bleeding
- You have persistent pelvic pain or unusual vaginal discharge
- You have questions about HPV or HPV vaccination
If you develop significant bleeding, severe pain or rapidly worsening symptoms, seek medical care promptly.
Early detection starts with a conversation
Cervical cancer awareness is not only about recognising symptoms.
It is also about understanding that screening can detect changes before cancer develops or before symptoms appear.
A simple conversation with a healthcare professional can help you understand your individual risk, determine whether you are due for screening and decide what should happen next.
Speak to a TruMD healthcare professional
With TruMD, you can speak to a qualified healthcare professional online about women’s health concerns, unusual symptoms, cervical screening, HPV or other reproductive health questions.
Where an examination, Pap smear, HPV test or further investigation is necessary, your healthcare professional can advise you on the appropriate next step.
Don’t wait for symptoms to prioritise your cervical health.
Early screening, appropriate vaccination and timely medical advice can all play a role in protecting your health.
