Second most common, and almost entirely preventable

Cervical cancer

Roughly one in 40 South African women will develop cervical cancer, and far too many are diagnosed late. Yet this is the one cancer we can nearly eliminate in a generation: vaccinate the girls, screen the women, treat what screening finds.

✓ Reviewed by the Ubufazi clinical reviewers Evidence grade A Last reviewed 26 August 2026

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This one is preventable. Genuinely.

Almost every cervical cancer is caused by a persistent infection with human papillomavirus (HPV), a very common virus that most people clear on their own. Two things break the chain: vaccinating girls before exposure, and screening women so pre-cancer is removed before it ever becomes cancer.

South Africa vaccinates Grade 5 learners through the school health programme, and offers free Pap smears from age 30 at every public clinic. Both are free. Both are underused.

What a Pap smear is really like

You lie back; a nurse gently opens the vagina with a speculum.
A small brush takes cells from the cervix. It takes under a minute.
It may feel odd or briefly crampy. It should not be painful, say so if it is.
Results take 2–6 weeks. Go back for them. An abnormal result is not cancer; it means cells can be treated now.

The WHO 90–70–90 target

By 2030: 90% of girls vaccinated by 15 · 70% of women screened with a high-performance test by 35 and again by 45 · 90% of women with disease treated. South Africa has signed up. This page is part of getting there.

Living with HIV?

Your risk of cervical cancer is substantially higher and progression is faster. Screening starts at diagnosis and repeats every three years, not every ten. Stay on your ART: a suppressed viral load is itself cervical protection.

Parents

The HPV vaccine, answered honestly

9–14The age band where the vaccine works best, before any exposure to HPV

2Doses, months apart, given at school with your written consent

R0Cost to you in the public programme

~90%Reduction in cervical cancer seen in countries that vaccinated early cohorts well

Consent is yours to give or withhold, in writing, and you may withdraw it. Side effects are usually a sore arm and occasional dizziness. Vaccination does not encourage earlier sex, that has been studied repeatedly and it does not hold up.

Questions women actually ask

Straight answers

Who can get a free Pap smear?

Any woman aged 30 or older can get a free Pap smear at a public clinic, three free screens, ten years apart, under national policy. Women living with HIV are screened from diagnosis and every three years.

Do I still need screening if I had the HPV vaccine?

Yes. The vaccine prevents most but not all high-risk HPV types, so screening remains part of the plan.

What does an abnormal Pap result mean?

Almost always that some cells have changed, not that you have cancer. Depending on the grade you will be watched, re-tested, or offered a small procedure to remove the affected area.

I have never had sex. Do I need a Pap smear?

Risk is much lower, but discuss it with your clinician rather than assuming you are exempt.

Is bleeding after sex serious?

It is a red flag worth checking within two weeks. It is often something benign, but it is one of the classic cervical cancer signs and should never be dismissed.

Can I still have children after cervical pre-cancer treatment?

Usually yes. Most procedures remove a small area and preserve fertility. Tell your clinician if pregnancy matters to you, before treatment.

This page is information, not a diagnosis

Ubufazi never diagnoses and never prescribes. If something on this page describes you, take it to a registered health professional this week. Care at a public clinic is free at the point of use.