Those who are at increased risk of developing cancer of the cervix should be especially careful to follow their doctor's advice about check-ups. Women who have had a hysterectomy (surgical removal of the uterus, including the cervix) should ask their doctor's advice about having gynaecological examinations and Pap smears of the vaginal vault. It is not always necessary to have a smear every year. Ask your doctor for advice.
In South Africa, it is not possible for all women who fall under state health care to have regular Pap smears and gynaecological check-ups for economic reasons. Research has shown that a national screening programme using a Pap smear three times in a woman’s lifetime (at about 30, 40 and 50 years) and with an 80% coverage will reduce the incidence of this cancer by more than half. All women in South Africa are entitled to three free Pap tests, one at 30 years and repeated at 40 and 50. The first smear is by far the most important.
A new tool in the prevention of cervical cancer is a vaccine that protection against the human papillomavirus - which is responsible for up to 80% of all cervical cancers. It is advised that girls and young women be vaccinated before their first sexual encounter. The vaccine is currently available only in the private health sector in South Africa.
(Reviewed by Professor Lynette Denny, Gynaecology Oncology Unit, Department Obstetrics & Gynaecology, University of Cape Town/Groote Schuur Hospital)