Why it matters in South Africa
Cervical cancer is one of the most common cancers affecting South African women, and HIV infection increases the risk and speeds up how quickly changes develop. Yet it is one of the most preventable cancers, thanks to vaccination and screening.
HPV: the cause
HPV is a very common virus passed on through intimate skin-to-skin contact. Most people will have it at some point, and the body usually clears it within a year or two. When high-risk types persist, they can cause cell changes in the cervix that may, over many years, become cancer.
Having HPV is common and does not mean you will get cancer, and it says nothing about faithfulness in a relationship, since the virus can stay inactive for years.
HPV test or Pap smear?
| HPV test | Pap smear (cytology) | |
|---|---|---|
| What it looks for | High-risk HPV types | Abnormal cervical cells |
| Sensitivity (in the cited SA guidance) | About 95% | About 55% |
| Interval if normal | Longer (5 to 10 years) | Shorter |
| Self-collection possible | Yes, in some settings | No |
Because the HPV test detects the cause, a negative result gives long-lasting reassurance. A Pap smear (or liquid-based cytology) is still useful, often as a follow-up test after a positive HPV result.
How often? (South African laboratory guidance, 2026)
| Group | Start | Interval if negative |
|---|---|---|
| General population | 25 to 30 years | Every 5 to 10 years |
| Women living with HIV | 25 years | Every 3 to 5 years |
| Stopping | From 50 after three consecutive negative HPV tests, or 60 if any result was abnormal |
The public health sector follows the national Cervical Cancer Prevention and Control Policy, which may use different intervals depending on available tests. Your doctor or clinic will tell you which schedule applies.
Self-sampling
In some settings you can collect your own vaginal swab for HPV testing, using an instruction leaflet. Many women find this easier and more private. Ask your doctor whether it is available to you.
What does a positive HPV result mean?
It means a high-risk HPV type was found, not that you have cancer. Next steps depend on the type:
- HPV 16, 18 or 45: higher risk; usually referred for a closer look at the cervix (colposcopy).
- Other high-risk types: often followed up with cytology or another triage test, then monitored or referred.
Early changes found this way can usually be treated with a simple procedure.
HPV vaccination
The HPV vaccine prevents infection with the main cancer-causing types and works best before someone becomes sexually active. South Africa offers it to girls at school through the national programme. Vaccinated women still need screening.
When to see a doctor
Don't wait for your next screen if you notice:
- bleeding after sex, between periods, or after menopause;
- unusual or bad-smelling discharge;
- pelvic pain or pain during sex.
These are usually caused by something else, but should be checked.
Frequently asked questions
Does screening hurt?
It may be briefly uncomfortable. Tell the clinician if you are anxious or have had a difficult experience; they can go slowly or discuss self-sampling.
Can I be screened during my period?
It is usually better to book mid-cycle, but ask the practice, as HPV testing may be less affected.
I'm not sexually active anymore. Do I still need screening?
Usually yes, as past HPV infection can persist. Discuss with your doctor.
I've had a hysterectomy. Do I need screening?
It depends on why it was done and whether the cervix was removed. Ask your doctor.
References
- Ampath. Fast Facts: HPV PCR in cervical cancer screening. March 2026. https://www.ampath.co.za/storage/637/Fast-Facts----HPV-PCR-in-Cervical-Cancer-Screening-Final-March-2026.pdf
- Ampath. HPV fact sheet. July 2024. https://ampath.co.za/storage/504/HPV-Fact-Sheet-FINAL-July-2024.pdf
- National Department of Health. Cervical Cancer Prevention and Control Policy. https://knowledgehub.health.gov.za/node/997
This article is for general educational purposes only, like a health newsletter. It is not medical advice, diagnosis or treatment, and reading it does not create a doctor and patient relationship. Please speak to your own doctor about your situation. In an emergency, call 10177 or 112, or go to your nearest emergency unit.