Cervical Cancer

Cervical cancer is a disease in which abnormal cells grow in the cervix—the lower, narrow part of the uterus (womb) that connects to the vagina.

The disease often develops slowly, over years, allowing screening and preventive steps to make a big difference in outcomes.

• Approximately 13,800 new cases are estimated to occur in South Africa annually. ³
• In South Africa, it is the second most common cancer among women, with a lifetime risk of about 1 in 41. ¹
• Roughly 3,000 women die from cervical cancer each year in South Africa, making it a leading cause of cancer mortality. ⁴
• Women living with HIV are at notably higher risk: their immune system is less able to clear HPV (Human Papilloma Virus) which is strongly associated with cervical cancer, and they may progress faster from precancerous changes to cancer. ⁵
• Despite its high burden, cervical cancer is highly preventable and curable when detected early. ⁶

• The main cause is persistent infection with HPV, particularly high-risk types. ²
• HPV is spread via skin-to-skin contact, often through sexual activity (vaginal, anal, or oral), and even by sharing sex toys. ²
• Other risk factors include:
  • Smoking (which weakens the immune system) ⁶
  • A weakened immune system (e.g., HIV infection) ⁵
  • Long-term use of hormonal contraceptives ⁶
  • Early childbirth or having multiple children ⁶

• Anyone with a cervix can develop cervical cancer, even if the remaining part of the uterus has been removed (sub-total hysterectomy).
• Women with HIV are disproportionately affected and may develop cervical cancer at a younger age. ⁶

In South Africa, screening coverage, by pap smear, remains low, with only about one in five eligible women over age 30 accessing regular screening. ⁷

Early cervical cancer may produce no symptoms, making screening vital. However, as cancer develops, you might notice:

• Unusual vaginal bleeding (after sex, between periods, or after menopause) ⁶
• Unusually heavy or long menstrual periods ⁰
• Persistent vaginal discharge (possibly watery, bloody, or foul-smelling) ⁴
• Pelvic pain or pain during sex ⁴
• Frequent urination or urinary discomfort (in some cases) ⁴

Because these symptoms can also result from benign conditions (like fibroids or infections), it’s important to consult a healthcare provider if something feels “off” for you.

1. Screening / Pap Smear
   • In South Africa,  the 2021 Cervical cancer prevention and control policy provides for asymptomatic women to be screened at ages 30, 40 and 50. High risk patients (e.g. HIV positive) can be screening 1 – 3 yearly, depending on previous pap smear results. ⁷
   • Liquid-based cytology and HPV testing identifies strains at high risk of causing cervical cancer. ⁶
2. Colposcopy & Biopsy
   • If screening results are abnormal, a specialist may use a colposcope (a magnified microscope) to examine the cervix.
   • A small tissue sample (biopsy) may be taken for lab analysis.
3. Further Tests
   • To assess whether cancer has spread, additional tests such as imaging (MRI or CT), blood tests, and specific examinations of internal organs (e.g., bladder and bowel) may be used, depending on the case.

If cervical cancer is found, your treatment plan will depend on: the stage (how large or spread the cancer is), your general health, and your fertility desires.

• Surgery:
  • For early cancer, less invasive surgery can remove only the cervix, preserving fertility.
  • More advanced cases may require a total hysterectomy (removal of the uterus) and/or removal of nearby structures.
• Radiotherapy:
  • Uses high-energy rays. Sometimes combined with chemotherapy (chemoradiation).
  • Includes brachytherapy, where radiation is delivered from within the body.
• Chemotherapy:
  • Used alongside radiotherapy, or for more advanced disease, to shrink or control the cancer.
• Targeted therapies / Immunotherapy:
  • For recurrent or advanced disease, newer medicines may help boost your immune response or block cancer-specific pathways.
• Palliative Care:
  • If a cure is not possible, the focus may shift to symptom control and quality of life.

While diet alone cannot prevent cervical cancer, healthy nutrition supports your immune system and may help manage symptoms:

• Antioxidant-rich foods: Include plenty of fruits and vegetables (berries, leafy greens, bell peppers) to support immune health.
• Vitamin C & E: Foods like citrus fruits, nuts, and seeds may help combat inflammation.
• Folate: Green vegetables, legumes, and whole grains support DNA repair and cellular health.
• Lean protein: Fish, chicken, beans, and legumes help your body maintain strength, especially during treatment.
• Healthy fats: Avocado, olive oil, and nuts for heart health and anti-inflammatory benefit.
• Hydration: Plenty of water helps support overall wellbeing, especially for managing treatment side-effects.
• Limit processed foods, sugar & alcohol: Reducing these supports immune function and helps keep hormone balance stable.

This brochure is for educational purposes only and is not intended to provide a diagnosis or treatment or replace the advice of your doctor, pharmacist, primary health care nurse or other health care provider. You are advised to discuss any questions or concerns you have with your health care provider.