Vaccination against HPV has been given another shot in the arm – a study suggests it may reduce the number of Pap tests needed to just three in a lifetime. At present, the Cancer Association of South Africa (CANSA) advises starting Pap tests within two years of first becoming sexually active, then having one at least every two years – though, the national government screening programme allows for only three free tests, recommended around ages 30, 40 and 50.
What studies have shown so far
In a study in the International Journal of Cancer, researchers at Queen Mary University in London have suggested that for vaccinated women, having just those three tests could have the same benefit.
The lead author, Professor Peter Sasieni, told the BBC that reducing the number of Pap smears for women who have been vaccinated would make sense – and save money.
"These women are far less likely to develop cervical cancer so they don’t need such stringent routine checking as those at higher risk," he said. He noted this could free health resources for where they are needed most.
The importance of cervical screenings
Cervical screening may be uncomfortable, but having it done often has been vital, given the prevalence of HPV – the most common STI globally.
It’s estimated that 80% of us will be infected by it at some point in our lives, and while those with a healthy immune system will clear the virus, others will not.
Infection can take place with only a single encounter, without penetration, because the virus is transmitted by skin-to-skin contact. And the World Health Organization (WHO) reports that the human papillomavirus (HPV) is responsible for at least 70% of cervical cancer cases.
The prevalence of cervical cancer in South Africa
In South Africa, cervical cancer is the second most common cancer after breast cancer, according to the National Cancer Registry. It affects one in 39 of us, and kills more women than any other cancer: eight a day, with the WHO reporting that this could rise to 12 by 2025. It also leaves many women infertile.
Yet, cervical cancer is potentially a completely preventable disease, says Professor Michael Herbst, health specialist with CANSA – with regular screenings and early vaccination.
These are crucial because cervical cancer develops slowly and has very few signs or symptoms until it’s far advanced, when there may be abnormal bleeding and discharge, bleeding after intercourse, pelvic pain and even kidney failures, says Herbst. It’s rare to have pain.
The vaccine isn't only for women
Vaccines like Cervarix and Gardasil protect against two strains of HPV responsible for 70% of cervical cancers, and in boys may prevent genital warts, cancer and the spread of HPV to their future partners.
"Men can get anal, penile and oropharyngeal (mouth and throat) cancer from HPV infection," says Herbst. "Men and boys are the carriers of the virus and yet South Africa still has no programme for vaccinating boys."
Girls and boys younger than 15 need two shots, six months apart; those older than 15 need three.
The Department of Health provides free shots for girls in Grade 4, aged 9 or older at government schools. Those at non-government schools, and boys, can be vaccinated by your health professional or at a pharmacy clinic.
The vaccine can be given up to age 26, but preferably before age 15, before the start of sexual activity. Discuss it with your health provider or pharmacy nursing practitioner.
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