Cervical cancer | Profmed’s Dr Moratwe Masima on prioritising prevention

“Early cervical cancer detection enables women to receive appropriate medical care, leading to better survival rates," says Profmed’s Dr Moratwe Masima. Image supplied.

Masima emphasises that too many South African women cannot access screening tests and early disease detection services, and is urging medical professionals to direct their efforts toward prevention instead of focusing solely on treatment.

She talks to us about the need for preventative care in South Africa and why screening should be a standard part of wellness.

What is cervical cancer, and why does it predominantly affect women?

Cervical cancer develops in the cells of the cervix, which is the lower part of the uterus that connects to the vagina. It affects women because the cervix is part of the female reproductive system.

The main cause is a long-term infection with high-risk types of the human papillomavirus, or HPV.

Most HPV infections clear up on their own, but in some cases, the virus can persist and cause abnormal cell changes that may progress to cancer over several years.

Why are underserved women most at risk?

Women living in underserved or rural communities often face barriers to regular screening, HPV vaccination, and quality healthcare.

Many depend on public clinics that may be understaffed or under-resourced. Without access to routine Pap smears or HPV testing, these women are more likely to be diagnosed at later stages when the disease is harder to treat.

Factors like poverty, limited education, and poor health literacy also increase risk.

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Can education really change outcomes?

Yes, it can make a huge difference. When women understand what cervical cancer is, why screening matters, and how early detection can save lives, they’re far more likely to take action.

Education helps reduce stigma and fear around gynaecological exams. It also empowers women to share information with their peers, creating a ripple effect in their communities.

What stops women from getting screened?

There are a few key barriers. Many women are simply unaware of when or how often they should be screened.

Others fear pain, embarrassment, or even the potential results. In some cases, there’s stigma around going for a pelvic exam.

For many women, it’s also a matter of practicality – transport costs, time off work, or long queues at clinics can be real obstacles.

Are screening programmes reaching enough women?

Unfortunately, not yet. South Africa has made great progress, but we still have a long way to go.

Many women, especially those in rural or peri-urban areas, are not being reached consistently.

Screening needs to become part of routine healthcare – as normal as checking your blood pressure or doing an HIV test – so that it feels like a standard part of wellness, not something to fear.

How important is follow-up care after treatment?

Follow-up care is essential. Even after successful treatment, there’s a chance of recurrence, and women need regular check-ups to monitor their health.

It’s also a time for emotional and reproductive health support.

Without proper follow-up, some patients fall out of the healthcare system, which can lead to delayed detection if the cancer returns.

How can the healthcare system help women stay healthy through preventative care?

Prevention should be our starting point. That means making Pap smears, HPV testing, and vaccinations easily accessible and affordable.

We can also integrate screening into services women already use, like family planning or HIV clinics.

When prevention becomes part of everyday care, we empower women to take charge of their health before problems arise.

Black women have the highest risk of developing cervical cancer. What are some of the lifestyle co-risk factors related to the disease?

Some of the major risk factors include smoking, multiple sexual partners, early sexual debut, long-term use of oral contraceptives, and HIV infection.

In South Africa, the high HIV prevalence is particularly important because HIV weakens the immune system and makes it harder to clear HPV infections.

Regular screening is especially vital for women living with HIV.

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How does healthcare inequity contribute to preventable deaths from cervical cancer?

When access to healthcare depends on where you live or what you earn, outcomes become unequal.

Women in well-resourced areas can access regular screening, HPV vaccination, and specialist care.

Those in poorer communities often can’t. This inequality leads directly to preventable deaths, which is heartbreaking for a disease that is both preventable and curable when caught early.

What can be done to ensure women are being screened early enough? Is there enough education on early detection?

We need to make cervical screening feel routine and accessible for every woman.

In South Africa’s public sector, screening officially starts at the age of 30, with three free Pap smears offered at 10-year intervals through government clinics.

Women living with HIV are screened more frequently, usually at the time of diagnosis and every three years thereafter.

In the private sector, where women often have access to medical aid or private gynaecologists, we recommend starting earlier, from the age of 21 or within three years of becoming sexually active.

What are some of the treatment options for South African women?

Treatment depends on how advanced the cancer is. In the early stages, surgery or remove a small part of the cervix may be enough. More advanced cases often require radiotherapy, chemotherapy, or both.

For women who are diagnosed late, palliative care plays an important role in improving quality of life and providing comfort and dignity.

How can the healthcare system help women stay healthy through preventative care?

Our healthcare system can do a lot by prioritising prevention.

Expanding HPV vaccination to reach all eligible girls – and boys – is one of the most effective steps.

We also need to improve access to screening and make sure women with abnormal results are followed up promptly.

Prevention isn’t just about medicine; it’s about making sure every woman feels seen, informed, and supported in maintaining her health.