Specialist Gynaecologist & Gynaecological Oncology Surgeon
As a gynaecological oncologist, cervical cancer to me is not just a statistic. It is a diagnosis I deliver all too often and a story that does not always end as we hoped.
As Cervical Cancer Awareness Month comes to a close, I cannot help but reflect on this disease, how far we have come, and why it remains such a painful paradox: cervical cancer is largely preventable, yet it still claims too many lives.
Cervical cancer develops in the cells of the cervix, the lower part of the uterus (or womb) that connects to the vagina. Almost all cases are caused by a virus called human papillomavirus (HPV), which is extremely common and spread through sexual contact. Most people who get HPV will never know it and will clear the infection naturally. However, in some women, the virus persists and slowly causes abnormal changes in the cervix. Over many years—often 10 to 15—these changes can develop into cancer if they are not detected and treated early.
This long, slow process is exactly why cervical cancer is one of the most preventable cancers we know. Screening allows us to find abnormal cells well before they become cancer. Traditionally, this has been done with the Pap smear, which looks for abnormal cervical cells under a microscope. More recently, HPV testing has become the preferred method in many countries because it detects the virus itself and identifies women at risk even earlier. Screening works. Countries with strong screening programmes have seen dramatic reductions in cervical cancer deaths over the past few decades.
Prevention does not stop at screening. In fact, HPV vaccination has been one of the greatest breakthroughs in women’s health. The vaccine protects against the high-risk HPV types that cause most cervical cancers. When given before exposure to the virus—ideally in early adolescence—it can prevent the vast majority of cases. Even when given later, it still offers important protection. Combined with screening, vaccination brings us closer than ever to a future where cervical cancer becomes rare, and hopefully non-existent.
When I look back at the history of this disease, the progress is remarkable. A century ago, cervical cancer was one of the leading causes of cancer deaths in women. There was no screening, no understanding of HPV, and treatment was often limited and brutal. Today, we can detect pre-cancer, vaccinate against the virus that causes it, and treat early cancers with high success rates. Some countries now speak seriously about eliminating cervical cancer as a public health problem within our lifetime. That is not wishful thinking—it is based on science.
And yet, in my own practice here in this country, I still see women presenting with advanced disease. Many did not have regular screening. Some were afraid. Some were embarrassed. Some were too busy caring for others. Some believed myths: that screening is painful, that they were too young or too old, or that they did not need it because they felt well. Sadly, cervical cancer often has no symptoms until it is advanced. By the time bleeding, pain, or discharge appear, the disease may already be difficult to cure.
I am deeply grateful to the patients who have shared their stories during this month. Their courage in speaking about diagnosis, treatment, fear, and survival helps other women recognise the importance of screening and vaccination. Their voices turn medical facts into human truth. My hope is that fewer women will ever need to tell these stories at all, brave as they are.
But alongside these stories are the others I carry quietly: women whose cancers were found too late, families who lost mothers, wives, daughters, sisters, and friends. There is a particular deep sadness in losing someone to a disease that we know how to prevent. For me, this is something that never becomes routine, no matter how many years I have been practising.
So, as Cervical Cancer Awareness Month ends, my work does not. Cervical cancer occupies a large part of my professional life, not just in the operating theatre or clinic, but in conversations with women about their fears, their results, and their futures. I sometimes wish the urgency of this message could be sustained all year round, because the disease does not follow the calendar.
If there is one message I hope this month leaves behind, it is this: cervical cancer is not inevitable. It is caused by a virus we can vaccinate against and preceded by changes we can detect by Pap smear screening and HPV testing. Screening saves lives. Vaccination saves lives. Awareness saves lives.
And my commitment, long after January ends, is to keep repeating this message again and again until it becomes unnecessary: this is a cancer we have the power to prevent.
