Explainer: Why you should get a pap smear test
Lorret Machogu, who is using her social media platforms to raise awareness of the importance of early HPV screening for cervical cancer prevention.
What you need to know:
- About 10 per cent of women in the general population are estimated to have cervical HPV-16/18 infection at a given time, a strain attributed to 63 per cent of cervical cancer cases.
- Dr Meghan Murphy Steen explains that HPV is found in areas such as the penis, anus, cervix and throat, and can cause cervical and throat cancer if left untreated.
A new year presents a number of possibilities.
As women set career, financial and personal goals, Lorret Machogu wants you to schedule a pap smear test as part of your resolutions.
She tells Nation.Africa how a random medical check-up presented the chance of one of her worst fears coming true: cervical cancer.
“I saw an online post of a woman who had a good experience getting a pap smear.
"I knew the procedure could be quite uncomfortable, so I chose to get mine done by the same doctor as the woman said hers was pleasant,” Lorret reminisces.
She got the pap smear done and was informed that the hospital would email the results to her if everything was fine.
They did not get back to her. Lorret started getting anxious and decided to visit the hospital. She was informed that she had to see a doctor.
“I became very anxious because I thought the doctor wanted to tell me I had cervical cancer. I called my mother who calmed me down and advised me to call my sister to accompany me to the doctor’s appointment.”
The doctor informed Lorret and her sister that although she did not have cervical cancer, she had Human Papillomavirus (HPV) infection.
“The pap smear showed that I had low-grade lesions and minor cell changes on my cervix. We had to get a HPV DNA test to determine whether I had high-risk or low risk HPV.
"We found that I had high-risk HPV and the variant was HPV-18, which accounted for the second highest number of cervical cancer cases. My heart sank.”
She says her doctor explained the difference between the two types of HPV, saying: “Low-risk HPV only causes genital warts and not cancer, while the second strain can cause cervical cancer if left untreated.”
“I was presented with two options: to have a leep procedure where precancerous cells would be cut, removed to give my cervix a new life or wait it out and see if my body would fight off the HPV infection. I chose the second option,” she recalls.
She waited a year and a half before going back for another test to see whether there was any progress.
“The doctor told me the HPV infection had advanced from low grade to high grade lesions. The next stage would have been cervical cancer. I had to get the leep procedure.”
Fortunately, the procedure was a success because the high-risk HPV was detected early.
“I choose to share my story even though it's a bit embarrassing so that other women can know the link between HPV infection and cervical cancer. I didn't understand that once you are sexually active, you have to go for tests. Early HPV screening saves life.”
According to the Human Papillomavirus (HPV) Centre 2023 Kenya fact-sheet, every year 5,236 women are diagnosed with cervical cancer and 3,211 die of the disease.
Cervical cancer is the second most common cancer among women in Kenya and about 10 per cent of women in the general population are estimated to have cervical HPV-16/18 infection at a given time, a strain attributed to 63 per cent of cervical cancer cases.
Dr Meghan Murphy Steen, an obstetrician and gynaecologist, explains that HPV is found in areas such as the penis, anus, cervix and throat, and can cause cervical and throat cancer if left untreated.
“HPV is very silent until it makes a mass in your cervix. You are probably not going to have any abnormal bleeding or discharge like other sexually transmitted infections (STIs). This is why screening through a pap smear test is important.
“HPV is also the number one STI in Kenya, second to Chlamydia,” she says.
She goes on to explain that after a pap smear test reveals the presence of high-grade changes in the cervix, infected cells can be removed through a minor procedure such as leep surgery. However, if advanced, a hysterectomy or radiation will be used.
“You should get a pap smear as soon as you start having sex. If you are sexually active at 14, you should start that early.
"If you don’t have sex until late in life, you should start at 21. In general, it should be every two to three years if you are vaccinated and every year if you are not,” Dr Steen adds.
Can you prevent HPV infection?
Dr Angela Migowa, a consultant paediatrician, rheumatologist and adolescent health Expert at Aga Khan University Hospital, cites three ways: vaccination, use condoms, or avoiding sexual contact.
“Most international health organisations recommend vaccination to girls between the ages of nine and 15. This is meant to target girls and women before they are potentially exposed to the virus.
“However, it should be noted that the vaccine may be administered to anyone until age 45,” Dr Migowa states.
“The effectiveness of the vaccine cannot be ascertained after sexual activity has begun as you may have already been exposed.”
Dr Steen adds that although condoms are not a foolproof method as HPV can spread through skin contact, maintaining a monogamous relationship while using condoms can significantly reduce the chance of contracting the virus.
She says boys and men can also get the vaccine even though they don't have cervix, as it would help to prevent the spread of the virus.
“Since HPV is a sexually transmitted infection, boys and men getting vaccinated can decrease the risk of transmitting the infection to their girlfriends or wives who bear the most consequence of HPV. They can get vaccinated as early as 18 years.”
