Cervical cancer remains a major global health challenge, affecting more than 660,000 women and causing approximately 350,000 largely preventable deaths each year. In South Africa, it is the second most commonly diagnosed cancer among women – but unlike many cancers, there are proven ways to prevent it and detect it before it becomes life-threatening.  If Human Papillomavirus (HPV) vaccinations can prevent the infection that causes most cervical cancers and regular screening can identify abnormal cervical cell changes before they develop into cancer, why are thousands of women still being diagnosed every year?

This disconnect is prompting Bestmed Medical Scheme and the Sport, Exercise Medicine and Lifestyle Institute (SEMLI) at the University of Pretoria to call for a more proactive and preventable approach to cancer prevention, because prevention cannot only start when something feels wrong.

The screening gap is hard to ignore

Bestmed’s own claims data illustrates the challenge. Among eligible female members, pap smear utilisation increased from 5.6% in 2023 to 10.5% in 2024, before marginally decreasing to 10% in 2025. The improvement is encouraging, but it also means that around nine in 10 eligible female members did not have a pap smear recorded in 2025.

For a cancer where screening can identify changes before symptoms develop, that raises an uncomfortable question: are too many women still treating screening as something to do when there is a problem, rather than something to do to prevent one?

“Cervical cancer shows us what preventative healthcare can achieve. Through vaccination, screening and informed lifestyle choices, we have opportunities to intervene before cancer develops. Prevention is always more effective than treatment after the fact,” says Dr Lee Moses at Bestmed Medical Scheme. “You don’t need to feel unwell to benefit from screening. In fact, the whole point is to identify changes early, before they become a serious health problem.”

CANSA’s latest figures put a woman’s lifetime risk of developing cervical cancer at 1 in 41. It is also why South Africa has committed to the World Health Organization’s 90-70-90 cervical cancer elimination targets: 90% of girls vaccinated against HPV, 70% of eligible women screened using a high-performance test, and 90% of women identified with precancerous lesions or invasive cancer receiving appropriate treatment. Global modelling estimates that achieving the elimination goal could avert 74 million new cases of cervical cancer and prevent 62 million deaths by 2120.

The country has also made positive progress on HPV vaccination. Bestmed’s HPV vaccinations number was 1 231 patients for the period January 2025 to September 2026.

Prevention doesn’t happen in a doctor’s room alone

This is also where the conversation needs to become broader, says SEMLI. A 2026 British Journal of Sports Medicine call to action on physical activity and cancer prevention in Sub-Saharan Africa argues for physical activity to be incorporated more deliberately into cancer prevention and care. The paper highlights physical activity as a relatively low-cost, evidence-based intervention option.

The message is not that exercise replaces screening or vaccination. It is that cancer prevention needs more than a single intervention – it needs healthier behaviours to become part of everyday life. Evidence from South Africa cited in the paper points in the same direction. In a retrospective cohort of people with stage I cancers, even low levels of physical activity were associated with a 16% lower risk of cancer progression or death, while moderate-to-high levels were associated with a 27% reduction.

“Physical activity is not a substitute for screening, vaccination or medical treatment, but it is an important part of the bigger prevention picture,” says Dr Lervasen Pillay, Specialist Sports and Exercise Medicine Physician at SEMLI. “We need to move away from thinking about prevention as something that happens only when we visit a healthcare professional. It starts with the behaviours we build into everyday life – including staying active, understanding our risk and keeping up with appropriate screening.”

WHO recommends that adults aim for 150–300 minutes of moderate-intensity physical activity a week, or 75–150 minutes of vigorous-intensity activity, alongside muscle-strengthening activities.

The opportunity is before the diagnosis

“The challenge now is turning prevention into a habit. Prevention is most effective when it happens consistently and proactively, not only when symptoms appear. This means keeping vaccinations up to date, prioritising regular screening, staying physically active and taking ownership of your long-term health,” concludes Dr Moses.