alexa If you have had sex even once you need to get a pap smear - Daily Nation

If you have had sex even once you need to get a pap smear

Saturday August 3 2019


A medic performs Pap smear. Cancer of the cervix is among the commonest cancers among women in Kenya. ILLUSTRATION | NATION MEDIA GROUP 

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I met Lillian three and a half years ago. Valentine’s Day was just around the corner. Her desire to satisfy her husband sexually pushed her to seek care in the sexology clinic.

“I am afraid if you don’t help [me] my marriage will break!” she said as she took her seat in the consultation room.

“What exactly is happening in your bedroom?” I asked, trying to strike a rapport. Well, it is Valentine period and everybody is showing love but for me I am unable. They say when it rains it pours, and for me it is happening literally!” I was not sure I understood her parables so I requested that she explains.

“It is my periods, they just won’t go. My husband is very upset and thinks I am pulling one of those strings on him,” she explained.

Daisy had been bleeding continuously for one month. Her flow used to last for four days previously. She had no tummy pains.



With time she had noted that the blood was getting dirty and starting to smell. “My husband hates blood. It has been over a month with no sex, can you imagine?” she asked rhetorically.

I examined Lillian and found the bleeding to arise from her cervix. There was a friable growth in the cervix which was bleeding easily.

The growth seemed to be extending to the pelvis. I feared this could be a serious condition, possibly cancer. “When did you last have a Pap smear?” I asked.

Pap smear is an important test that every woman should undertake routinely. It detects changes in the cervix that could develop into cancer. Treating those changes in good time averts cancer of the cervix.

Lillian had never had a Pap smear. “I know about the test,” she explained. “But, I have never dared to do it. Many women I talk to just hate it; it is uncomfortable.”


Lillian was booked for examination in the theatre under anaesthesia to confirm the extent of the growth and also take a biopsy for testing in the laboratory.

Results of the tests were ready a week later. Lillian came with her husband to the clinic to receive them.

“This is turning out to be unbearable for me,” she told her husband, tears rolling down her cheeks. The test confirmed that she had cervical cancer.

“Do you mean bleeding alone is the symptom of cancer?” asked Lillian’s husband. “My wife has always been fine, what could have caused cancer?”

Unfortunately, cancer of the cervix shows no symptoms until it is at an advanced stage. That’s when the continuous bleeding starts.


Some women may also experience bloodstained smelly discharge. Pain happens late in the disease. The only way to detect cancer early is to go through routine screening using Pap smear or other tests.

Because most ladies do not go for screening, cancer of the cervix is among the commonest cancers among women in Kenya.

It is estimated that over half a million cases of the cancer are newly diagnosed globally each year leading to about 280,000 deaths of women.

In Kenya, about 2,500 cases are diagnosed each year leading to about 1,700 deaths. Any woman who has had sex needs to be screened.

For young girls who are yet to be exposed to sex, there is now a vaccine. The vaccine can be administered from the age of nine years. Parents should help their children get the vaccine.

“When you say that it happens in women who have had sex does it mean that it is sexually transmitted,” Asked Lillian curiously.


The connection between cancer and sex is found in a virus, the Human Papillomavirus (HPV). The virus is common and is sexually transmitted.

There may be no signs of infection until cancer happens. In a few cases, there may be growths in the private part called warts.

Lillian underwent surgery to remove her uterus. She then underwent radiotherapy. Unfortunately 10 months later, her kidneys failed.

The cancer cells had invaded the urinary system and interfered with the flow of urine leading to the destruction of her kidneys.

Realising that the cancer had advanced to levels beyond repair, Lillian was referred to the hospice for terminal care. She, unfortunately, passed away a few months later.