Cervical Cancer: Why Prevention Works (and Why Many Neglect It)
January 23-29, 2026: European Cervical Cancer Prevention Week
A cancer that can be avoided
There are few cancers that can truly be prevented. Cervical cancer is one of them.
However, in Switzerland, approximately 260 women are diagnosed each year, and 70 die from it. These figures may seem low compared to other cancers. But here's the important point: most of these cases could have been prevented.
This article explores a medical reality that is often hidden: cervical cancer is one of the few cancers for which we have the tools to prevent its onset. And yet, a significant portion of the female population does not use them.
It's a story of science, prevention, and also of barriers that are sometimes financial, often psychological.
Understanding cervical cancer
Anatomy and Epidemiology
The cervix is the lower part of the uterus that connects to the vagina. It is a highly vascularized area, constantly subject to physiological changes.
Cervical cancer is a disease of the cells in this region. It usually develops slowly, first passing through precancerous states (abnormal cell changes that can progress to cancer over several years).
The Age of Diagnosis
The majority of diagnoses occur between the ages of 25 and 44. This means that it is a cancer that strikes women in the prime of their lives, at a time when they often have professional, family, and social responsibilities.
This is also the age when symptoms are often ignored or minimized — attributed to something else, postponed "until when I have time".
The culprit: Human Papillomavirus (HPV)
The discovery that changed everything
For a long time, the causes of cervical cancer remained mysterious. Then, in 1983, Harald zur Hausen, a German virologist, demonstrated that certain types of human papillomavirus (HPV) were responsible.
This discovery revolutionized the approach. Suddenly, it was no longer a "cancer that one catches for no known reason." It was a viral infection—and viral infections can be prevented.
How HPV works
HPV is an extremely common virus. The majority of sexually active people will contract it at some point in their lives. The virus is transmitted through sexual contact.
In 90% of cases, the immune system eliminates the virus naturally within a few months. No problem. No consequences.
In about 10% of infected individuals, however, the virus persists. And it is this persistent infection that can progress to abnormal cellular changes, and then to cancer.
There are between 100 types of HPV. Only 12-15 are considered carcinogenic. Types 16 and 18 are responsible for approximately 70% of cervical cancers.
Important: HPV is not a death sentence
Having an HPV infection does not mean you will get cancer. Far from it. It means you need regular monitoring to ensure the virus is not causing dangerous cell changes.
This is precisely where screening comes in.
Prevention: three levels
Cervical cancer prevention works on three levels.
Level 1: HPV Vaccination
HPV vaccination is the most effective preventive intervention. It protects against the most carcinogenic types of HPV before exposure to the virus.
HPV vaccination is recommended for everyone aged 11 to 26. It is free of charge through cantonal vaccination programs. Ideally, it should be administered before first sexual intercourse, as it is most effective before exposure to the virus.
Current HPV vaccines protect against 4 to 9 types of HPV, including types 16 and 18. Clinical studies show an efficacy of over 99% in people vaccinated before exposure to the virus.
Important: Even if you are vaccinated, Pap testing is still necessary. Vaccination does not protect against all types of cancer-causing HPV.
Level 2: Screening by Pap test
The Pap test (cervical smear) is the standard screening test. It involves collecting cells from the cervix and examining them under a microscope to detect abnormal changes.
A Pap test is recommended every 3 years for women aged 21 to 70. It is covered by basic health insurance.
The Pap test has a sensitivity of 80-85% for detecting high-grade precancerous lesions. This means that 15-20% are missed — hence the importance of regular repeat testing.
Level 3: the HPV test
More recently, direct HPV detection tests have been developed. These tests identify the presence of the virus itself, rather than looking for cellular changes.
Advantage: The HPV test is more sensitive than the Pap test alone — it detects about 95% of precancerous lesions.
Limitations: The HPV test alone is not ideal for population screening, as it also detects transient infections that will resolve naturally. Therefore, it is generally used in combination with the Pap test ("co-testing").
Screening: successes and shortcomings
The Impact of Screening
Since the introduction of the Pap test in Switzerland more than 30 years ago, mortality from cervical cancer has decreased by more than 50%. This is a major public success.
This decrease has saved thousands of lives. It results directly from the detection and treatment of precancerous lesions before they progress to invasive cancer.
The problem: non-participation
Despite this success, approximately 30% of eligible women never participate in screening in Switzerland.
These women represent the majority of diagnosed cervical cancer cases. These are not "rare" or "unpredictable" cases. These are cases that simply participating in screening would likely have prevented.
What's striking is that the Pap test is not difficult to access. It costs nothing. It only takes a few minutes. And yet, 30% don't get it done.
Precancerous lesions: when intervention matters
From normal cells to malignancy
Cervical cancer progresses in stages:
HPV infection — usually asymptomatic
Mild cellular changes (CIN1) — often regress spontaneously
Average cellular changes (CIN2) — may regress, may progress
Severe cellular changes (CIN3) — high risk of progression to invasive cancer
Invasive cancer — requires chemotherapy, radiation therapy, or surgery
The window period between CIN3 and invasive cancer can last several years. It is this window that screening aims to capture.
Treatment of precancerous lesions
If a precancerous change is detected, treatment is relatively simple and non-invasive:
Conization: removal of a small portion of the cervix containing the lesion
Cryotherapy: destruction of the lesion by freezing
Laser: destruction by laser
These procedures can be performed on an outpatient basis. They have success rates exceeding 90%.
Compared to the treatment of invasive cancer — major surgery, chemotherapy, radiotherapy, potential sterility, complications — interventions for precancerous lesions are simple and effective.
The role of medical imaging
Diagnosis confirmed
If an abnormal change is detected during the Pap test, a colposcopy is usually performed. This involves direct visualization of the cervix with a magnifying instrument, often accompanied by a biopsy of any suspicious areas.
Medical imaging plays a secondary but important role in advanced stages.
Cancer staging
If cervical cancer is diagnosed, medical imaging (CT scan, MRI, sometimes PET scan) is used to determine the extent of the disease:
Has it invaded adjacent tissues?
Are any lymph nodes affected?
Are there any distant metastases?
This staging determines the treatment and prognosis.
Post-treatment follow-up
After treatment (surgery, radiotherapy, or chemotherapy), medical imaging monitors recurrence and complications.
Why do many people neglect screening?
Psychological barriers
The Pap test is simple, quick, and inexpensive. And yet, 30% don't get it done.
For what ?
Embarrassment. Many women find the test invasive or embarrassing. It's a fact: getting into stirrups isn't comfortable for everyone. Anxiety. The fear of learning an abnormal result paralyzes some women. Sometimes it's easier not to know than to know. Forgetfulness or procrastination. Screening isn't an emergency. There are no symptoms. It's easy to postpone it indefinitely. Lack of awareness.In some communities, screening isn't a cultural or social priority.
Practical barriers
Limited access. In rural areas or some urban neighborhoods, clinics offering Pap tests may be far away. Hidden costs. Although the test itself is covered by insurance, the doctor's visit or transportation can be a barrier. Scheduling. Women working full-time or with family responsibilities may find it difficult to book an appointment.
A call to action
For women
If you are between 21 and 70 years old and have not been screened in the last three years, consult your doctor or a women's health clinic. The test takes 5 minutes. Results take one to two weeks.
The discomfort of 5 minutes is infinitely better than the treatment of a cancer diagnosed late.
For health systems
Cervical cancer screening is one of the most effective public health programs. But its success depends on participation. Efforts to improve access, raise awareness, and reduce barriers are crucial.
For young women
If you are between 11 and 26 years old, talk to your doctor about the HPV vaccine. It is free and offers long-lasting protection against the most cancer-causing types of HPV.
Even if you are vaccinated, screening remains important once you reach the age of 21.
A possible victory
Cervical cancer is rare in Switzerland compared to countries without organized screening. This is a victory for public health.
But this victory is not complete. A 30% non-participation rate means 30% of women exposed to a risk they could have avoided.
Each year, approximately 260 women are diagnosed. How many of them could have been healthy if they had participated in screening a few years earlier?
This is a question we can all ask ourselves. And it's a question that deserves a collective response—improving access, reducing barriers, and reminding every woman: you deserve this prevention. Take it.
