Published 15 September 2025

One of the guiding principles of family medicine is that every patient encounter holds an opportunity for health promotion and prevention.

Recently, this principle became very real for me. A patient I had seen several times for her chronic conditions was later diagnosed with advanced cervical cancer. When she arrived at the district hospital with severe bleeding, I was asked to facilitate her transfer to a tertiary hospital.

In that moment, I realised I had missed earlier opportunities to ask a simple but vital question: “Have you had a Pap smear?”

Cervical cancer is largely preventable through regular screening. Yet in the busyness of routine consultations, it can be easy to focus on the presenting issue and overlook what lies beneath.

This experience has shifted my practice. I now ask every female patient - no matter the reason for their visit - whether they’ve had a recent Pap smear. Sometimes, a brief question can open a conversation that prevents devastating outcomes.

It has also reminded me of a broader truth: whether with patients, colleagues, or students, our role is not only to respond to what is brought into the room, but also to notice what may be unspoken. That noticing can change the trajectory of a life.