Cervical Cancer

Cervical cancer is the fourth most ​common cancer ​among women worldwide.¹ The best way to detect cervical cancer is by having regular Pap smears.

“Cervical cancer has a precancerous stage. It can be prevented in the long run when the pre-cancerous stage is detected and treated,” says Dr Shamini Nair, Specialist in Obstetrics and Gynaecology, Raffles Women’s Centre.

Dr Shamini’s clinical interests include pre-invasive diseases of the cervix, vulva and vagina; antenatal care; gynaecological and minimally invasive surgery; family planning and contraception; general infertility; and treatment of menopausal problems.

Women who are sexually active should have a ​Pap smear done every one to three years. Dr Shamini stresses that the Pap smear is not a diagnostic tool but a screening tool that would indicate whether further evaluation is necessary. If you receive abnormal Pap results, your gynae may recommend further tests such as colposcopy.

“It is important to remember that an abnormal Pap smear test does not equate to cervical cancer. Inflammation, lower genital tract infections and blood can also result in a abnormal Pap smear result,” says Dr Shamini. 

Cervical cancer is the only cancer so far which can be protected via vaccination. There are various types of HPV that may cause cervical cancer and HPV types 16 and 18 cause about 70 per cent of cervical cancer.² Gardasil and Cervarix,  the two vaccines which are currently approved for use in Singapore by females aged nine to 26 years, protect against infection by HPV types 16 and 18​.^​

The vaccine will have most effect when it is used in women before they become sexually active and become at risk of HPV infection. However, it does not protect against other types of HPV that cause the other 30 per cent of cervical cancers. Therefore, Pap smear screening with early detection and treatment would remain the mainstay of management.

Besides getting a Pap smear, there are different screening tests recommended for women from different age groups. Consult a gynae today to find out the screening tests that are ​suitable for you.

Facts about cervical cancer

1. Cervical cancer is cancer that arises from the cervix which is the lower part of the womb (uterus), often called the neck of the womb.
2. Cervical cancer is the ​10th most common cancer among women in Singapore.³
3. In most cases, before cervical cancer develops, changes occur in the cells of the cervix which are precancerous. These precancerous changes called cervical intraepithelial neoplasia (CIN) have the potential to become cancerous if not treated.
4. Precancerous cell changes of the cervix or CIN, which usually do not have any symptoms, can be detected by the Pap ​smear.
5. Precancerous disease of the cervix can be easily and effectively treated, thus preventing cervical cancer.
6. All women who have ever had sexual intercourse are advised to go for regular Pap smear screening.
7. Most cervical cancer is caused by a virus called Human Papillomavirus or HPV. HPV can be transmitted by having skin or sexual contact with someone who has it. However, although many sexually active women will be infected with HPV, most of them will not develop cervical cancer. The majority of HPV infections are transient and do not cause changes to the cervical cells.
8. It is now possible to help protect against cervical cancer through HPV vaccination. The current vaccines available protect against HPV types 16 and 18 which account for an estimated 70 per cent of all cervical cancers.

References:

¹ World Health Organisation. (2015). Human papillomavirus (HPV) and cervical cancer: Fact sheet.

² Health Promotion Board. (2014). FAQs on Human Papilloma Virus (HPV) and HPV vaccination.

³ National Registry of Diseases Office. (2014). Singapore Cancer Registry Annual Registry Report Trends in Cancer Incidence in Singapore 2009 – 2013.