Cervical cancer is the seventh most common cancer in Singaporean women*. It can be effectively treated if it is detected early. The best protection against cervical cancer is to go for regular Pap smear once every three years. You can also speak to your doctor about HPV vaccination to determine if you are suitable.
Click here for a list of Frequently Asked Questions on HPV vaccination.
Information on Cervical Cancer and HPV Vaccinations
The link between cervical cancer and HPV
- Cervical cancer is the cancer of the neck of the womb which is called cervix.
- Some types of Human Papilloma Virus (HPV) can infect the cervix, causing the cells to change.
- In about 90% of the infection cases, the virus clears by itself and the cells return to normal.
- In some cases, the infection can persist and cause the cells to grow in an abnormal way, developing into cervical cancer.
- Specifically, HPV types 18 and 18 causes about 70% of the cervical cancer cases worldwide.
Types of cervical cancer
- Squamous cell carcinomas begin in the thin flat cells at the lower part of the cervix.
- Adenocarcinomas occur in the glandular cells that line the upper portion of the cervix.
- Adenosqumous carcinomas are cancers in which both types of cells are involved in cervical cancer.
Risk factors
Factors which may increase the risk of cervical cancer include:
- Multiple sexual partners: The greater the number of sexual partners, the higher is your risk of HPV infection. Having sexual activity with a partner who has had multiple sex partners can also increase your risk of HPV infection.
- Sexual activity at an early age
- Weakened immune system: People with weakened immune systems (e.g. may be due to Human Immunodeficiency Virus (HIV) / Acquired Immune Deficiency Syndrome (AIDS) or immune-system suppressing drugs such as steroids often given to organ transplant patients) are at higher risk of HPV infection.
- Long term consumption of combined oral contraceptive pills (birth control pills)
- Cigarette smoking
- HPV infection
Symptoms
In the early stages, women with cervical cancer may not have any symptoms.
As the cancer progresses, these symptoms and signs include:
- Vaginal bleeding following intercourse, or in between periods or after menopause
- Watery, bloody vaginal discharge that may be heavy and have a foul smell
- Lower abdominal pain or pain during intercourse
Screening for cervical cancer
- A Pap smear can detect the precancerous stage of cervical cancer when the abnormal cells (dysplasia) are in the outer layer of the cervix and have not spread to the deeper tissues.
- During a Pap smear, the doctor gently brushes cells from the narrow neck of the cervix and sends the sample to the laboratory for further examination of any changes in the cervix.
Click here for more information on Pap Smear.
Diagnosis
To confirm the diagnosis, the specialist may perform the following tests:
- Colposcopy involves examining the cervix using an instrument called the colposcope and taking samples of cells for analysis (biopsy).
- Punch Biopsy involves taking a small sample of cervical cells and examining the tissue under a microscope.
- Cone biopsy (conisation) involves removing a cone-shaped area of cervical cells using laser or a scalpel.
Treatment
Cervical cancer if detected in its early stages can be treated. Treatment is simple and almost 100% effective. Treatments of early stage cancer include:
- Cone biopsy (conisation).
- Laser surgery.
- Loop electrosurgical excision procedure (LEEP).
- Cryosurgery.
- Hysterectomy.
Cervical cancer that invades deeper into the cervix is referred to as invasive cancer and requires more extensive treatment. Treatment options may include:
- Radical hysterectomy is the surgery used to remove the uterus and cervix. The neighbouring reproductive organs such as the ovaries and fallopian tubes may be removed.
- Radiation therapy uses high-powered energy to kill cancer cells and can be given externally using external beam radiation or internally by placing devices filled with radioactive material near the cervix.
- Chemotherapy uses strong anti-cancer chemicals to kill cancer cells.
Prevention
You can reduce your risk of cervical cancer by:
- Having regular Pap smear as it is the most effective way to detect cervical cancer.
- Speaking to your doctor about HPV vaccination.
- Delaying first sexual intercourse, having fewer sexual partners and avoiding smoking.
Click here to view Frequently Asked Questions on Cervical Cancer.
Click here to find out more information on the national cervical cancer screening programme, CervicalScreen Singapore (CSS).
* Singapore Cancer Registry. Interim Report.Trends in Cancer Incidence in Singapore. 2004-2008.
