Cervical Cancer Prevention

Precancer of the Cervix — Why the Pap Smear is Important

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Precancer of the cervix can be detected by pap smear screening and can be treated to prevent cervical cancer from occurring.

Cervical cancer is the tenth-commonest cancer among women in Singapore. Each year, about 300 women in Singapore will develop cancer of the cervix. However, it can be easily prevented by screening, by undergoing a pap smear.

The cervix is the lower, narrow end of the womb that opens into the vagina. Cervical cancer occurs when the cells of the cervix start to grow in an abnormal, uncontrolled way, which can damage other healthy parts of the body.

Fortunately, some early changes in the cervix can be seen long before cancer develops (these are known as precancerous changes). Treating the cervix at this stage can prevent cervical cancer from ever occurring.

What Are the Warning Signs of Cervical Cancer?

  • Irregular vaginal bleeding
  • Frequent foul-smelling and/or bloody vaginal discharge
  • Bleeding after sexual intercourse

Unfortunately, by the time these symptoms occur, the cancer may already be at an advanced stage. So it is vitally important that you have your pap smears performed regularly even if you are feeling well.

What Is the Pap Smear?

The pap smear is a simple, relatively painless test in which cells from the cervix and vagina are examined for any abnormalities. This involves inserting an instrument called a speculum gently into the vagina. The doctor or nurse can then obtain the necessary cells for examination.

The cells obtained are then checked under a microscope in order to find early changes in the cells, which can be treated to stop cervical cancer from developing. Sometimes they can also find cervical cancer at a stage that is easy to cure.

The pap smear is a good test but is not perfect. Occasionally the results can be normal even though there may be abnormalities in the cervix. Fortunately, most cervical precancers grow very slowly. So having a pap smear test at regular intervals will find almost all abnormalities before they have a chance of progressing.

How Often Should I Have a Pap Smear Test?

Only women who are sexually active need a pap smear test. Sexually active women should have a pap smear from the age of 25 onwards. This is repeated every three years until the age of 65, provided there are no abnormalities. However, your doctor may recommend that you have a pap smear more frequently.

What if I Have an Abnormal Pap Smear?

An abnormal pap smear does not mean that you have cancer. It simply means that there are abnormal cells, which may require further evaluation by a doctor. Often these abnormal cells are due to an infection, or may be due to the thinning of the skin of the cervix after menopause.

This can be easily treated with an antibiotic or hormone cream. In some cases, the pap smear may suggest that there are some precancerous cells and you may be asked to come for a colposcopy examination.

What Is A Colposcopy Examination?

A colposcope is an instrument with a magnifying glass through which a better view of the cervix can be obtained.

It is a relatively painless procedure that takes no more than 10 to 15 minutes. A speculum is inserted into the vagina in the same way as for a pap smear. The doctor is then able to examine the cervix after applying a mild vinegar-like solution (acetic acid) to wash away the mucus.

Sometimes, a small biopsy may have to be taken from the cervix for further evaluation. Many patients do not feel anything at all. Depending on the results of the biopsy, you will be advised on the best treatment.

How is Treatment Performed?

At KKH, we have several methods of treating precancerous changes of the cervix:

  • Laser vaporisation
  • LEEP (Loop electrosurgical excision procedure)
  • Cone biopsy with laser, diathermy or knife

For most women, these procedures can be performed under local anaesthetic either in the Colposcopy Suites or in Day Surgery. However, in some instances a general anaesthetic may be used and this may involve staying in hospital for a day or two.

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