Cervical Cancer

Cervical cancer is the 10th most common cancer in Singaporean women*. It can be effectively treated if detected early.

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Mother and Daughter 

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 (Human Papilloma Virus) vaccination to determine if you are suitable.

* Singapore Cancer Registry, Interim Annual Registry Report, Trends in Cancer Incidence in Singapore 2010-2014

Link Between Cervical Cancer and HPV

Diagram of Cervical Cancer 

  • Cervical cancer arises from the cervix, or the neck of the womb .

  • Some strains 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 16 and 18 causes about 70% of the cervical cancer cases worldwide.

Related: HPV Vaccination FAQa

Risk Factors

Women with the following conditions are at a higher risk of developing cervical cancer:

  • Infection with HPV

  • Human Immunodeficiency Virus (HIV) positive

  • Immunosuppression: People with weakened immune systems (e.g. may be due to HIV / AIDS or immune-system suppressing drugs such as steroids often given to organ transplant patients) are at higher risk of HPV infection.

  • Multiple sexual partners

  • Having sexual intercourse at an early age

  • History of sexually transmitted infections such as genital warts or genital herpes

  • Long term consumption of combined oral contraceptive pills (birth control pills)

  • Cigarette smoking

Women who have never had sexual intercourse are at low risk for cervical cancer.

Related: Know Your Status—Testing for Sexually Transmitted Infections

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.

Related: Endometrial Cancer

Screening for Cervical Cancer

Pap Smear Illustration 

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.

Related: Screening FAQs

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.

Related: FAQs on Pap Smear

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: A surgery to remove the uterus and cervix. Neighbouring reproductive organs such as the ovaries and fallopian tubes may also 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.

Related: Cervical Cancer

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.

For more information on your recommended screenings, visit screenforlife.sg and FAQs on Screen for Life.

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