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Dr Ida Ismail, Associate Consultant at the National University Hospital Women's Centre gives advice on how to protect yourself from cervical cancer.
Talk to your doctor about regular cervical cancer screening and cervical cancer prevention.
Young women are encouraged to make it a habit to go for a Pap test once every 3 years if you are between 25 to 29 years old or a HPV test if you are 30 years old and above, even if you do not experience any symptoms or pain.
You should go for a Pap test even if you have received the injection to prevent cervical cancer.
Screening is repeated every five years if the patient remains well, has no adverse events in vaginal bleeding or discharge, and has no abnormal findings of the cervix during the routine medical examination.
Source: The Straits Times, 3 July 2014 © Singapore Press Holdings Limited. Permission required for reproduction.
Q Is there any vaccine to protect girls from cervical cancer? I heard from a gynaecologist that it is good for young girls to receive a vaccine to rule out the future possibility of being affected by this cancer. Is it true?
A The short answer to your question is "yes". We now know that cervical cancer is caused by a virus called the human papillomavirus, or HPV for short.
HPV is a very common virus that can be transmitted via skin-to-skin contact, including sexual intercourse. Most infections are harmless and our body's immune system will get rid of them.
A small group of HPVs, however, do cause genital warts. Genital warts do not cause or have any association with cervical cancer, but they are a growing problem, particularly among young adults, as it is the most common manifestation of HPV infection in the community.
Less common effects of genital warts include severe infections that result in difficulty passing urine or giving birth naturally. A much smaller group of HPV infections are categorised as high-risk or oncogenic, as they have been associated with cervical cancer.
Among these oncogenic HPVs, type 16 and type 18 are the most common and cause 70 per cent of cervical cancer cases.
Cervical cancer is a global problem. It is the second-most deadly cancer among women worldwide. The unique thing about the disease is that we can screen for the cells that can change into cancer cells in the future.
These cells are called pre-cancer cells and, when identified, can be removed safely and easily, so as to prevent cervical cancer from developing.
It is now established that an organised cervical screening programme can reduce the number of women getting the cancer. Singapore's cervical screening programme, called CervicalScreen Singapore, invites sexually active women from the age of 25 to 29 to take a Pap test every three years to detect pre-cancer cells, or a HPV test once every five years to detect high-risk cancer-causing HPV strains for women who are 30 years and above.
There is no doubt that an organised cervical screening programme is an important initiative that should continue in order for us to eliminate cervical cancer once and for all.
However, this is not enough. Prevention is always better than cure. We also need to prevent oncogenic HPV infections from happening, so that pre-cancer cells are not produced in the first place.
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This vaccine does not contain a live virus. Instead, a virus-like particle or VLP (an empty shell without virus DNA) is used to trick the body into increasing its immune response to oncogenic HPV infections.
The vaccine protects you from HPV types 16 and 18. It is therefore extremely important, even if you have had HPV vaccination, to continue going for regular Pap smears to check if you are infected with any of the other oncogenic strains.
Given that HPV is transmitted sexually, the risk of being infected before the first sexual encounter is extremely low.
The best time to get the vaccine is before any sexual contact. This allows the vaccine to build up a strong immunity against types 16 and 18 infections that may come in the future.
We also know that women who had been or are currently sexually active, or have had previous treatment for pre-cancer cells, will also benefit from getting the vaccine for prevention of future infections.
Even though the benefit is lower compared with those who receive the vaccine before their first sexual contact, it is still much greater than that for women who did not get the vaccine at all.
In Singapore, HPV vaccination is indicated for females between nine and 26 years old. The vaccine is given in three doses in the span of six months. No additional or booster shots are needed.
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The most common side effects, as expected, would be slight pain at the site of injection.
Some may have slight redness or swelling at the injection site. This will usually go away after a few days.
The vaccine is very closely monitored worldwide and no adverse effects directly associated with the vaccine have been reported.
If you have a daughter who falls within the recommended age group for HPV vaccination, do consider doing so. You may also wish to seek further advice from your doctor regarding the vaccine.
DR IDA ISMAIL-PRATTAssociate consultant at the National University Hospital Women's Centre
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This article was last reviewed on
Monday, May 31, 2021
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