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Cervical cancer is the 6th most common cancer among women in Singapore. Cervical cancer occurs when abnormal cells in the cervix (the lower part of the uterus that opens into the vagina) start to grow out of control. The majority of cases go through a premalignant phase (known as Cervical Intraepithelial Neoplasia, or CIN for short) which can be present for a fairly long time before turning into actual cancer. Hence, cervical cancer screening aims to detect women still in the CIN stage, as early detection and treatment results in far better treatment outcomes.
What Are The Risk Factors For Cervical Cancer?
Most cervical cancers begin with an infection by the human paillomavirus, or HPV. There are numerous sub-types of HPV and you get it via sexual contact with someone who has it. Some types of HPV cause cervical cancer, whilst others cause genital warts.
There have been vaccines developed in recent years to protect against the sub-types of HPV known to cause cancer. HPV-16 and HPV-18 account for about 70% of all squamous carcinomas of the cervix.
Risk Factors for Cervical Cancer Include:
• Infection with HPV
• Multiple sexual partners (in either partner)
• Starting sexual intercourse at an early age
• Having multiple sexual partners
• Cigarette smoking
• Long term consumption of oral contraceptive pills
• HIV infection and other immunosuppressive states
What Are The Symptoms Of Cervical Cancer?
Cervical cancer in the early stages rarely produces any symptoms. As the cancer progresses, various symptoms may be experienced, including:
• Vaginal bleeding which is not part of normal menstruation
• Vaginal bleeding after intercourse
• Pain during sexual intercourse
• Vaginal discharge, especially if tinged with blood
• Symptoms of advanced cervical cancer may include loss of appetite, loss of weight, pelvic pain, bone pain, swelling of one leg etc. There may also be symptoms due to metastatic spread.
Screening For Cervical Cancer
Papanicolaou (Pap) smears are the best way to screen for cervical cancer. It is a simple test which can be done by gynaecologists and most general practitioners.
All women who have ever had sexual intercourse should start screening for cervical cancer via a Pap smear from the age of 25 years of age. Also, women under the age of 25 years, who feel that they are at high risk for cervical cancer, should discuss with their doctor if they should start screening earlier.
If Pap smear results have been normal, then screening may take place at least once every 3 years. Otherwise, more frequent intervals of screening are required.
Screening may be stopped at 69 years of age provided that the results of the Pap smear at 69 years is negative, and that she has had 2 previous consecutive normal smears within the last 10 years.
It should be noted that women who have been vaccinated against HPV, should still continue to have Pap smear screenings at the above recommended intervals.
Find a Gynaecologist
The article above is meant to provide general information and does not replace a doctor's consultation.
Please see your doctor for professional advice.
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