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 Regular cervical cancer screening is the single most effective way to prevent one of the most treatable cancers for women. When precancerous changes in the cervix are detected early, it is much easier for a woman to beat the odds of getting cervical cancer later.
“Cervical cancer is the fifth most common cancer affecting women in Singapore,” says Associate Professor Tan Hak Koon, Senior Consultant and Head of the Department of Obstetrics & Gynaecology at Singapore General Hospital (SGH).
“Precancerous changes usually show no symptoms. The only way to detect any abnormality is through regular cervical cancer screening. Screening also checks for HPV (human papillomavirus) infection which must be treated early to prevent it from progressing to cancer,” adds A/Prof Tan.
What is the cervix?
The cervix is located at the neck of the uterus; it widens during childbirth and is the passageway for menstrual fluid to flow out of the uterus or for sperm to travel up into the uterus.
Being the passageway, the cervix is susceptible to virus infections such as the sexually-transmitted HPV. The body’s immune system will normally prevent the HPV from doing any harm. But what if the virus survives and stays in the body for years? A precancerous condition called cervical dysplasia may develop if the virus is one of the 13 types of HPV known to cause cervical cancer.
What to do when Pap smear shows precancerous changes…
First, do not panic. Precancerous cells are not cancer. They are simply abnormal-looking cervical cells. Your doctor may recommend a repeat pap smear or any of these procedures:
Colposcopy examination
A colposcopy scrutinises the cervix through an instrument with a magnifying lens. If precancerous changes are confirmed, the doctor may recommend a cone biopsy or loop electrosurgical excision procedure (LEEP).
Cone biopsy
Cone biopsy removes a cone-shaped piece of the abnormal cervical tissue to be examined for any malignancy. It can also be used to remove the entire abnormality, thereby clearing away any precancerous cells.
LEEP
LEEP uses an electric wire loop to cut away abnormal tissues from the mouth of the cervix. These tissues are then examined for any malignancy.
Cryosurgery
This involves freezing and killing both precancerous and cancerous cells.
Laser surgery
A narrow, intense beam of light is used to kill precancerous and cancerous cells. Which treatment method will depend on the location and severity of the abnormal cervical cells, and whether a biopsy is needed.
Signs and symptoms of cervical cancer
While precancerous changes in the cervix are not visible to the naked eye, signs of cervical cancer are more obvious. Watch out for:
- Vagina bleeding between menstrual periods, after menopause or after sex
- Bloody discharge from the vagina
- Pelvic pain or abnormal bleeding after sex
Make cervical cancer screening a habit
Though Singapore’s cervical cancer rates have fallen in the past 30 years, the decline is slower than in the US and Europe.
If you are sexually active, aged 25 to 65, go for cervical cancer screening (Pap smear and HPV test) once every three years.
“Even if you have been vaccinated against HPV, it is still advisable to go for regular Pap smear tests,” says A/Prof Tan. “The vaccine is only effective against two types of HPV that cause 70% of cervical cancer cases. Most new cervical cancer cases are found in women who never went for Pap smear,” A/Prof Tan cautions. |