Cervical Cancer & HPV Vaccination

Cervical cancer is the 10th commonest cancer amongst women in Singapore—about 190 new cases are diagnosed yearly. The cervix (the neck of the womb) is made up of millions of tiny cells, and cervical cancer occurs when these cells in the cervix undergo malignant change.

The most common cause of cervical cancer is the Human Papilloma Virus (HPV). There are over 100 types of HPV viruses and 15 types lead to cervical cancer and it is these HPV types that spread through sexual contact. All sexually active persons are at risks of contracting HPV infection and it can be prevented with HPV vaccination. Many people who have HPV infections may not show any signs or symptoms, hence they may transmit the virus unknowingly.

Cervical Cancer Screening

• Cervical cancer screening involves a routine pap smear which is a painless test aimed at women with no cancer symptoms. Cells from the cervix are collected and examined for any abnormalities that could lead to cancer.
• Fortunately, early precancer changes in the cervix can be easily detected long before cervical cancer develops. Once HPV infections and cervical precancer are diagnosed and treated, cervical cancer can be prevented. It is recommended for all sexually active women to have regular pap smears with their gynaecologist, so that problems can be detected early and treated before they become serious.

• Colposcopy surgery is the simple procedure of observing the cervix through a special magnifying device after coating the cervix with the appropriate staining solutions. This allows the doctor to detect cervical abnormalities that cannot be seen with the human eye alone.
• Cervical biopsies of the abnormal areas are taken for further evaluation and treatment can be performed based on these results.

Cervical Cancer Treatment & Prevention

• LEEP and cone biopsy are minor surgical procedures that involve the removal of a cylindrical or cone-shaped piece of the cervix in which abnormal cells are detected by using a heated electrical loop wire or with laser, diathermy or knife.
• For LEEP, local anaesthetic is administered prior to the procedure. For cone biopsy, an anaesthetist will discuss with you the types of pain-relief available.

• Among the over 100 types of HPV strains, there are 15 cancer-causing types which can lead to cervical cancer. Together, HPV types 16, 18, 45 and 31 account for over 80% of cervical cancer cases in Asia Pacific. Other HPV types 33, 52 and 58 are associated with cancer of the cervix, vagina, vulvar and anus. Genital warts are caused by HPV types 6 and 11.
• Fortunately, there are safe and effective vaccines available to protect against the most common strains of HPV infections that cause the majority of cervical cancers and genital warts.
• Depending on the type of HPV vaccine used, one can achieve up to 70% to 90% lifetime immunity against cervical cancer and 90 % immunity against genital warts underscoring the importance of prevention and timely vaccination. Both men and women can receive HPV vaccination.
• For maximum efficacy, the HPV vaccine should ideally be administered to one who has not commenced sexually activity yet but is also effective in sexually active couples without prior HPV exposure. However, one may still benefit from some level of protection even if one has had HPV exposure before. This is because one may not have been exposed to a particular strain of HPV that the vaccine protects against.
• That said, it must be noted that the HPV vaccine is not a substitute for routine regular Pap smear screening.