Cervical Cancer

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

• Human Papillomavirus (HPV) is a common virus and certain strains can infect the cervix, causing the cells to change.

• In about 90% of the infection cases, the virus clears by itself.

• In some cases, the infection of some high risk HPV strains 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 cervical cancer cases worldwide. Thus, you can lower your risk or your daughter’s risk of developing cervical cancer by getting a HPV vaccination. Speak to your doctor to see if you are suitable for this vaccination.

Related: HPV Vaccination FAQ

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

• 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) and are on 2 or more immunosuppression drugs are at higher risk of HPV infection.

• Undergone solid organ transplant

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

Related: Getting Support (for STIs)

In the early stages, women with cervical cancer do not have any symptoms.

As 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.

During a cervical cancer screening (Pap test or HPV test), the doctor/nurse gently brushes cells from the narrow neck of the cervix and sends the sample to the laboratory for further examination.

A Pap test will be done if you are 25 to 29 years old. A Pap test 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. At this age, you will be able to clear HPV infections at a faster rate, thus, you do not need a HPV test.

A HPV test will be done if you are 30 years and above. Your cells will be sent for a HPV test to detect high-risk cancer-causing strains. At this age, a HPV test is more effective in determining your risk of developing cervical cancer.

Related: Screening FAQs

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.

Cervical cancer if detected in its early stages can be treated effectively. 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.

You can reduce your risk of cervical cancer by:

• Having regular cervical cancer screening (Pap or HPV test) at the recommended intervals 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.