When it comes to cervical cancer, prevention is not only better than cure, it is also very possible. And it takes just five steps to cut your risk of developing the disease.
Did you know that, around the world, a woman dies of cervical cancer every two minutes? In Singapore, cervical cancer is the 10th most common cancer among women, and the eighth leading cause of death among all the cancers that affect them. Dr Ida Ismail-Pratt, consultant from the O&G Gynaecologic Oncology Division at National University Hospital, shares how you can lower your risk of developing it.
WHAT CAUSES CERVICAL CANCER?
Cervical cancer is caused by the human papillomavirus (HPV). This virus is common in sexually active people, with nine out of 10 contracting the infection in their lifetime.
The virus works its way into the cervical cells through small abrasions in the cervix. Over several weeks, the virus replicates and the infection spreads. In 90 per cent of cases, the infection heals on its own, usually within two years. However, some infections do not heal and this can progress into cancer 10 to 30 years later. By this time, the virus would have invaded the deeper layers of tissue within the cervix and become cancerous.
A PREVENTABLE CANCER.
The good news is that cervical cancer is preventable. In fact, it is the only cancer you can effectively prevent. To lower your risk of developing the disease, follow these five steps:
1 Vaccinate against HPV.
HPV vaccines consist of particles that resemble the virus. As they do not contain viral DNA, they can’t cause an infection and are therefore safe. The HPV vaccine is known to protect up to 99 per cent of women against the most common HPV virus types, HPV 16 and 18, that can lead to cervical cancer.
Two types of HPV vaccine are available today. Both the quadrivalent and bivalent vaccines protect against HPV 16 and 18 that cause 70 per cent of cervical cancers, while the quadrivalent vaccine provides added protection against HPV types 6 and 11 that cause genital warts.
The HPV vaccines are licensed in Singapore to males and females between the ages of nine and 26, and are usually given in three doses within six months. Those aged between 12 and 14 may be eligible to have the vaccines in two doses within six months. Speak to your doctor to see if you are suitable for the vaccination. Since the HPV vaccine protects against only two out of 14 cancer-related HPV, you are advised to continue with your cervical cancer screening if you meet the national criteria for screening.
Pre-cancer cells are cells that have the potential to become cancerous in future. The earlier pre-cancer cells are detected, the easier it is to treat the condition as they have not turned cancerous yet.
That’s why screening is so important. A simple cervical screening, usually with a Pap smear, can help detect these cells and stop them from progressing. There is evidence that women who have never undergone cervical screening or who do not go for regular cervical cancer screening are at the highest risk of getting cervical cancer. The Singapore national cervical cancer screening guidelines advise women who are or have been sexually active to go for Pap smears at least once every three years, starting from 25, till they are 69 years old. If you have never had sexual intercourse, you are not required to go for cervical cancer screening as your risk is extremely low.
3 Watch for symptoms.
Pre-cancer cells do not cause symptoms. But if you experience abnormal vaginal bleeding, such as bleeding after sexual intercourse or between periods, it may be a sign of cervical cancer. So if you experience any of these symptoms, go to your doctor to have it checked out. However, abnormal vaginal bleeding is not always a sign of cervical cancer. A majority of causes are non-cancer conditions like vaginal infection, normal changes on your cervix or benign growths on your cervix. See your doctor, who can help you determine the cause of the abnormal bleeding.
4 Quit smoking.
Smoking is known to increase your risk of cervical cancer. Even if you are a light smoker, you are still putting yourself at risk.
5 Practise safe sex.
Responsible sexual habits can lower your risk of cervical cancer. This means limiting the number of sexual partners you have and using condoms during sex. While condoms will not prevent you from getting HPV infections, they do prevent the spread of sexually transmitted diseases, such as chlamydia and gonorrhoea, which can weaken the cells on the cervix and increase your risk of getting persistent HPV infections that can eventually lead to cervical cancer.
WHO SHOULD GET THE HPV VACCINE?
HPV vaccines are suitable for females aged nine to 26, and are most beneficial if administered before they are sexually active. However, the vaccine can still benefit those who are sexually active, under 45 years old, who have had an abnormal Pap smear or received treatment for pre-cervical cancer cells. Speak to your doctor before you get the vaccine.
The NUH Women’s Centre at National University Hospital offers a comprehensive range of cervical cancer screening and prevention services, and facilities including a gynaecology cancer screening clinic, HPV vaccine clinic, general gynaecology clinic, colposcopy clinic, as well as treatments for pre-cancer disease and cervical cancer.
For more information or to make an appointment, contact the Women’s Clinic at 6772-2255/2277 or e-mail Womens_Clinic@nuhs.edu.sg.