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What
Is The Cervix?
The
female reproductive system consists of ovaries,
fallopian tubes, uterus (womb) and the vagina.
The cervix is the neck of the womb and is visible
during a vaginal examination. This allows a swab
to be taken from the cervix for microscopic examination
to exclude a cancer (Pap smear).
What
Is Cervical Cancer?
Cervical
cancer starts from the cells of the lining of
the cervix. Cervical cancer is believed to be
due to infection from a virus known as human papilloma
virus (HPV) which is transmitted during sexual
intercourse.
The
virus causes the cells to grow abnormally. These
abnormal cells are called cervical intraepithelial
neoplasia (CIN). Left untreated, they will become
cancerous. This is a slow process and may take
up to 15 years.
When
the cancer is confined to the lining of the cervix,
it is at an early stage known as cancer in situ
(CIS). As the cancer grows, it invades the womb,
vagina and neighbouring organs. It can also spread
to the nearby lymph glands. Eventually, it spreads
via the blood streams to the bones, lungs and
liver.
How Common Is Cervical Cancer?
Cervical
cancer is the 4th most common cancer in Singapore
women. About 200 new patients are diagnosed yearly.
The risk is equal among the 3 ethnic groups.
Risk Factors
The risk is greater for the following groups of
women:
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Prostitutes |
|
Those
with multiple sex partners |
|
Those
who had sexual intercourse at an early age |
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Promiscuous
sexual behaviour in male partners |
Pre-cancer
and early cancer of the cervix are often without
symptoms and detected by routine vaginal examination
and Pap Smear.
Can
Cervical Cancer Be Prevented?
There are two effective methods:
| 1. |
Minimising
early sexual activity and number of sexual
partners. The use of a diaphragm or condom
may have a protective effect. |
| 2. |
Regular
Pap Smear test: The accessibility of the cervix
allows a Pap Smear test to be performed easily
and quickly. The Pap Smear test can detect
pre-cancerous changes (CIN) or early cancer
(CIS) which are easier to treat and which
have better survival outcome. |
What
Is A Pap Smear?
During a vaginal examination,
a specimen of cells is obtained with a spatula
from the cervical lining and examined under the
microscope. If the Pap Smear is abnormal, further
tests are needed.
Who Needs A Pap Smear?
All
sexually active women between 20 and 70 years
of age are advised to have a Pap Smear regularly.
How
Often Should It Be Done?
An initial smear is performed
once a woman is sexually active and repeated after
one year. After that, the Pap Smear can be done
every one to three years, as advised by the doctor.
Signs & Symptoms
The
most common symptoms are:
| 1. |
Abnormal
vaginal bleeding, often after sexual intercourse
or vaginal douching. |
| 2. |
Foul-smelling
vaginal discharge. |
| 3. |
Non-specific
pain in the pelvis. |
| 4. |
Pre-cancer
and early cancer of the cervix are often without
symptoms and detected by routine vaginal examination
and Pap Smear. |
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