Cervical cancer, or cancer affecting the lower part of the womb, is one of the top 10 cancers in women in Singapore. According to the National Cancer Centre, some 190 cases are diagnosed every year.

Of these, a large majority is caused by the Human Papilloma Virus (HPV), a very common virus and one of the most common sexually transmitted infections.

Out of the 150 sub-types of HPV, 13 can cause cervical and other cancers, including those of the vulva, vagina, penis, anus, and oropharynx (cancers of the back of the throat, including the base of the tongue and tonsils). According to the National Cancer Institute, United States, the top two types – 16 and 18 – account for 70 per cent of cervical cancer cases.

There is no need to be alarmed, however, if you have been infected by the HPV. Not every case of HPV infection leads to cancer. In fact, figures from Singapore’s Health Promotion Board show that in 90 per cent of infection cases, the virus will go away by itself. In a small number of cases does the infection persist, causing cells to develop into cervical cancer.

HPV spread and infection
The HPV is usually spread through skin-to-skin contact. The risk increases for those with multiple sexual partners, and those who have sexual activity with partners who have had multiple sex partners.

According to Parkway Cancer Centre’s Medical Oncologist Dr See Hui Ti, women between the age of 17 and 20 have the highest chance of HPV infection. This is the age when they tend to have their sexual debut, are less likely to use condoms, and more likely to have multiple sexual partners.

However, one can be infected by HPV even if there are no sign or symptoms, or if a person has not been sexually active for years. The risk of HPV infection can also increase for those who smoke, use long-term oral contraceptives, or have a weakened immune system.

Vaccination
While there is no treatment for HPV, preventive measures can minimise the risk of infection and developing HPV-related cancers. For women, vaccinations and early screening may help.

Two of the most common HPV vaccines available in Singapore are Cervarix and Gardasil, which are considered safe by the World Health Organization. They are believed to be able to prevent 70 to 80 per cent of cervical cancer, and are approved for use by girls and women between the age of 9 and 26. They are administered in three doses over six months.

People are advised to seek their doctors’ advice first, however, to determine which vaccine is suitable and whether they are suitable for the vaccination at all.

What is important is when these vaccines are given: HPV vaccinations have maximum benefits when given before the start of sexual activity, where there is greater exposure to HPV.

Said Dr See: “That is why it is important to vaccinate young women early, preferably before they start sexual activity.”

She recommends that women get screened every year for three years from the age of 18, or from when they start sexual intercourse. Subsequently, it can be reduced to once every three years.

She added: “Screening once every three years would reduce the overall incidence of cervical cancer by 91.2 per cent.”

By Kok Bee Eng



Tags: human papillomavirus (HPV) cancer, women (gynaecological) cancer