28 AUGUST 2013

Ask The Expert: Cervical Cancer - The Power of Prevention is in your Hands

Cervical cancer is malignant cancer that forms in tissues of the cervix (the organ connecting the uterus and vagina). It is now the ninth most common cancer among women, with around 250 women diagnosed every year. Unfortunately these women are often diagnosed in advanced stage because most of them never had a pap smear before, or haven’t had one in the last five years.

Cervical cancer is the most preventable of all female cancers and it is caused by the persistence of a virus known as Human Papillomavirus (HPV) that is usually transmitted during sexual activity. However, with advancement in the medical field, vaccines are now available to help prevent HPV infection and cervical cancer. By preventing the relevant HPV infection, a reduction of up to 70% to 80% of the number of cervical cancer cases can be achieved.
Take the opportunity to join our discussion for this issue of #AskTheExpert with Dr Quek Swee Chong, a specialist in Obstetrics & Gynaecology at the Parkway Gynaecology Screening & Treatment Centre in Gleneagles Hospital.

Click “Join” to participate in this Live Chat on our event wall. Post your questions on this wall and Dr Quek will discuss on this topic jointly with you on the following date. Dr Quek will be sharing on the importance of the approach to HPV vaccination and regular PAP smear screening to be assured of the best protection against cervical cancer.

Date: 28/08/2013 (Wednesday)
Time: 11.30am to 12 noon
Venue: Online @ Facebook event wall

#Ask The Expert
PCC #AskTheExpert Live Chat allows you to ask a doctor any cancer related/medical question online for free. You can browse through previously answered medical questions as well. We have over 60 questions answered to date.

About Dr Quek Swee Chong
Dr Quek was formerly Senior Consultant & Head, Pre-invasive Disease & Screening Unit, Department of Gynaecological Oncology, KK Women’s & Children’s Hospital. He serves on the board of the International Federation of Colposcopy & Cervical Pathology. A former president of the Society of Colposcopy & Cervical Pathology of Singapore, he now sits on the present council.

Recap for #ASK THE EXPERT Session (28 August 2013) with Obstetrician & Gynaecologist Dr Quek Swee Chong


Q1: What does a routine Pap smear show? How often should one have a medical checkup?
The pap smear will pick up any abnormal cells on the cervix that could indicate precancer changes on the cervix. The pap smear should be done between 1-3 years apart. We usually start pap smears in women from the age of 25 if they have been sexually active before.


Q2: How much does the HPV vaccination cost usually? How long does it last?
The full course of vaccination consist of 3 injections. The typical costs for 3 injections will range between $350-$500.


Q3: Hi Dr Quek, I am turning 30 coming dec. I've read some brochures saying that the recommended age for the vaccine is from as young as 9 to 26. I would like to find out if HPV vaccines are still applicable or effect for my age?
Yes you certainly can still have the vaccination. It's just that you cannot use Medisave to pay for the injections once you are above 26 years. The vaccines have been shown to be effective even in women in their 40s.


Q4: Hi, I know this is a discussion on cervical cancer, however as HPV attacks both man and woman, and man do not get cervical cancers, will a male get cancer should he be infected with HPV? is it possible for males to take the HPV vaccines?
Yes men can have the vaccination as well as HPV is known to cause cancers of the penis, anus and some ear/nose/throat cancers as well. In addition vaccinating men will also help to reduce the cancers in women as well because of the reduced transmission of HPV overall.


Q5: Is there an age limit to whether its too late to take HPV jab once you are married? Or we should still go for it irregardless as long as there hasn't been a jab taken yet?
Ideally the vaccine works best in young girls before they start to have sexual intercourse. However they will still be effective in women who are already married or sexually active. You can use medisave to pay for the vaccines up to age 26. Women older than 26 will need to bear the cost themselves.


Q6: Hi, I would like to find out if one is not sexually active, what are the chances of getting Cervical Cancer? Do I still need to get a vaccine to prevent it? Also, will recurrent UTI lead to cervical cancer or other woman related cancers eventually?
If you are not and have never been sexually active, then the chance of getting cervical cancer is practically zero. The vaccine will be most effective in this situation to prevent the HPV infection if intercourse occurs in the future. No recurrent UTI will not lead to cancer of the cervix, or other gynaecological cancers.


Q7: Hi, Dr Quek, will taking birth control such as Diane-35 increase the chance of getting cervical cancer? I have read somewhere, taking birth control will help prevent woman-related cancer by up to 50%, is it true?
The birth control pill (e.g. Diane 35) definitely has benefits beyond just providing birth control. It has been shown to reduce the risk of uterine and ovarian cancer. Taking the pill itself will not cause cervical cancer, because that is caused by infection with HPV. However there is some evidence that women who take the pill on the whole have a higher incidence of cervical cancer. This effect may be due to the fact that most women on the pill are sexually active as well. So we cannot definitively say that the contraceptive pill causes cancer


Additional Notes:
One of the more common questions about HPV vaccines is the issue of safety and side effects. The vaccines have been licensed in hundreds of countries around the world and advocated by the World Health Organisation (WHO). Some women experience some pain/soreness or redness in the arm for a couple of days after the vaccination but there are no serious long term side effects.

The most effective strategy for the prevention of cervical cancer is a combination of HPV vaccination and regular screening with pap smears. The vaccination can start any time after age 9 but pap smear screening only needs to start after age 25 in women who have ever had sexual intercourse. There is no need for a pap smear if you have not had sexual intercourse before.

READ MORE ABOUT Cervical Cancer