Cervical cancer: Catch it early
When detected early, cervical cancer is one of the most treatable forms of cancer. Photos: Shutterstock
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Well known for taking on challenging roles embodying the multiple facets of womanhood, Singapore actress and TV host Mastura Ahmad has a lot on her plate.
But despite her busy work schedule, the veteran actress, 50, recognises the importance of making time to protect herself against cervical cancer, one of the most commonly diagnosed women cancers in Singapore.
About 200 women get the cancer each year and 70 die from it, Senior Minister of State for Health Dr Amy Khor said in Parliament in March.
Ms Mastura said: “When detected early, cervical cancer can be treated with a high chance of survival. In fact, I have (my screening appointment date) locked in my phone calendar.”
Ms Mastura has been going for a Pap test every three years but that will soon change. She intends to switch to a new and more effective screening test for women aged 30 and above, called the human papillomavirus (HPV) test. More than 99 per cent of cervical cancer is due to a persistent HPV infection from a high-risk strain.
Recommended for women aged 30 and above who have had sexual activity, the newly introduced HPV test is part of the enhanced Screen for Life programme. The programme allows women to go for cervical cancer screening at a highly subsidised rate.
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Mastura Ahmad, Diana Ser and Nithya are encouraging women to take the HPV test, in HPB's new ad on cervical cancer protection.
BETTER SCREENING TOOL
While a Pap test looks for abnormal cells in the body that might develop into cervical cancer, the HPV test detects the genetic material of high-risk strains of the HPV that could develop into cervical cancer.
Cell samples for the HPV test are collected in the same manner as a Pap test.
HPV infections are as common as a common cold in both men and women, and can be spread through skin-to-skin contact, including sexual activity.
There are over 100 HPV strains, some of which can also cause genital warts. While the majority of HPV infections are cleared by the body’s own immune system spontaneously, at least 14 high-risk strains, such as HPV 16 and 18, may cause a persistent infection that can lead to cervical cancer.
SCREENING AT A LOW COST
According to Dr Ida Ismail-Pratt, consultant at the Division of Gynaecologic Oncology at the National University Hospital and National University Cancer Institute, Singapore, the new test also has a strong negative predictive value. “A negative HPV test has been shown to protect women from developing pre-cancerous or cancerous cervical disease for up to five years, compared to the three years for a normal Pap test,” she said.
So instead of scheduling an appointment for a Pap test every three years, women undergoing the new test will only need to repeat it every five years if the result from a prior test is normal.
Under the Screen for Life – National Cervical Cancer Screening programme, the HPV test is heavily subsidised and costs the same as the Pap test.
Eligible Singapore citizens pay S$2 (for both Blue and Orange CHAS cardholders and Merdeka Generation cardholders) or S$5 at participating CHAS GP clinics.
The new HPV test is also available at polyclinics at S$22.50 for Singapore women and S$33.75 for permanent residents.
Women who are up-to-date with their screening (via a Pap test) do not need to rush for an additional screening test with the HPV test.
“They can wait until their next round of screening, which will be three years from the last normal Pap test. If they are 30 years and above by then, they can opt for the HPV test,” said Dr Ismail-Pratt.
PAP TEST STILL GOOD FOR WOMEN BELOW 30
While the new test is found to be a more effective cervical cancer screening tool in women aged 30 and above, Dr Ismail-Pratt said it does not replace the Pap test for younger Singapore women.
Women aged 25 to 29 years old are recommended to go for a Pap test.
“Even though persistent infection from high-risk HPV strains leads to cervical cancer, 95 per cent of these infections are cleared by the body’s immune system without increasing the risk of cervical cancer, particularly in younger women under the age of 30,” she explained.
“The goal of cervical cancer screening, either with a Pap test or HPV test, is not to detect HPV infection but to detect precancerous and cancerous changes on the cervix. In young women, what the HPV test will do is to detect HPV infection that most likely may not lead to disease, but increases the risk of psychological stress and tendency to unnecessarily over-treat the HPV infection.”
Dr Ismail-Pratt added that women can stop regular cervical cancer screening once they reach 69 years old, and have had two negative HPV test five years apart in the last 10 years.
TAKE REGULAR SCREENING SERIOUSLY
According to Dr Ismail-Pratt, women who develop the preventable cancer are usually those who have never gone for cervical cancer screening, despite being eligible. Another group includes women who do not undergo regular screening as recommended by the National Cervical Cancer Screening programme.
For these women, cervical cancer is typically diagnosed only in the later stages where there is a lower survival rate and treatment becomes more complicated.
However, there is a good chance for a cure when the disease is detected early via screening. Survival rate of early-stage cervical cancer has been shown to be up to 90 per cent.
To learn more about cervical cancer screening and whether you are eligible for the Screen for Life subsidies, visit healthhub.sg/cervical-screening and screenforlife.sg, or call 1800 223 1313.
