Revised GST rate of 9% starting 1 January 2024: The Singapore government will increase the Goods & Services Tax (GST) in 2024. The increase from 8% to 9% will take effect from 1 January 2024. The GST increase will be reflected in SCS fees and charges accordingly.
Our female reproductive system consists of two ovaries, two fallopian tubes , the uterus (womb) that is attached to the cervix and the vagina. The cervix is also called the neck of the womb. It is made up of millions of cells. Changes can occur to these cells which, if left untreated, can develop into cervical cancer. Persistent infection of the cervix with the high risk human papilloma virus (HPV) is the most common cause of cervical cancer.
Cervical cancer is the tenth most common cancer among women in Singapore.* It is however a highly preventable cancer because we are able to catch the precancerous stages caused by the persistent high risk or cancer-causing HPV infection using a very reliable and affordable cervical smear test.
All women between the ages of 25 and 69 years old who has ever had sexual activity are recommended to go for their regular cervical smear (Also known as Pap test) as part of the national cervical screening program. Regular screening can help to prevent you from getting cervical cancer in future.
* Singapore Cancer Registry 50th Anniversary Monograph (1968 – 2017)
Fortunately for most of us, most HPV infection are transient because our immune system will get rid of the infection just like it gets rid of the common flu virus. However, we do know that for some of us, there are risk factors that may allow the HPV to stay longer in our body to cause changes that may increase our risk of getting cervical cancer in future.
These risk factors include:
Cigarette smoking
Sexual intercourse at an early age
Previous HPV infection or exposure
Having multiple sexual partners
A history of sexually transmitted infection such as Chlamydia or Gonorrhoea
Immunosuppressive conditions such as having HIV infection, taking medication that can lower your immune system or recipient of a solid organ transplant.
Even if you are healthy and you do not have any of the risk factors above, going for your regular cervical screening is still very important because it is not yet possible to guarantee that your exposure to HPV infection will not lead to cervical cancer in future.
Regular cervical screening will help protect you from this risk.
Screening
To help reduce the incidence of cervical cancer, Singapore Cancer Society (SCS) provides Cervical Cancer Screening at no costto eligible females who meet the following criteria:
• Singaporean or Permanent Resident • Aged 30 years and above who have previously engaged in sexual intercourse • Not pregnant • Screening done 14 days from 1st day of menstrual period • Recommended to be screened once in 5 years
• Singaporean or Permanent Resident • Aged 25 to 29 years who have previously engaged in sexual intercourse • Not pregnant • Screening done 14 days from 1st day of menstrual period • Recommended to be screened once in 3 years
For women who are of the younger age group, you can also get yourself protected from Cervical Cancer by having your HPV vaccination done. You can get your HPV vaccination at a polyclinic or GP clinic. It is advisable for you to consult your doctor to find out more before going for your HPV vaccination. For more details on HPV vaccination click here.
Cervical cancer is highly preventable and curable when detected and treated early through regular screening.
To make an enquiry/tentative appointment for a HPV test, please complete and submit the following form to us and we will be in touch with you within 3 working days.
* compulsory fields
In line with the PDPA’s Guidelines and under the Private Hospitals and Medical Clinics (PHMC) Regulations, we are required to maintain accurate, complete and up-to-date medical records with personal particulars, which includes full NRIC numbers. As such, we will be collecting your full NRIC number for your participation in our screening services.
Signs & Symptoms
Invasive cervical cancer doesn’t usually have any symptoms until the late stages.
The signs and symptoms of invasive cervical cancer may include:
Lower abdominal pain or pain during sexual intercourse
Vaginal bleeding after sexual intercourse
Irregular vaginal bleeding between periods or after menopause
Watery, bloody, and foul-smelling vaginal discharge
The stage before cancer called the precancerous stage have no symptoms at all and can only be detected by your regular cervical screening.
This is why regular cervical screening is important because there are effective treatment available for the precancerous stage that will help prevent progression to invasive cervical cancer.
Diagnosis
There are 2 types of screening test available for cervical screening depending on your age.
Pap Test
The Pap test is recommended if you are between the ages of 25 to 29 years old.
The Pap test is a simple procedure that takes only a few minutes. It can be done in a clinic by a doctor or a nurse.
During the procedure, the woman being examined lies on her back with her knees drawn up and apart.
The cervix lies at the top of the vagina (birth canal), and an instrument called a speculum is carefully inserted into the vagina to help the healthcare professional (doctor or nurse) to see the cervix.
The healthcare professional then uses a small disposable brush to collect a sample of cells from the outer opening of the cervix. This sample is then put into a container and sent for analysis.
It is important to remain calm and relaxed during the test. Some women may experience mild discomfort or dull pressure during the Pap test. However, these procedures should not be painful. Please inform the healthcare professional immediately should you experience any pain.
HPV Test
The HPV test is recommended if you are 30 years old and above.
The sampling procedure for a HPV test is carried out in the same way as a Pap test.
During the procedure, the woman being examined lies on her back with her knees drawn up and apart.
The cervix lies at the top of the vagina (birth canal), and an instrument called a speculum is carefully inserted into the vagina to help the healthcare professional (doctor or nurse) to see the cervix.
The healthcare professional (doctor or nurse) then uses a small disposable brush to collect a sample of cells from the outer opening of the cervix. This sample is then put into a container and sent for analysis.
It is important to remain calm and relaxed during the test. Some women may experience mild discomfort or dull pressure during the HPV test. However, these procedures should not be painful. Please inform the healthcare professional immediately should you experience any pain.
Colposcopy
If you have an abnormal Pap smear or HPV test result, it does not always mean that you have cervical cancer.
An abnormal Pap smear or HPV test result mainly requires you to be referred to another healthcare professional who is usually a specialist in detecting precancerous cells to perform a procedure called colposcopy.
A colposcopist is the specialist that performs the colposcopy.
A colposcopy is an instrument that allows your cervix to be examined in detail under high magnification. The colposcopist will be able to identify possible abnormal areas on your cervix that may indicate the presence of precancerous cells. The colposcopist may want to take a small biopsy of your cervix to check it further.
Endocervical Curettage
This procedure uses a small spoon-like instrument that is passed into the cervical opening (canal) to obtain some tissue for microscopic examination.
Not all women will need this test and your colposcopist will be able to advice you further regarding this.
Cone Biopsy (Conisation)
A large portion of the cervix which has become abnormal is surgically removed for microscopic test. This procedure is performed under local anaesthesia and as a day patient. It can diagnose as well as treat an abnormal smear.
Treatment
Treatment differs for different stages of cervical cancer:
Pre-cancerous stage*
Precancerous stage is the stage before cervical cancer develops.
Pre-cancerous cells of the cervix may be effectively treated by either ablation techniques (destroying the abnormal cells using heat or freezing) or excision techniques (cutting the abnormal cells out).
To destroy the precancerous cells by ablation, we can use laser vaporisation, cold coagulation (heat treatment) or cryotherapy (freezing treatment).
To remove the precancerous cells from your cervix, we can use a thin heated loop wire, a procedure called Loop Electorsurgical Excision Procedure (LEEP). Another way to remove the precancerous cells is a procedure called cone biopsy. Cone biopsy can be done using laser, a surgical knife or a sharp heated needle.
All the treatments above are very effective in treating precancerous cells on your cervix. However, different women will require different type of treatment to ensure total removal of the precancerous cells and prevention of development of cervical cancer in future.
Your colposcopist will be able to advice you on which treatment is most suitable for you.
Invasive cervical cancer*
For women who go for regular cervical screening, the chances of getting cervical cancer in future is very low.
However, should you be diagnosed with cervical cancer, there are still treatments available for cure.
Treatment for cervical cancer can involve surgery (usually removing your cervix, uterus, fallopian tubes and ovaries), radiotherapy or chemotherapy. Occasionally it can be a combination any of these methods.
Treatment for cervical cancer depends on a lot of factors but two of the most important factor is the stage of the cancer and your overall health. All women with cervical cancer should be seen by a gynaecology oncologists( a gynaecologist specialising in female cancers) to ensure they get the best treatment aiming towards cure.
Your gynaecology oncologist is the best person to advise you regarding the best treatment for you.
*Information from singhealth.com.sg/patient-care/conditions-treatments/cervix-cervical-cancer/treatment
Support Groups
Bishana is a women's support group specifically established for all female cancer patients and survivors. Besides participating in educational, social, and recreational activities, Bishana provides a platform for these women to give and receive psychological and emotional support. Membership is free.
The Look Good Feel Better Programme was developed specifically for women undergoing chemotherapy or radiotherapy. The programme aims to help women minimise and manage the physical changes brought about by cancer treatment. Workshops organised are hands-on and held at various private and public hospitals island-wide. Membership is free.
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What is Cervical Cancer?
