Cervix cancer is the 5th commonest cancer among women in Singapore. This year, about 300 women in Singapore will develop cancer of the cervix. However it can be easily prevented by screening with the Pap smear.
The cervix is the lower, narrow end of the womb that opens into the vagina. Cervix cancer occurs when the cells of the cervix start to grow in an abnormal, uncontrolled way, which can then damage other healthy parts of the body.
Fortunately some early changes in the cervix can be seen long before cancer develops (Pre-Cancer changes). Treating the cervix at this Pre-Cancer stage can therefore prevent cervix cancer from ever occurring.
Unfortunately, by the time these symptoms occur, the cancer may already be at an advanced stage. Therefore it is vitally important that you have your pap smears performed regularly even if you are feeling well.
The pap smear is a simple relatively painless test in which cells from the cervix and vagina are examined for any abnormalities. This involves inserting an instrument called a speculum gently into the vagina. The doctor or nurse can then obtain the necessary cells for examination.
The cells obtained are then checked under a microscope in order to find early changes in the cells, which can be treated to stop a cancer from developing. Sometimes they can also find cervical cancer at a stage that is easy to cure.
The pap smear is a good test but is not perfect. Occasionally the results can be normal even though there may be abnormalities on the cervix. Fortunately most cervical pre-cancers grow very slowly. So having a pap test at regular intervals will find almost all abnormalities before they have a chance of progressing to cancer.
Only women who are sexually active need a pap smear test. Sexually active women should have a pap smear from the age of 25 onwards. This is repeated every 3 years until the age of 65, provided there are no abnormalities. However, your doctor may recommend that you have a pap smear more frequently.
An abnormal pap smear does not mean that you have cancer. It simply means that there are abnormal cells, which may require further evaluation by a doctor. Often these abnormal cells are due to an infection, or to the thinning of the skin of the cervix after the menopause.
This can be easily treated with an antibiotic or hormone cream. In some cases the pap smear may suggest that there are some precancer cells and you may be asked to come for a colposcopy examination.
A colposcope is an instrument with a magnifying glass through which a better view of the cervix can be obtained with good lighting.
It is a relatively painless procedure that takes no more than 10 to 15 minutes. A speculum is inserted into the vagina just like when taking a pap smear. The doctor is then able to examine the cervix after applying a mild vinegar-like solution (acetic acid).
Sometimes, a small biopsy may have to be taken from the cervix for further evaluation. Many patients do not feel anything at all. Depending on the results of the biopsy, you will be advised on the best treatment.
At KKH, we have several methods of treating precancerous changes of the cervix:
For most women, these procedures can be performed under local anaesthetic either in the Colposcopy Suites or in Day Surgery. However in some instances a general anaesthetic is used and this may involve staying in hospital for a day or two.