Shots and Screens
Arm Yourself Against Cervical Cancer
Every two days, more than one case of cervical cancer is diagnosed in Singapore; and every five days, a woman dies of it.1 It’s a pretty distressing statistic for something that can be avoided by a simple screening or vaccination. In spite of the big efforts from the government and the medical industry to defeat cervical cancer, the disease still ranked the third most common cancer among women in Singapore.
Although cervical cancer is one of the most common types of cancer among women worldwide, 92% of the cases can be detected and treated if a woman undergoes regular pelvic exams and Pap tests.2 In Singapore, however, about one-third of women aged 25 to 69 years old have not been screened for cervical cancer. According to Dr Tay Eng Hseon – one of the country’s leading gynaecological oncologists – culture, shyness and fear of discomfort and pain are among the main reasons why many women in Singapore are still hesitant to go for a cervical cancer screening.
Self Screen Might be the Answer
To encourage more women to go for cervical cancer screening, Dr Tay decided the above-mentioned barriers must be eliminated. He has partnered with the HPV Research Group at the VU University Medical Center, Amsterdam, and medical innovators from Delphi Bioscience BV, to launch in Singapore the Delphi Screener, a self-screening device against cervical cancer.
Promising to be easy and painless to use, the self-screening device is used to collect cervical and vaginal cells by inserting it into the vagina to the top of the cervix. The specimen collected is then sent to an authorised laboratory for testing. “The Delphi Screener uses a different testing methodology from the Pap smear, the conventional screening method for cervical cancer. A sample taken with a Delphi Screener will be used for detecting high-risk Human Papilloma Virus (HPV) in a clinically validated DNA-test,” explained Dr Chris Meijer, Head of the HPV Research Group at the VU University Medical Center, Amsterdam, during the launch of the product. “Studies that we have conducted, as well as studies by other leading research groups have shown that HPV tests can result in earlier detection of clinically relevant pre-cancerous lesions compared to cytology tests. This means that more cervical cancers can be prevented.”
Dr Tay added that the Delphi Screener will be made available to family physicians in Singapore and will cost about S$79.90, inclusive of the laboratory test. It is a reasonable price, he said, considering Pap smear test costs around $30 to $40 and HPV test is more or less $100, depending on the clinic.
A Shot or Two Can Make a Difference
In Singapore, Cervarix and Gardasil are the two commercially available vaccines against cervical cancer. Both vaccines have been shown to be effective in protection against HPV 16 and 18, which cause up to 70% of cervical cancers.3 The vaccines are recommended for female between ages of 10 and 25 and are most effective if given before first sexual exposure.4
Both vaccines comprise three doses at zero, one (or two) months and six months. Although approved as safe to use, the long-term protective effect and efficacy of the vaccines are still being evaluated.4 Soreness where the vaccines were injected was the most common short-term side effect.
All women of reproductive age are encouraged to get vaccines against cervical cancer. However, as some women may still develop the cancer even after vaccination, cervical cancer screening is still recommended.
Cervical Cancer at a Glance
Cervical cancer is cancer that starts in the cervix, the lower part of the uterus that opens at the top of the vagina.
Worldwide, cervical cancer is the second most common type of cancer in women.
It is much less common in developed countries because of the routine Pap smear.
The cancer starts in the cells on the surface of the cervix.
Cervical cancer usually develops very slowly.It starts as a precancerous condition called dysplasia. It can be detected and is 100% treatable.
It can take years for precancerous changes to turn into cervical cancer.
Almost all cervical cancers are caused by HPV. HPV is a common virus that is spread through sexual intercourse.
A woman’s sexual habits and patterns can increase her risk for cervical cancer.
Most of the time, early cervical cancer has no symptoms. Symptoms that may occur can include: abnormal vaginal bleeding between periods, after intercourse, or after menopause; continuous vaginal discharge, which may be pale, watery, pink, brown, bloody, or foul-smelling; and periods become heavier and last longer than usual.
Cervical cancer may spread to the bladder, intestines, lungs, and liver.
Patients with cervical cancer do not usually have problems until the cancer has advanced and has spread.
Symptoms of advanced cervical cancer may include back pain, bone pain or fractures, fatigue, leaking of urine or feces from the vagina, leg pain, loss of appetite, pelvic pain, single swollen leg, and weight loss.
2WHO Cervical cancer summary report update, September, 15: 2010.