[{"@context":"https:\/\/schema.org\/","@type":"NewsArticle","@id":"https:\/\/thehomeground.asia\/destinations\/singapore\/women-are-not-doing-enough-to-protect-against-cervical-cancer\/#NewsArticle","mainEntityOfPage":"https:\/\/thehomeground.asia\/destinations\/singapore\/women-are-not-doing-enough-to-protect-against-cervical-cancer\/","headline":"Women not doing enough to protect against cervical cancer","name":"Women not doing enough to protect against cervical cancer","description":"Worldwide, cervical cancer is the second most common cancer in women with half a million new cases diagnosed each year. And according to the Singapore Cancer Society, it is the 10th most common women’s cancer in Singapore and a major cause of gynaecological deaths. Yet, it is preventable through regular Papanicolaou (Pap) smear screening, and […]","datePublished":"2021-03-30","dateModified":"2022-04-14","author":{"@type":"Person","@id":"https:\/\/thehomeground.asia\/author\/Ming%20En%20Liew\/#Person","name":"Ming En Liew","url":"https:\/\/thehomeground.asia\/author\/Ming%20En%20Liew\/","identifier":132,"image":{"@type":"ImageObject","@id":"https:\/\/secure.gravatar.com\/avatar\/8fe7a89455a989038349633329a6e4ad6299388f5e1e3ea83c28126090b2314f?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/8fe7a89455a989038349633329a6e4ad6299388f5e1e3ea83c28126090b2314f?s=96&d=mm&r=g","height":96,"width":96}},"publisher":{"@type":"Organization","name":"TheHomeGround Asia","logo":{"@type":"ImageObject","@id":"https:\/\/thehomeground.asia\/wp-content\/uploads\/photo_2021-07-22-222533.jpeg","url":"https:\/\/thehomeground.asia\/wp-content\/uploads\/photo_2021-07-22-222533.jpeg","width":640,"height":640}},"image":{"@type":"ImageObject","@id":"https:\/\/thehomeground.asia\/wp-content\/uploads\/1617092166675_1280X626_282529.png","url":"https:\/\/thehomeground.asia\/wp-content\/uploads\/1617092166675_1280X626_282529.png","height":626,"width":1280},"url":"https:\/\/thehomeground.asia\/destinations\/singapore\/women-are-not-doing-enough-to-protect-against-cervical-cancer\/","about":["Asia","Community","Health & Wellness","Local","Sex & Gender","Singapore"],"wordCount":1501,"articleBody":"Worldwide, cervical cancer is the second most common cancer in women with half a million new cases diagnosed each year. And according to the Singapore Cancer Society, it is the 10th most common women’s cancer in Singapore and a major cause of gynaecological deaths. Yet, it is preventable through regular Papanicolaou (Pap) smear screening, and curable if detected early. While its prevalence has dropped over the years, do women do enough to care for their sexual and reproductive health? TheHomeGround Asia finds out. When asked why it was important to visit a gynaecologist for regular screenings, Hong Li Xuan, 23, answers, \u201cTo identify problems, if any, early.\u201d Yet, despite being aware, she has not done so.\u00a0\u201cWhere do I start?\u201d she questions. \u201cDo I just go to the hospital?\u201d\u00a0Carolyn Tan, 37, expresses similar confusion about the process: \u201cI was not sure which gynae was good and which gynae does what services. Most gynaes are just packed [with pregnant women].\u201d\u00a0Prior to getting pregnant, Ms Tan had not visited a gynaecologist at all, and had only gotten her first Pap smear after childbirth.Their situations are not unique. According to the Cervical Cancer Epidemiology and Screening Behaviour in Singapore by the Ministry of Health (MOH), Pap smear screening rates fell between 2007 and 2013.\u00a0The MOH report had been based on the National Health Surveillance Surveys from 2001, 2007 and 2013, as well as the National Health Surveys from 2004 and 2010. In each of these reports over 10,000 households were surveyed.In recent years, the National Population Health Survey found a marginal increase in cervical cancer screening rates from 46.3 per cent in 2017 to 48.2 per cent in 2019. But, screening rates have fallen by more than half for women aged 25 to 29 in the long-term, from 49.5 per cent in 2007 to 21 per cent in 2019.\u00a0Why are Pap smears important?According to HealthHub, Pap smears are pivotal in the early detection and prevention of cervical cancer.\u00a0Cervical cancer is caused by a prolonged infection by the sexually transmitted virus called the Human Papilloma Virus (HPV). Dr Christopher Ng, a practising gynaecologist from GynaeMD Women\u2019s and Rejuvenation Clinic, explains that while HPV infections may not always result in cancer, repeated infection or prolonged infection can lead to a pre-cancer stage known as Cervical Intraepithelial Neoplasia (CIN). Left untreated, this can eventually lead to cancer.Given that cervical cancer is slow-progressing and can take up to 15 years to develop, regular screening serves to catch HPV infections before they develop into cancer.\u00a0MOH guidelines recommend that all women who have had sexual intercourse undergo cervical cancer screening from the age of 25 years old. Between 25 and 29, women are advised to get Pap smears every three years. From 30 onwards, women should go for a HPV DNA test, a more sensitive screening tool, once every five years.\u00a0Screening should continue in regular intervals until the age of 69. After which, women can be discharged from screening if the smear taken at 69 years old, and the two previous smears taken in the past decade, are consecutively negative.According to Dr Christopher Ng, Pap smears should not be painful if done properly. (Source: Canva)While there are some who are afraid that Pap smears may be painful, Dr Ng assures that \u201cif done properly, it shouldn\u2019t be.\u201d To reduce anxiety, he often chats with his patients while conducting the test, and they do not even realise that the test is done until it is over.\u00a0Prevention is better than cure: HPV vaccinesBesides regular screening, women are also advised to go for the HPV vaccine, which immunises them against specific types of HPV infection that may lead to cervical cancer. The HPV vaccine is recommended for females aged between nine and 26 years old. Women above 26 who wish to receive the vaccination are advised to speak to their doctor to find out if they are suitable.\u00a0For a more comprehensive coverage of the vaccination, MOH announced in 2019 that the HPV vaccination will become part of Singapore\u2019s national school-based health programme, on a fully subsidised opt-in scheme.\u00a0While the HPV vaccine provides an additional layer of protection against cervical cancer, it does not immunise against all types of HPV infection and should not replace regular screenings.Why the hesitance?While testing and vaccination are important, Dr Ng suggests that inertia stops more women from not getting routine checks.\u00a0\u201cThey don\u2019t seem to go routinely,\u201d he says. \u201cUnless maybe they had a Pap smear [that was] abnormal, and they come to get treated… [but] subsequently, if they get normal Pap smears for the next few years, then there\u2019s a high chance that women will drop out [and not] come back for the follow-up.\u201d\u00a0Women should be getting Pap smears every 3 years from the ages of 25 to 29, if they are sexually active. Those above 30 should get HPV tests every 5 years. (Source: Canva)He draws a parallel to people\u2019s attitudes toward the ongoing pandemic. Many were initially hesitant to download the TraceTogether application even though it would have allowed the nation to move into Phase Three, where regulations have since been relaxed. He also highlights how some individuals are still holding off being vaccinated against COVID-19 even if they are eligible, despite the potential upsides of being able to travel sooner.Dr Ng questions, \u201cCOVID-19 affects your life, everybody has to wear mask [and] cannot travel, and there\u2019s [still] some resistance from people wanting to get vaccinated, then can you imagine, pre-COVID, asking people to come and see us to do your Pap smear, do your vaccine? Even more inertia, isn\u2019t it?\u201dHe adds, \u201cAnd that one [regular screening when you are well] does not even affect your lifestyle. But the consequences are worse…A lot of people with COVID-19 survive. Not the case for these cancers.\u201dA report in 2018 by The Catalan Institute of Oncology and the International Agency for Research on Cancer estimates that 429 women are diagnosed with cervical cancer in Singapore every year, and 208 die from the disease.\u00a0The disease is especially fatal in its later stages, which is usually when symptoms start appearing, according to the Singapore Cancer Society. While the five-year outlook on survival is high at 80 to 90 per cent in Stage 1, it can drop to a mere 10 to 20 per cent in Stage 4.\u00a0But some women, like Ms Tan, never saw the need to visit the gynaecologist for a check-up prior to getting pregnant.\u00a0She says, \u201cI think it\u2019s just not the norm among my peers to visit the gynaecologist for no reason. Most of my friends either visit due to painful cramps or pregnancy.\u201dThis may have to do with a lack of education, as cervical cancer, Pap smears, and HPV vaccines are not included in schools\u2019 sexual education syllabus.\u00a0Heng Si Yun, 24, had only heard about the HPV vaccine recently from a friend who is a nurse. Likewise, she had only encountered Pap smears when it was brought up by a doctor during an unrelated visit to the polyclinic. Ms Hong, too, had only heard about Pap smears and HPV vaccines from her mother.Progress has been made, but more can still be doneCervical cancer is the 10th most common cancer among women in Singapore. (Source: Canva)Generally, there has been a fall in the prevalence of cervical cancer. From being the fourth most common cancer in the 1970s, it is now ranked 10th. But, according to the Cervical Cancer Epidemiology and Screening Behaviour in Singapore by MOH, there was a slight increase in cases recorded from 2011 to 2015.\u00a0The report also mentions that despite knowledge of Pap smears spiking between 2001 and 2013, from 69.3 per cent to over 90 per cent, many women still cite reasons such as them being \u201cnot at risk\u201d or \u201chealthy\u201d for not going for Pap smears.\u00a0MOH explains that these findings mean many still lack a proper understanding of cervical cancer and its risk factors, which can be dangerous. In the pre-cancerous stage of CIN, an individual will not experience any symptoms or see any signs. It is only detectable through routine Pap smears, without which, it may go undetected and untreated until cervical cancer develops.\u00a0Advice from a gynaecologistTo protect yourself from the potentially fatal consequences of an HPV infection and cervical cancer, Dr Ng has one piece of advice: \u201cSee your gynaecologist when you are supposed to for your routine screenings… Even if you get a normal result, and your gynaecologist recommends when is your next screening test, you should follow that and don\u2019t get complacent.He adds: \u201cIf every time you do the test and the result comes back normal, I would look at that as a very good reassurance and everything is healthy, rather than \u2018Oh, every time I come, it\u2019s always normal, so maybe I don\u2019t come anymore\u2019 because that\u2019s when things happen.\u201d\u00a0For more information on cervical cancer, screening, and the HPV vaccine, refer to this brochure by the Health Promotion Board.\u00a0Join the conversations on THG’s Facebook and Instagram, and get the latest updates via Telegram."},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Destinations","item":"https:\/\/thehomeground.asia\/destinations\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"Singapore","item":"https:\/\/thehomeground.asia\/destinations\/\/singapore\/#breadcrumbitem"},{"@type":"ListItem","position":3,"name":"Women not doing enough to protect against cervical cancer","item":"https:\/\/thehomeground.asia\/destinations\/singapore\/women-are-not-doing-enough-to-protect-against-cervical-cancer\/#breadcrumbitem"}]}]