Gynaecological cancer screening and vaccination

Gynaecological cancers comprise of uterine, ovarian, and cervical cancers. Currently, uterine cancer, ovarian cancer and cervical cancer rank as the 4th, 5th and 10th most common cancer among women in Singapore.

Cervical Cancer occurs at the cervix which is at the neck of the womb. Nearly all cervical cancer cases (99%) are related to genital infection with Human Papilloma Virus (HPV). Early-stage cervical cancer generally produces no signs or symptoms. Advanced cervical cancer can present with abnormal vaginal bleeding such as bleeding after intercourse, between menses or after menopause. Do see the doctor if you have any of the above symptoms.

HPV vaccination to reduce the risk of cervical cancer

HPV vaccination is recommended in females aged 9 to 26 years old. The vaccine is most effective if it is given before the first sexual exposure and is protective against 70% to 90% of the common cancer-causing HPV strains.

In women aged >26-45 years old, there is emerging evidence that HPV vaccination can be useful in this age group as well. Please discuss with your doctor about your suitability for the HPV vaccination.

You can enquire at the polyclinics, GPs or gynaecology clinics if they provide HPV vaccination.

How to detect cervical cancer early

Cervical cancer screening is recommended in sexually active women aged 25 and above, even if you have received your HPV vaccination.

PAP smear is used for screening every 3 years in women who are 25 to 29 years old, whereas HPV test is used for screening in women aged 30 to 70 years old and done every 5 years.

Cervical cancer screening tests can be done at polyclinics, GPs or gynaecology clinics. It is advisable to make an appointment prior to going for your screening test.

What is Ovarian Cancer?

A woman has 2 ovaries. Each ovary is located on either side of the womb (uterus). The ovaries produce eggs for reproduction and the female hormones, estrogen and progesterone. The cause of ovarian cancer is largely unknown. The symptoms of ovarian cancer are usually vague in the early stages of ovarian cancer. Symptoms may include increased abdominal size or discomfort, bloatedness, decreased appetite, feeling full after a small meal, or urinary symptoms such as urgency and frequency. As a result, ovarian cancer often presents late.

Risk factors for ovarian cancer include older age, obesity, family history of ovarian cancer, endometriosis and never having been pregnant.

Tips to reduce the risk of ovarian cancer

Some ways to reduce the risk of ovarian cancer include breastfeeding, use of birth control pills, tubal ligation and maintaining a healthy BMI. However, these measures can’t completely prevent one from getting ovarian cancer.

Unfortunately, there is no known effective way to screen for ovarian cancer.

What is Uterine Cancer?

Uterine cancer is also known as endometrial cancer. It is a cancer that begins from the endometrium which is the inner lining of the uterus (womb). A prolonged exposure to an excess of the female hormone (oestrogen) is the predominant cause for developing endometrial cancer. Risk factors for endometrial cancer include obesity, never having been pregnant, late menopause, tamoxifen use in breast cancer, etc. The most common presenting symptom is abnormal vaginal bleeding which includes vaginal bleeding after menopause.

Tips to reduce the risk of uterine cancer

Some ways to reduce the risk of uterine cancer include maintaining a normal body mass index (BMI) with good dietary habits and exercise, and the use of birth control pills. However, these measures cannot eliminate completely the risk of developing uterine cancer.

There is currently no effective way to screen for uterine cancer. As a result, women with abnormal vaginal bleeding should see a doctor for further evaluation.