Most of us know that we should go for a Pap smear at least once every few years. Most of us also keep pushing the procedure back because, well, we’re busy people with better things to pencil into our schedule. But we have to stop doing this.
“Routine Pap smears are still the most common method for detecting cervical cancer. It accurately detects 90 percent of cervical cancers before symptoms develop,” says Dr Christopher Ng, Medical Director of the GynaeMD Women’s & Rejuvenation Clinic at Camden Medical Centre.
Who needs one?
If you’re sexually active, a Pap smear should be on your to-do list as it tells you if you’re at risk of developing cervical cancer, and also helps to prevent it.
“A Pap smear screens for pre-cancer cell changes,” says Dr Chua Yang, Director of A Clinic For Women at Mount Alvernia Medical Centre. “Appropriate treatment is then implemented to remove the abnormal cells. This prevents cancer from developing.”
Most important to know, these pre-cancer cells are usually found in women around our age.
“The age group with the peak incidence [of cervical cancer] is around 40, but pre-cancer cells are most commonly found in 20 to 30-year-olds,” she adds. “Remember, we’re trying to screen for pre-cancer cells rather than find cancer cells, which is too late.”
Also, according to Dr Ng, while cervical cancer is not common in women between the ages of 21 and 29, it’s not unheard of. After all, cervical cancer is the 10th most common cancer affecting women in Singapore.
If you’ve never had sex before, a Pap smear isn’t required, no matter what age you are.
“Only sexually active women need a Pap smear” says Dr Ng. This is because most cervical cancers are caused by the human papilloma virus (HPV), which is sexually transmitted. Symptoms of HPV usually include common warts and genital warts, which can appear on the vulva but also near the anus.
“HPV is a very common virus. In the US, it was found that up to 50 percent of couples who have ever been sexually active are likely to be infected with it at some point in their lives,” he adds.
While there are cases of non-HPV cancer of the cervix, the percentage is really small. According to Dr Chua, there are less than 20 of such cases in Singapore every year.
Even if you aren’t particularly sexually active but have had sex before, you should still follow the recommended intervals for the Pap smear.
“A woman is at lower risk if she’s had sex with only one sexual partner. If that’s the case, going for a Pap smear once every three years is more than adequate. If all Pap smears are normal, she can stop at 65,” says Dr Chua.
Because HPV is sexually transmitted, you’re naturally at higher risk if you have multiple sexual partners. If so, you should get yourself checked once a year.
All about prevention
The best way to protect yourself against HPV infection is by getting a vaccination.
“The most important step is to vaccinate young girls who aren’t sexually active yet. This is primary prevention… [and provides] in excess of 80 percent protection against cervical cancer,” she says.
But since current vaccines don’t cover all the 15 strains of HPV that have high cancer-causing potential, a vaccine doesn’t guarantee you won’t get HPV.
“The vaccine targets the major culprits… [however], some minor high-risk strains may still be at play, so the recommendation still is to do a Pap smear every three years even if you’ve had a vaccination,” says Dr Chua.
If abnormal cells are detected in your cervix, you can undergo minor surgery to get them removed. But that doesn’t always mean you have the all-clear.
“[The abnormal cells] can return as new HPV infections since these infections are sexually transmitted. Following surgery, Pap smears should be performed every six months until the tests are back to normal,” he adds.
As long as you’ve been sexually active, it’s a good idea to get a Pap smear. Cervical cancer is very much preventable – and all it takes are regular trips to your gynae’s office.
An earlier version of this article first appeared in the January 2018 issue of CLEO magazine.
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