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Cervical Cancer, Pap Smear & HPV Vaccination – What You Need To Know

What is Pap Smear?

Pap smear is a cervical cancer screening recommended every 3 years for all sexually active females starting from age 25 years old.
This is a quick, simple and painless procedure that can be done in the clinic and it only takes a few minutes.  A brush will be used to collect some cells from the neck of the womb (cervix) and it will be sent to the lab to identify any precancerous and cancerous cells.

Cervical Cancer

In Singapore, cervical cancer is the 3rd leading cause of cancer deaths in women age 15-44 years old.
Cervical cancer risk is increased with :

  1. Multiple sexual partners
  2. Human papillomavirus (HPV) infection
  3. Smoking
  4. Unprotected sex

What is Human papillomavirus (HPV)?

Human papillomavirus (HPV) is one of the commonest sexually transmitted infection. It can affect both men and women.
There are 2 types of HPV – the low risk and high-risk types.

  1. Low-risk HPV can cause genital warts in both female and males. These are flesh coloured growths on the genitals, and they are infectious.
  2. High-risk HPV plays a significant role in the increased risk of cancer, such as cancer of the cervix, vulva, and vagina in women as well as anal cancer in men who have sex with men (MSM)..

The American College Obstetrician and Gynaecologist (ACOG) strongly recommends co-testing using Pap smear and HPV DNA testing (high-risk HPV types) especially for women ages 30-65 years old.
Patients are advised to repeat these tests in 5 years if pap smear and HPV results are negative.
This allows patients to extend their screening interval.
However, for women who test positive for high-risk HPV types, this means their risk is increased and hence, may need to have Pap smear screening at a closer interval, i.e once a year and depending on the results of the pap smear, some may need a referral to a gynaecologist for early intervention.
Remember, women can have no symptoms with an abnormal pap smear and HPV infection. Hence, early detection and screening are crucial as early intervention can be life-saving. Symptoms such as bleeding and pain during sex (postcoital bleeding), bleeding in between periods, heavy vaginal bleeding, and bleeding after menopause are usually late signs of cervical cancer.

The good news is cervical cancer can be prevented through vaccination.

GARDASIL 9 is a vaccine that helps protect against Human Papillomavirus (HPV). Most people infected with HPV show no signs or symptoms, this means they can transmit the HPV virus to others without knowing it in any kind of sexual activity or skin to skin contact.
Gardasil 9 provides protection against 9 major strains of HPV, which includes HPV types 6,11,16,18,31,33,45, 52 and 58 which are responsible up to 90% of genital warts and cervical cancers or precancer changes.
The vaccine, however, does not treat the infection.
It can be given to both females and males from the age of 9 up to 45 years old.
From the age of 9-14 years, 2 doses 6 months apart is recommended while those age 15 onwards, 3 doses will be recommended according to the schedule of 0, 2 and 6 months.
The side effects post vaccination is usually mild and temporary including pain, swelling, bruising over injections site and very rarely may cause fever and nausea.
HPV vaccine reduces your risk significantly but it does not mean your risk becomes zero.
After the completion of HPV vaccination, all women who are sexually active and above the age of 25 should still undergo routine screening via pap smear.

If you are due for your routine PAP smear or if you have questions about cervical cancer screening & HPV vaccination and wish to find out more, please call or visit any of our clinics or drop us an email at hello@dtapclinic.com
We have Female doctors at our Robertson Walk, & The DUO Galleria Branches Location. Call our Women’s Clinic @ +65 6976 5023 

Take Care! 

Other Interesting Reads:

    1. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
    2. 11 Causes of Dyspareunia (Pain During Intercourse)
    3. What is HPV Vaccination (Gardasil 9)
    4. 10 Causes of abnormal Vaginal Lumps and Bumps
    5. An Overview of Gonorrhoea
    6. Herpes – What You Need to Know
    7. The Good Wrinkles, Bad Wrinkles & the Ugly Wrinkles

Genital Warts: The Cauliflower-Like Lumps on the Genitals

Genital warts are white or flesh-coloured, smooth, small bumps that can appear anywhere in the general area of the genitals. They can also grow larger and appear as fleshy, cauliflower-like lumps on the genitals. Neither of which are more dangerous than the other, it is merely a characteristic and the stage that the illness was noticed.
Genital warts is an STD symptom caused by the Human Papilloma Virus (HPV).

HPV can cause multiple illnesses in the body as there are multiple strains of the virus attributing to different diseases in humans. Out of the hundreds of known strains of HPV, about 30 strains of the virus cause diseases of the genital area. These include warts, or in more sinister cases, cancer of the anus, cervix, vagina, and penis. Read: Causes of Vaginal Lumps & Bumps & Perianal Warts (Peri-Anal Warts)

Most of the other strains have no known effect on humans.


How do I get infected by the Human Papilloma Virus (HPV)?

Human Papilloma Virus (HPV) is a contagious disease that is transmitted through genital skin contact or through direct contact with genital fluids of a person already infected with HPV.
For transmissible illness such as these, using barrier methods of protection for sexual intercourse such as condoms should be emphasised. However, condoms are not very effective against transmitting HPV just because the HPV virus does not require penetrative sex to transmit the virus.

It can also be transmitted from a mother to an unborn child if the mother has an active HPV infection during the course of the pregnancy.


How do I know I am infected with HPV? How can it be detected?

A majority of people infected with HPV do not realise they even have the virus as it does not present with any symptoms.

Some people will notice bumps or warts around the genital area, otherwise known as genital warts. These usually occur one to three months after initial infection with HPV.


The most sinister manifestation of the HPV disease is cervical cancer affecting women in their 30s or 40s. The simplest way to detect cervical cancer is by identifying if an individual is an active risk of getting the disease and doing regular PAP smears. MOH guidelines are also apparent on the timing and interval for PAP smears for women in the reproductive age group. Sometimes a biopsy of unhealthy cervical looking tissue may be needed.

For men-who-have-sex-with-men (MSM), it is recommended that they do an anal PAP smear to investigate for HPV.

We also provide Rapid HPV Testing (next day result) in all our clinics in Singapore.


How can HPV & Genital Warts be treated?

In most cases, the HPV infection is self-limiting therefore no treatment is deemed necessary.

Unless an individual has issues with antibodies or a weak immune system in general, the body should be able to contain and eradicate the virus from the body in due time.
If an individual has an impaired immune system or a weak immune response, a lingering infection or a co-infection with another sexually transmitted illness can occur.

In cases of genital warts, the treatment options are largely dependent on the severity of the infection. The most common treatment options include creams and paint-on ointments. These induce a state of cell death so warts around the genital will eventually wither and fall off the skin.

Some patients may be offered cryotherapy where the wart is frozen then removed. The wart is frozen prior to that so that there will be no transmission of the wart after.
Apart from the above surgical options for wart removal also exist. This is where a surgeon uses electrocautery or a scalpel and surgically excise warts. See: Genital Warts Removal

Unfortunately, the majority of genital warts or other warts can recur very frequently and is rather common to have warts recur post removal. Sometimes, repeated treatments are required for complete remission, but patients should be aware of the recurrence rates in such an infection.


HPV and Cervical cancer

Some HPV viruses are known as high-risk viruses. This is particularly true in virus strains 16 and 18. This is because it induces changes in the cells in the cervix of a woman and causes cervical if not detected early.

It is in this light that it is recommended that all sexually active women are advised to go for regular PAP smear tests, screen for HPV infections and visit your doctor for HPV vaccination in Singapore.


HPV and PAP Smear

Pap smear is a relatively painless test that can be quickly done. It involves inserting a speculum into the vagina of the patient to allow for inspection then a tool is inserted to obtain scraping. The patient should go back to resume activities of daily living with no hindrance once after the procedure completed by our female doctor.
These scrapings and obtained cells are then examined under a microscope to look for abnormal cells.

We also provide Rapid HPV Testing & Pap Smear in all our clinics in Singapore.

HPV and HPV Vaccination

Human Papilloma Virus (HPV) is a group of virus that can cause:

  • Vaginal Cancers
  • Vulvar Cancers
  • Anal Cancers
  • Penile Cancers
  • Oropharyngeal Cancers (cancers of the throat and tongue)
  • Genital warts or Papillomas

HPV vaccination is used to protect against HPV-related diseases and cancers.
To complete the HPV vaccination, 3 doses of injections will be given. The recommended HPV vaccine schedules are:
First dose: During your doctor visit.
Second dose: 1 – 2 months after the first dose
Third dose: 4-5 months after the second dose


Get More protection with New 9-valent HPV vaccine (Gardasil 9)

There are over a hundred strains of HPV and they are each given a designated number e.g. HPV 6 or HPV 16 or HPV52.
HPV strains that cause warts will NOT cause cancers and HPV strains that cause Cancer will NOT cause warts.

Compared to the older Gardasil, the new GARDASIL 9 offers a wider range of protection against HPV strains.
Both Gardasil and Gardasil 9 give you protection against the cancer-causing HPV 16 and 18 and the wart-causing HPV 6 and 11.
Gardasil 9 protects additional 5 other high-risk types: 31, 33, 45, 52 and 58.
Together these types cause about 90% of cervical cancers.

Another HPV vaccine Cervarix, on the other hand, protects only against the commonest cancer-causing HPV 16 and 18. There is no wart protection with Cervarix.
If you are interested in getting the HPV testing & PAP smear, genital warts treatment or HPV vaccine, please visit our STD clinics and speak to our male and female doctors.
If you or your partner are experiencing any possible signs or symptoms of infection, or have had any potential risk exposures, please see our STD doctors today.
Take Care. Be Safe!



Other Interesting Reads:

  1. An Overview of STD – From an STD Doctor
  2. Anal Pap Smear for Anal Cancer Screening
  3. HIV Rash: What You Need To Know
  4. Genital Blister, Genital Ulcers & Genital Warts – What You Need to Know
  5. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  6. 11 Causes of Dyspareunia (Pain During Intercourse)
  7. 10 Common HIV related to Opportunistic Infections
  8. What is HPV Vaccination (Gardasil 9)
  9. 10 Causes of abnormal Vaginal Lumps and Bumps
  10. An Overview of Gonorrhoea
  11. What is the Treatment for Cold Sores? What causes Cold Sores?
  12. Herpes: Everything You Need to Know!
  13. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  14. Syphilis Symptoms (Painless STD Sores & STD Rashes)