If you’re on the fence about breast cancer screening, there are many risk factors including age and family history. A woman can be considered at high risk of breast cancer if she’s had a personal history of breast cancer, a strong family history of breast cancer, or there was a damage in their genes resulting to an increased risk of breast cancer (e.g. When the Breast Cancer gene is altered, it will not be equipped to fight cancer cells hence leading to a higher risk of breast cancer). High risk women are recommended to get annual screening from the age of 30 years onwards.

For women at average risk for breast cancer (i.e. do not fall into the high risk
categories above), guidelines recommend:

If you are under 30 years old, you need not feel left out. While mammogram may not be
the best option for breast cancer screening, your doctors will most likely recommend
breast ultrasound for you.

Cervical Cancer

Cervical cancer is a cancer that affects the lower part of the womb, otherwise known as
the cervix.

Women who are aged 25 years old and above and who have ever been sexually active
are encouraged to go for cervical cancer screening.

Types of cervical cancer screenings recommended for women in different age groups:

For women aged 25-29, the recommended test for cervical cancer screening is a Pap
smear once every three years, which is a specialised test that looks for abnormal cells
in the cervix.

For women aged 30 and above, the test of choice for cervical cancer screening is a
Human Papillomavirus (HPV) test performed every five years, with or without a concomitant Pap smear. HPV is a virus with more than 100 different strains known and
is closely associated with the development of cervical cancer and certain other types of
cancers (e.g. anal, oral).

This test is important in identifying certain high-risk strains of HPV that may place a
patient at an increased risk of developing cervical cancer in the future.

Anaemia

You probably heard of Anaemia before but do you really know what Anaemia does to
your body? We break it down for you. Anaemia is a condition where the body lacks
sufficient red blood cells to transport oxygen to the body’s organs.

Some symptoms include:

• Fatigue
• Reduced exercise tolerance
• Shortness of breath
• Weakness
• Dizziness
• Headaches
• Pale skin
• Brittle hair and nails
• Brain fog

There are many possible causes of anaemia. Some of the more common causes of
anaemia are iron deficiency and other nutritional deficiencies such as reduced levels of
Vitamin B12 or folate.

Iron deficiency is the most prevalent nutritional deficiency and the most common cause
of anaemia worldwide. Iron deficiency is more commonly seen in women of childbearing
age and older individuals.

Risk factors for iron deficiency include:

• Heavy menstrual bleeding
• Gastrointestinal bleeding (can be occult, i.e. not obvious)
• Vegan or vegetarian diet
• Medical conditions such as coeliac disease that may impair the absorption of iron
  from the gut
• Certain medications such as those for acid reflux
• Pregnancy – a 2019 study found that nearly three-quarters of Singaporean
  women were iron deficient in the early third trimester of their pregnancy

Individuals who are found to have iron deficiency anaemia can be treated even in the
absence of any symptoms to prevent further organ damage and worsening of anaemia.
Dietary changes alone are usually insufficient to completely correct iron deficiency even
foods high in iron contain only a few milligrams of iron at best. As such, iron
replacement is usually required, either in the form of oral supplements or intravenous
injections. IV iron infusions are now recommended as first line treatment in most
patients with symptomatic, moderate to severe iron deficiency. With successful
treatment of iron deficiency, the haemoglobin level – which is the protein in our red
blood cells that is responsible for transporting oxygen to our body’s organs and tissues
and bringing back carbon dioxide to it – should return to normal levels after about six to
eight weeks.

Dr. Jonathan Chong