PAP SMEAR SCREENING

Cervix cancer is the sixth most common cancer among women in Singapore. However, it can be easily prevented with the Pap Smear test.

The cervix is the lower, narrow end of the womb that opens into the vagina. Cervix cancer occurs when the cells of the cervix start to grow in an abnormal and uncontrolled way.

Fortunately, some early pre-cancerous changes in the cervix can be seen long before cancer develops. Treating the cervix at this stage will prevent cervix cancer transformation.

• Irregular vaginal bleeding
• Frequent, foul-smelling and/or bloody vaginal discharge
• Bleeding after sexual intercourse

Unfortunately, by the time these symptoms occur, cancer may be at an advanced stage. Therefore, it is vital that you have your PAP SMEAR performed regularly even if you are feeling well.

The PAP Smear is a simple and relatively painless test to examine cells from the cervix and vagina for any abnormality. This involves inserting an instrument called a speculum gently into the vagina to obtain the necessary cells for examination under microscopy.

The Pap Smear is a good test but not 100% accurate. Occasionally, the results can be normal although there may be abnormalities on the cervix. Fortunately, most cervical pre-cancers grow very slowly. So having a pap test at regular intervals will find almost all abnormalities before progression to cancer.

Only women who are sexually active need a Pap Smear test. Sexually active women should have a Pap Smear from the age of 25 onwards. This should be repeated every 2-3 years until the age of 65, if there are no abnormalities. However, we may recommend that you have a Pap Smear more frequently if any suspicions of abnormalities.

An abnormal pap smear does not mean that you have cancer. It simply means that there are abnormal cells, which may require further evaluation. Often these abnormal cells are due to infection or menopause. In some cases, the Pap Smear may suggest pre-cancer cells and you may be asked to have a colposcopy examination.

A colposcope is an instrument with a magnifying view through which a better view of the cervix can be obtained.

It is a procedure that takes 20-30 minutes. This process can be done under local or general anesthesia. A speculum is inserted into the vagina. We will be able to examine the cervix after applying a mild vinegar-like solution (acetic acid).

A tissue biopsy may be taken from the cervix for further evaluation. Depending on the results of the biopsy, you will be advised on the best treatment.

The Colposcopy examination cannot be performed while you are having your period.

There are several methods of treating pre-cancerous changes of the cervix. These include:

• Laser vaporization
• LEEP (Loop electrosurgical excision procedure)
• Cone biopsy with laser, diathermy or knife

For most women, these procedures can be performed under local anaesthesia. However, some women may require a general anaesthesia in day surgery centre.