What is cervical cancer?

1. Cancer which occurs when the cells of the cervix grow abnormally

2. Usually caused by the human papilloma virus (HPV)

3. Common in women worldwide

What are the symptoms of cervical cancer?

There are usually no symptoms during early stages. At later stages of cervical cancer, there can be pelvic pain and vaginal bleeding.

Who is at risk for cervical cancer?

Women who:

• Use oral contraceptives

• Smoke

• Are sexually active

• Have persistent HPV infection or are at risk of being infected with HPV. This includes those with:

  ○ Early sexual onset

  ○ Multiple sexual partners

  ○ A high-risk sexual partner (e.g. a partner with multiple sexual partners or an HPV infection)

  ○ A history of sexually transmitted infections (e.g. Chlamydia trachomatis, genital herpes)

  ○ A history of vaginal or vulvar cancer

  ○ A suppressed immune system

Are there any tests for early detection of cervical cancer?

Yes, the following are cervical cancer screening tests that detect cervical cancer in its early stages:

• Pap smear

• Human papilloma virus (HPV) test

How is a Pap smear and an HPV test done?

These tests can be done during a pelvic examination in the clinic. They take about 10 to 15 minutes.

During the pelvic examination, your doctor will insert a speculum into your vagina to examine your cervix. This may cause mild discomfort but should not cause any pain.

Your doctor will then perform the Pap smear by using a small brush or spatula to gently scrape some cells from the cervix. These cells are then sent to the laboratory to look for abnormal changes. An HPV test can be done along with a Pap smear or as a separate test.

How often do I need a Pap smear and HPV test done?

Aged 21‒29:

• Pap smear every 3 years

• HPV test not routinely needed. It may be done if the Pap smear results are abnormal

Aged 30‒65:

• Pap smear every 3 years or combined Pap smear and HPV test every 5 years

Aged above 65:

• May no longer need Pap smears done; talk to your doctor to determine your needs

More frequent testing may be required if:

• Your Pap smear or HPV test results are abnormal

• You have human immunodeficiency virus (HIV)

• You have other conditions that suppress your immunity

Talk with your doctor to have a personalized plan made.

Do I still need to do Pap smear and HPV test if I have had a hysterectomy?

This depends on:

• Why your hysterectomy was needed 

• Whether your cervix was removed

• Whether you have a history of moderate or severe dysplasia

Do I still need a Pap smear and HPV test if I have had an HPV vaccine?

Yes. You will still require a regular Pap smear and an HPV test. The Pap smear helps to determine presence of abnormal cervical cells. With or without HPV vaccination, this test should be regularly done for early detection and treatment.

The HPV test is also necessary because the HPV vaccine does not protect against all forms of HPV.

I am a transgender person. Should I be tested?

Everyone who has a cervix should get checked on a regular basis. Testosterone therapy may affect test results. Let your doctor know if you are on testosterone therapy.

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