After breast cancer, cervical cancer is the second highest cancer-related cause of death among Filipino women. Although considered a highly preventable disease, the high mortality rate is due to the fact that women are diagnosed at a late stage where treatment is expensive and in most parts outside of the metro, unavailable.
A study by the Philippine Cancer Society points to the strong link between the incidence of the human papillomavirus (HPV) among the Filipinas afflicted with cervical cancer. Other factors that seem to increase the likelihood of HPV infection and cervical cancer are early sexual contact, low socioeconomic status, high parity, smoking, use of oral contraception and risky sexual behaviors.
In the 2005 cancer registry, there was a marked increase in new cases of cervical cancer, and reported deaths. The high mortality rate was attributed to the fact that 75% of women were diagnosed at late stage. The Philippine General Hospital (PGH), the country’s government tertiary center, reported the highest number of new cervical cancer cases.
We consulted gynecologic oncologist Dr. Chia Yin Nin practicing at Gleneagles Hospital in Singapore about this alarming finding and its implications on women’s health.
What advice can you give women on how to protect themselves against cervical cancer?
In the past, we would say that women with multiple sexual partners are high risk. But that has changed because normal women are now affected by cervical cancer. Now, we realize that, although HPV is sexually transmitted, it is not an STD. It can be acquired through personal contact like fondling, petting and sexual intercourse. Nowadays, all women who are active sexually can have cervical cancer.
Young girls should get vaccinated before their sexual debut to protect against the HPV virus. The vaccine provides up to 95% coverage against cervical cancer. For older women who have started sexual activity, they can still have the vaccines ’till age 45, but I also advise screening: the PAP Smear or the HPV test kit.
Unless women go for tests, they will never know that they have signs of the virus. It takes years before the virus can develop into a cancer but this can progress very quickly depending on the strains of HPV virus they acquire e.g. type 16 and 18 are highly aggressive.
Cancer can deprive a woman of her fertility.
Once these pre-cancer changes are detected, they can be easily treated by burning away those abnormal cells to prevent any chances of progression into cancer. Pre-cancer treatment does not involve removal of the womb.
Early screening not only saves your life, it saves your womb.
What are the symptoms to look for?
The virus is so prevalent in the community, almost all women can have it. For about 20% of these women, the virus can develop into cancer. It is only when the cancer develops that you experience the signs like bleeding during intercourse, bleeding between menstrual periods or bleeding after menopause. The patient can also experience other symptoms like back pain, cough and swelling in the abdomen or limbs if the cancer has spread.
How can women protect themselves against cervical cancer?
There are 2 types of protection: primary and secondary. Vaccination is, by far, the best means of primary protection. Secondary protection to monitor the presence of pre-cancerous changes is done by PAP smear and/or the HPV test kit. The PAP smear is a test done by a General Practitioner or an OB Gynecologist to detect pre-cancer changes in the cervix.
Aside from the PAP smear, there is the HPV test kit. It is a swab test similar to the PAP smear. The accuracy is so much better than the PAP SMEAR. It is so accurate that you can space out your screening to 3-5 years. For PAP smears it is recommended that you test once every year because it is quite prone to interpretation error.
I tell my patients that cervical cancer can happen to any of us. My cervical cancer patients are normal married women, not commercial sex workers. Regular women are complacent so they think they are healthy and don’t need to go for screening. Also, they are reluctant to ask their partners about their sexual history. I tell women that instead of doubting your spouse or partner, you empower yourself by protecting yourself so that you can stay healthy and live long as a mother to your children, as a wife to your husband and a person with a promising career.
With many of today’s women taking full control of their lives and careers, there is no excuse for making sure that their bodies are strong enough to cope with the demands of running a company and a home simultaneously.
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