Singapore Medical Guide | Singapore Healthcare

Cervical cancer remains the 6th most common cancer among Singapore women. The highest number of cervical intraepithelial neoplasia (CIN) cases is in the 35-44 age group.

The peak incidence of cervical cancer is in the 45-54 age group. On either sides of this spectrum, cases are far fewer. The 20-29 age group make up only 10% of all CIN3 while those above the age of 70 years makes up only 1.5%.

Certain conditions increase the risk of cervical cancer:

1. Human Papilloma Virus infection
2. Human Immunodeficiency Virus infection
3. Immune suppression
4. History of sexually transmitted diseases
5. Multiple sexual partners
6. Sexual intercourse at an early age
7. Cigarette smoking
8. Long-term oral contraceptive use

Recommendations for screening:
(MOH Clinical Practice Guidelines 2010)

1. All women who have had sexual intercourse should undergo screening from 25 years of age

2. Pap smear should be performed at least once every 3 years
     -20-39 years:     annual screening prevents 76% of cervical cancer
            3-yearly screening prevents 61% of cervical cancer
            5-yearly screening prevents 30% of cervical cancer
     -40-54 years: annual screening prevents 88% of cancer
            3-yearly screening prevents 84% of cancer
     -55-69 years:     annual screening prevents 87% of cancer
            5-yearly screening prevents 83%

3. Women over 69 years can stop screening if
    - 2 previous consecutive negative pap smears in last 10 years
    - latest pap smear at 69 years is negative

The Health Promotion Board runs a screening programme (CervicalScreen Singapore) with reminders sent to registered women to attend for screening every 3 years. Their Pap smears can be performed at polyclinics or family physician clinics. The MOH National Household Survey 2004 showed that 84% of Singapore women had at least one Pap smear. Though encouraging, greater awareness and public education may encourage more women to come forward for screening and will hopefully result in more lives being saved.