26 Questions answered

Will Medisave cover my vaccination cost if I am above the recommended age in Singapore?

In Singapore, unfortunately, Medisave is very strict. If you are not in the suitable age limit, you are not able to be covered under Medisave. However, the scheme is only applicable to the Cervarix or Gardasil (4-valent HPV vaccine). Gardasil-9 is actually very affordable.

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Answered By

Dr Timothy Lim

Gynaecologist

What age group is most at risk of developing cervical cancer?

Cervical cancer can affect women in their reproductive age group all the way to women who are already grandmothers. So, there is a wide spectrum. In fact, the youngest person with cervical cancer in Singapore is a teenager, that is the youngest. The oldest I have seen is maybe a patient in their 90s. As long as have been or are sexually active then there is a risk there.

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Answered By

Dr Timothy Lim

Gynaecologist

Is there anything I should do or prepare before an HPV screening or vaccination?

Before the screening, firstly, it must be done after your menstruation period has ended. Secondly, we will advise patients to avoid sexual intercourse for the last 48 hours before the screening. Thirdly, wear something comfortable. Of course, food-wise there are no restrictions before the screening. And remember the age limit, before the age of 30, we don’t recommend HPV screening, and the reason is that HPV infection is very common among the young, so we might end up taking a lot of infection but the cervix is fine.

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Answered By

Dr Timothy Lim

Gynaecologist

What is the link between cervical cancer and HPV?

Nowadays we know cervical cancer is actually caused by infection. That means if a lady gets infected by the HPV virus, she might get cervical cancer. Of course, it does not account for all, not 100% of cervical cancer that is caused by HPV but at least 96-98% is caused by this virus.

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Answered By

Dr Timothy Lim

Gynaecologist

How do doctors screen for HPV?

For cervical cancers screenings, you got the pap smears and more recently used for HPV testing, to test whether a person has high-risk HPV virus. I presume this is what the question is asking. So, HPV screening is supposed to be superior to pap smear screenings for women above 30 years old. So before 30 years old, you should still do a pap smear. HPV screening is testing whether a person has the virus or not, whether HPV 16, HPV 18 or the other types. So, do we need to do this testing before the vaccine?

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Answered By

Dr Timothy Lim

Gynaecologist

If I have been vaccinated with the old HPV vaccine, do I have to get vaccinated with the newer one?

Yes. The reason is that the old vaccine only covers the two types of high-risk virus HPV 16 and 18. So, although women can boost themselves, that means you go for the new vaccine too and get coverage for the additional high-risk types. And, there has been a study done that proves that it works. For the studies that have been done, usually, we do the boosters one year after the previous vaccination.

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Answered By

Dr Timothy Lim

Gynaecologist

What is HPV and what does it stand for?

HPV stands for human papillomavirus. It’s a virus, a double-stranded DNA virus.

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Answered By

Dr Timothy Lim

Gynaecologist

What is cervical cancer and how common is it in Singapore?

Cervical cancer is among the top 10 cancers that affect women in Singapore today. Cervical cancer is cancer that affects the part of the reproductive system. The cervix is the door to the womb, it sits between your vagina and uterus, the cervix is a part of the host of pregnancy. So, when the woman gives birth, the cervix has to violate fully before the baby comes out. So, the part of the uterus, the womb, can get a specific cancer.

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Answered By

Dr Timothy Lim

Gynaecologist

When should a guy take the HPV vaccination?

For boys and girls, both can start from age 9 all the way to age 26. So, for 9 to 14, both boys and girls can get two doses, which is sufficient. And then from 15 to 26, they can get three doses, so there is no difference between males and females.

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Answered By

Dr Timothy Lim

Gynaecologist

Does the HPV vaccine last for a lifetime?

This vaccination was only launched around 2007, the first vaccine. The participants enrolled in this study in 2002 and this group of women 18 years ago are still being followed up with their antibodies being tested once in a while. And as far as we know, the original group, there is no need to have a booster vaccination, so that’s the good news. As far as we know, for at least 15 years, there is no need to go for another. Theoretically speaking, we believe that this will last for a lifetime.

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Answered By

Dr Timothy Lim

Gynaecologist

Should my partner and I go for HPV testing if my partner had been sexually active before meeting me?

There is no need for the HPV test, both of you can just go for the vaccination. In fact, this vaccine is gender-neutral, so both men and women can both go for the vaccination.

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Answered By

Dr Timothy Lim

Gynaecologist

Can I donate blood if I am HPV positive?

The answer is yes. HPV is not a bloodborne disease.

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Answered By

Dr Timothy Lim

Gynaecologist

Can I get vaccinated if I am above the recommended age for HPV vaccination?

In other countries, the approved age is up to 45 years old, because its FDA approved, that is why in other western countries if they are above 26 years, they are still being given the vaccine. That is why in Singapore, if the person is above 26, the person can be given the vaccine. Why? because there are studies and it is evidence-based on the use of the vaccine. So, the answer is yes, you can still get the vaccination even though you are above the recommended age.

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Answered By

Dr Timothy Lim

Gynaecologist

How many people with HPV eventually suffer from cervical cancer, in percentages?

Very low, because HPV infection is common. So, cervical cancer is a very rare outcome of a small infection. The problem is that we do not know how to predict which person with the HPV virus will get cervical cancer. We can screen and prevent but we do not know how to predict.

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Answered By

Dr Timothy Lim

Gynaecologist

What is the most effective treatment for cervical cancer?

For cervical cancer, it depends on the stage of cancer. In the early stages, surgery is enough to cure the patient. As mentioned earlier, if the tumours are very small, microscopic, we can do something called a cone biopsy. If the tumour is bigger, more than 2cm, we can do a hysterectomy or a trachelectomy if the patient is young. But for stage 2 onwards, it gets more difficult, as the tumour may not be in one area anymore, it can be spread out and the patient will need chemoradiation.

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Answered By

Dr Timothy Lim

Gynaecologist

Practice

820 Thomson Road. #01-03 Medical Centre a, Mount Alvernia Hospital Singapore 574623

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* This profile has been last updated on March 5, 2021.