HPV and Cervical Screenings

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.

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

HPV has both low-risk type and high-risk type. The low-risk type causes symptoms such as genital warts or itchiness in the genital area, whereas high-risk HPV cause cancer and unfortunately, most of the time there are no obvious symptoms. That is why it can only be detected through screening for the high-risk types.

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.

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.

Yes, there is a home screening test available, instead of visiting a doctor to do the HPV test. In fact, the way HPV tests are done is similar to pap smear testing. For the home test kit, there will be a device to insert into your vagina to collect the secretion and then seal it and return to the clinic. Yes, there is such a device that is available in Singapore. Essentially, depending on which company manufactures it and depending on how they deliver the service, it can be a mailbag service or sending back to a clinic to check the results.

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.

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.

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.

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.