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Going for regular PAP smears will save your life - find out more about cervical cancer here. At the recent Women’s Health Day held by the Singapore Council of Women’s Organisations, we attended a talk given by Dr Lisa Wong, practising gynaecologist and women's cancer specialist at Mount Elizabeth Hospital on cervical cancer. It’s located at the end of the narrow neck of the womb, the small opening into vagina that allows menstrual blood to pass through. When do I need to go for a PAP smear?According to the Health Promotion Board, ‘all woman aged between 25 and 69 who ever had sex are advised to have a Pap smear done once every 3 years.”   Cells are collected from your cervix using a speculum and sent for a laboratory test. Your doctor will ask you to come back for a colposcopy, where your cervix is examined using a microscope (a colposcope) to see the abnormalities under magnification, like if it’s just a mild infection from the human papillomavirus (HPV) or something more serious. The human papillomavirus (HPV) is detected in 99.7% of cervical cancers - majority of them caused by type 16 and 18 of the virus.
Condoms can lower your risk but they’re not all effective.  The HPV vaccine protects a woman against HPV infection, and thus, cervical cancer. Going for your regular PAP smears is also important. As the precancer stage of cervical cancer is long (10-20 years) and can be asymptomatic, PAP smears are the most effective way of picking up abnormalities. We also asked our resident Sex Q&A expert, Dr Douglas Ong, an Obstetrics and Gynaecology specialist to comment on an important procedure that saves lives - PAP smears.
Q: Women nowadays are still afraid of going for PAP smears – what advice would you give them? Q: Should all women go for PAP smears, regardless of whether they've started being sexually active?
Q: We’ve read that PAP smears aren't good if you're intending to conceive, so women should go for one every 2 years.
Los Angeles women are at a higher risk of contracting HPV and developing cervical cancer than the rest of the county, according to a 2010 report by the Los Angeles County Department of Public Health. Researchers say the increased cervical cancer rate is linked to healthcare access issues and a lack of sexual education, particularly about the cancer’s leading cause, the human papillomavirus or HPV.
The study, presented at the 2010 Annual American Public Health Association Exposition, found that only 29 percent of L.A. Prevalent in most cases of cervical cancer, roughly 90 percent of all HPV strands are preventable by current FDA approved vaccinations.
Commonly referred to as the “common cold” of sexually transmitted infections, at least 20 million Americans are currently infected with HPV, according to the National Institute of Allergy and Infectious Diseases NIAID.
Kim-Farley said that there are roughly 12,200 new cases of invasive cervical cancer per year and 4,200 cervical cancer related deaths. According to a 1999 study in the Journal of Pathology, “the presence of HPV in virtually all cervical cancers implies the highest worldwide attributable fraction so far reported for a specific cause of any major human cancer.” Additionally, the study shows that the extreme rarity of HPV-negative cervical cancers reinforces the rationale for HPV testing.

Researchers recommend that all young women ages 9-26 be inoculated for HPV, regardless of sexual history. There are currently two different HPV vaccinations approved by the FDA that are known to prevent many strains of HPV and cervical cancer: Cervarix a bivalent HPV2 vaccine that contains two types of virus antigen or killed viruses and Gardasil, a quadrivalent HPV4 vaccine which contains four types of virus antigens. The cost of the vaccine is about $120 per dose, or $360 for the full series and covered by Federal health programs and by many large insurance companies.
The report also highlights that Latinas report the poorest self-rated health status amongst all ethnic groups. When asked about the high rate of infection amongst Latina women, Kim-Farley echoed the need to educate not only low-income families, but also healthcare providers on the dangers of HPV.
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Let me tell you one thing that the best health insurance plans has completely different set of meaning for different type of people. Additional Tests May Be Ordered if the Results of a Pap Smear are Abnormal?Additional Resources and References What are the Latest Advances with Pap Smear? HPV vaccination would dramatically decrease the risk of cancer, especially in women who don’t follow current screening recommendations. First, it has to be approved by Health Canada, he says, then the National Advisory Committee on Immunization will review the vaccine and make recommendations, including whether the costs should be covered by the provinces. McNeil and Bentley both worry that some women might stop getting regular pap smears if a universal HPV vaccination program is created to immunize females before they become sexually active.
Currently, the province spends $6 million per year on vaccines, says Scott, half of which comes from the federal government. Scott says federal funding will be a key factor in determining if and when Nova Scotia approves a universal HPV vaccination program.
The cervix also dilates during childbirth to allow the fetus to pass from the uterus to the vagina.
PAP smears can be painless – it really depends on the person doing it for you to be gentle, patient and skilled. Unlike many other tests that detect cancer after it has occurred, PAP smears are aimed at detecting precancerous lesions and actually prevent cancer from happening. However women who have already had sex in the past should continue to have PAP smears even if they are not currently sexually active. County parents, grandparents and guardians from low-income homes have had their daughters inoculated with at least one dose of the HPV vaccination.
Although there are 200 different known stains of HPV, the virus is often asymptomatic, increasing the importance of current vaccinations.

To combat the disease, the vaccines initiate an immune system, anti-body response to the virus without infecting the patient.
However, the NIAID said that the current vaccines will not prevent about 30 percent of cervical cancers and 10 percent of genital warts caused by HPV. Census data shows that Latino families make up 48 percent of the total population of Los Angeles County, 34.6 percent of those families are uninsured, the largest percentage amongst ethnic groups in the county.
County accept patients of all incomes and ethnicities, regardless of insurance or ability to pay for services. Dennis Kelly, a men’s health care physician at the University of Southern California, said it is also possible for men to contract cancer from exposure to HPV. Shelly McNeil, Dalhousie Infectious Disease Specialist, is starting a clinical trial for the HPV vaccine.A Halifax infectious disease specialist is trying to prove a vaccine will help prevent cervical cancer, even in women previously exposed to the virus. Jeff Scott says a number of events must take place before they consider including the HPV vaccine in public health programs. There are 2 types on the market now – Gardasil and Cervarix both cover types 16 and 18 of the virus. Vaccine uptake was significantly higher among those that had discussed the vaccine with a physician (81% vs. Nearly half of Latino adults have not heard of the HPV vaccine, according to a 2010 report by the Los Angeles County Department of Public Health. She says the medical community expects the vaccine to reduce cervical cancer rates by at least 60 per cent and many want it included in universal vaccination programs. The sexually transmitted virus infects 80 per cent of women by the time they reach 50 years of age, many of whom won’t realize they carried the virus. They think that insurance plan is the best for which they will have to pay minimum premium. However, the vaccine is not fool-proof and you still have to go for regular pap smears after.
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