9 Common Myths About Cervical Cancer Debunked

Cervical cancer is one of the most common cancers in women around the world, and it is the 10th most common cancer in Singaporean women. However, despite its prevalence, there are a lot of myths surrounding this cancer, which can lead to confusion and misunderstanding. Let's debunk some of the most common misconceptions so you can make informed decisions about your health risks and prevention options.

What is cervical cancer?

Cervical cancer develops in the cells of the cervix, the lower part of the uterus (womb) that connects to the vagina. Unlike many other cancers, cervical cancer is almost always caused by persistent infection with high-risk strains of human papillomavirus (HPV), particularly types 16 and 18.

This cancer begins with abnormal changes to cervical cells, known as dysplasia or precancerous changes. These changes can develop into cancerous tumours over time. However, this type of cancer progresses slowly from the initial stage to invasive cancer, providing opportunities for early detection and intervention.

Common myths surrounding cervical cancer

Although cervical cancer is relatively common, there are still many misconceptions about it. Let's address some of the most common ones.

Myth #1: Only women who are sexually active get HPV

Fact #1: Any woman who has had sexual contact could have been exposed to HPV, regardless of how many partners she has had. This is because genital HPV can spread through skin-to-skin contact during intercourse, oral sex, and anal sex. Condoms reduce the risk, but they do not cover all genital areas, so transmission is still possible.

Therefore, since HPV is highly contagious, people who are virgins or have engaged in non-penetrative sex are still at risk of contracting HPV through skin-to-skin contact. You don't need to exchange bodily fluids with someone to contract or spread the virus.

Myth #2: You need to get a Pap smear every year

Fact #2: While regular screening is important for cervical cancer prevention, annual Pap smears aren't necessary for most women. According to Singapore's Ministry of Health (MOH) guidelines, women aged 25 to 29 should have a Pap smear every three years. For women aged 30 and above, an HPV test is recommended every five years.

However, this recommendation does not apply to women who have previously had abnormal results and are under the care of a gynaecologist, who may require more frequent screening.

Are you unsure about getting a Pap smear or wondering if you need one? Schedule an appointment with Thomson Medical, where our specialists can address your concerns and provide guidance about cervical health screening in a comfortable, supportive environment.

Myth #3: If you have HPV, it means you will definitely get cervical cancer.

Fact #3: Having HPV does not mean that you have, or will develop, cervical cancer because the virus itself does not turn into cancer. Most people will probably be unaware that they have had HPV because infections usually go away on their own after being cleared by the immune system.

However, some low-risk strains of HPV can cause health problems, such as genital warts. But, if high-risk HPV infection persists, it can cause precancerous cell changes in the cervix. It is these abnormal cells that may eventually develop into cervical cancer if left untreated.

Myth #4: Cervical cancer only affects older women

Fact #4: Cervical cancer is most often found in women between the ages of 35 and 44, but younger women can also get it. Most people get HPV infections, which can lead to cervical cancer, in their late teens or early twenties, not long after they’re sexually active.

While it usually takes years for persistent HPV to develop into cancer, precancerous changes can occur much earlier. The cancer can then develop three to seven years after these abnormal cell changes begin. This is why screening guidelines in Singapore recommend starting Pap smears at age 25 - because cervical cancer can and does affect younger women.

Myth #5: HPV and cervical cancer always shows symptoms

Fact #5: This is one of the most misleading misconceptions, as it creates a false sense of security. In reality, both HPV infections and early-stage cervical cancer usually produce no noticeable symptoms.

Most HPV infections are asymptomatic, meaning affected individuals show no visible signs and may unknowingly transmit the virus. While some low-risk strains of HPV can cause genital warts, high-risk HPV strains, which can cause abnormal cell growth in the cervix that may eventually develop into cervical cancer, rarely produce any symptoms.

Even early-stage cervical cancer typically produces no symptoms, meaning it can remain undiagnosed for several years. By the time symptoms eventually appear, the cancer may have progressed to a more advanced stage. When cervical cancer symptoms do develop, they may include:

• Vaginal bleeding between periods, after sex or after menopause

• Unusual vaginal discharge that may be watery, bloody, or have an unpleasant odour

• Pelvic pain or discomfort during intercourse

• Heavier or longer menstrual periods than usual

Myth #6: The only way I can prevent cervical cancer is through Pap smears or HPV testing

Fact #6: Besides the HPV test and Pap smear, your risk for cervical cancer can be minimised by getting an HPV vaccination, maintaining a healthy lifestyle, practising safer sex using contraceptives such as condoms, and avoiding these risk factors:

• Smoking or consuming other nicotine products

• Having multiple sexual partners

• Engaging in sexual activity at an early age

However, vaccination and lifestyle changes work best alongside regular screening, not as a replacement. Since cervical cancer often shows no symptoms in its early stages, screening remains your most effective tool for detecting precancerous changes before they develop into cancer.

To help prevent these cancerous conditions, Thomson Women's Clinic and Cancer Surgery offer a 4-in-1 women's screening package, which includes:

• Consultation and examination with a women's cancer specialist

• Pap smear to detect abnormal cervical cells

• HPV test to identify high-risk virus strains

• Pelvic ultrasound scan for comprehensive assessment

An additional HPV vaccination is also available as an extra protective measure against cervical cancer.

Myth #7: Receiving the HPV vaccination means you no longer need Pap or HPV testing

Fact #7: Although the HPV vaccine offers effective protection, it does not eliminate the need for Pap tests or HPV testing. This is because the most commonly used vaccine, Gardasil 9, protects against nine HPV types that cause around 90% of cervical cancers. However, this means you're still at risk from other HPV strains not covered by the vaccine.

Additionally, the vaccine is most effective when administered before HPV exposure. If you have already been exposed to certain HPV types prior to vaccination, the vaccine may not protect against those strains.

According to Singapore's National Childhood Immunisation Schedule (NCIS) and National Adult Immunisation Schedule (NAIS), all females aged 9 to 26 are recommended to receive the HPV vaccine. The vaccine is most effective when administered at ages 11-12 before becoming sexually active. But it can still help those vaccinated up to 26 and some adults up to 45.

So, regardless of your vaccination status, all women should continue to have regular Pap smears or HPV testing as recommended by your doctor. The best way to protect yourself from cervical cancer is to get both the vaccine and the screening.

Myth #8: Cervical cancer is hereditary

Fact #8: Unlike other types of cancers like breast cancer and ovarian cancer, cervical cancer is not hereditary. It is primarily caused by persistent HPV infection, not genetic inheritance. This means that even if your mother or sister had cervical cancer, you haven't inherited an increased risk. However, the earlier cervical cancer is detected, the faster the intervention, and the higher the chances of recovery.

Myth #9: An abnormal Pap smear result means I have cervical cancer

Fact #9: If you receive abnormal results from a Pap smear, it's understandable if you feel worried, but try not to panic. An abnormal result does not definitively indicate cervical cancer; however, it signifies the presence of abnormal or precancerous cells that necessitate further examination.

Abnormal results can be caused by factors other than precancerous cells, such as inflammation or infection. However, if your results indicate further assessment is needed, you can consult a women's cancer specialist (gynaecological oncologist) at Thomson Women's Clinic and Cancer Surgery for further evaluation and personalised treatment.

If recommended, a colposcopy allows your doctor to examine your cervix more closely. This procedure helps identify exactly where abnormal cells are located. The cost of a colposcopy ranges from SGD 1,200 to SGD 10,400, depending on the complexity of the examination and any additional procedures required.

You may have to pay extra for things like consultation fees, imaging tests if needed, and follow-up appointments. Fortunately, there are several programmes in Singapore that can help lower the total cost, such as MediSave, MediShield Life, and Integrated Shield Plans. Depending on your eligibility and insurance plans, each of these offers different levels of coverage.

For more information, contact our medical concierge, who can provide detailed guidance based on your specific situation.

FAQ

Is it possible to live healthily 10 years after being diagnosed with cervical cancer?

Yes, many cervical cancer survivors go on to live healthy lives for decades afterwards. If cervical cancer is detected in its early stages, treatment is highly successful, with over 90% of affected women living healthily five years later. Even when the cancer is more advanced, there are many treatment options available, and survival rates continue to improve thanks to medical advances.

Why am I suddenly HPV positive?

Can a couple get HPV without cheating?

Should I panic if I test positive for HPV?

Will I be HPV positive forever?

Not necessarily. Most HPV infections clear up on their own within two years, as your immune system fights off the virus. However, some infections may persist for longer, or become undetectable while remaining dormant in your body.

How can I reduce my risk?

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, schedule an appointment at Thomson Women's Clinic & Cancer Surgery.