Frequently Asked Questions on Cervical Cancer Screening

What is a Pap smear?

The term “Pap smear” is often used to describe a cervical cancer screening test. This test involves collecting a sample of cells from the cervix with a spatula and creating a microscope slide for lab analysis. The test has evolved in recent times to use a soft sampling brush and liquid-based cytology, which improves the reliability of the test. HPV testing can also be performed on a liquid-based cytology sample, but cannot be done using a conventional Pap smear.

What is HPV?

The human papillomavirus (HPV) includes many subtypes, some of which are known to cause cervical cancer. Most people will encounter HPV at some point in their lives, and most types are harmless. We can detect the presence of high-risk HPV subtypes by doing the HPV test as part of cervical screening.

This allows your gynaecologist to assess your risk of developing cervical cancer and arrange any necessary follow-up test. Vaccination against high-risk HPV subtypes has been demonstrated to reduce the risk of pre-cancerous cervical abnormalities and cervical cancer.

When should I have the HPV vaccination?

HPV vaccination is most effective when given prior to your first sexual contact. For this reason, in Singapore, HPV vaccination is offered to women and girls aged 9 to 26 years old. HPV vaccination is included in the National Childhood Immunisation Schedule and the National Adult Immunisation Schedule.

Should I discuss HPV vaccination with my daughter?

You should consider discussing HPV vaccination with your daughter when you think it is most appropriate, and discuss the importance of protecting her against cervical cancer. Vaccination before the first sexual contact is the most effective.

I am worried about the examination. What will happen at my appointment?

An internal vaginal examination with a device known as a speculum is used to allow the doctor to view the cervix and take a sample. Before the examination, you will have the opportunity to discuss the test with your doctor. The screening test does not take long to perform and most women do not find the test painful. If you are concerned about the examination, please discuss with your doctor beforehand.

My mother had cervical cancer. Should I go for cervical screening?

Almost all cervical cancers are related to HPV exposure rather than genetic factors. It is important that every woman attends cervical screening whether you have a family member who has had cervical cancer or not.

I am 28 years old and did not have HPV vaccination when I was a child. What should I do?

HPV vaccination can be given to women who have never received it or those who did not complete the course previously. The vaccination is most effective prior to the onset of sexual activity and should therefore be considered by all women and girls.

I am pregnant but have never had cervical screening. What should I do?

Routine cervical screening is generally not performed during pregnancy, as the accuracy of the test can be affected by the natural changes in the cervix during this time. If you have never had an abnormal screening result, it is recommended to wait until after your baby is born to have cervical screening.

If you have had an abnormal result and are under follow-up, or if you have abnormal bleeding such as bleeding after sex, it is advisable to consult a gynaecologist.

I have abnormal vaginal bleeding and / or bleeding after sex. Should I have a Pap smear?

In the case of cervical screening, the most appropriate way to use the test is for women who have no abnormal symptoms. If you have concerns about your symptoms, please discuss this with your gynaecologist who will be able to advise further.