Screening For Cancer Of The Cervix
Cervical cancer is one good example of a preventable cancer. In fact, the incidence of this cancer has declined over the years in populations that have integrated wide-spread cervical screening programme. Pre cancerous changes of the cervix have enabled these early cases to be detected via cervical (Papanicolou) smears.
National Screening Programme For Cervical Cancer
The National Screening Programme in Singapore was initiated in 2008, and encouraged every
woman who is sexually active to have a Pap smear every
three yearly between the ages of 25 and 26 years old.
When the smear returned as suspicious, subsequent follow
on smears may be prescribed at shorter intervals according
to the abnormality reported. Many women, nevertheless,
continue to have annual Pap smear as to improve early
detection. There are known risk factors that put a woman
at a higher risk of cervical cancer. We will recommend
how often and when you should start the screening programme.
When the smear result is reported as abnormal, like ASCUS
, mild to severe dyskaryosis
; it is necessary to undergo a colposcopic examination to confirm the severity of the pre-cancerous changes, aided by directed biopsy
of the cervix or wide excision of the cervix.
Cervical cancer is preventable
Screening of cervical cancer is not only fairly straight-forward, but also affordable. No woman should deny herself the opportunity and the means of cervical cancer screening.
The purpose of performing a Pap smear
is to take a sample of cells from the surface of the cervix (which is the neck of the womb). A speculum is put into the vagina gently, to open up the walls of the vagina so as to visualize the cervix. The innner
and outer surface of the cervix is wiped over by a cytobrush several times to lift up cells that are shedded from the “skin” of the cervix. The collected cells sample may then be either; applied over a glass slide and fixed, or immersed into a liquid medium. The collected cells are subsequently examined under the microscope by the
cytopathologist, who will grade the cellular changes. The Pap smear is best performed in between the menstrual periods as excessive bleeding will obscure accurate examination. In the same light, it is ill-advised to have douched, used feminine deodorant or have sexual intercourse about twenty-four hours before performing the Pap smear.
Ovarian Cancer Screening
On current evidence, there is no cost effective and efficacious population program to screen for ovarian cancer in the early stage. Much resources and effort is spent the world over to devise a blood test or a combination of blood test and imaging. The truth is ovarian cancer is mostly detected late and this gives poor outcome; resulting in severe pain and discomfort and premature death. Without an effective program of screening for ovarian cancer
, diagnosis is often delayed, which is largely due to the ovaries being sited deep in the pelvis, and they remain inaccessible until the tumors arising from them become large (by which time the disease has spread to other areas). At this late stage, the woman may complain of abdominal discomfort, pain, nausea, vomiting, constipation, diarrhea and painful intercourse.
Screening For Ovarian Cancer By Tumour Markers & Ultrasound Scan
The presence of ovarian cancer may be detected by pelvic ultrasonography and
assessment of certain tumor markers in the blood. The
conduct of these tests, either alone or in combination,
is not completely reliable in early detection, but they
can, to some extent, alleviate the worry regarding the
ovaries being abnormal. The value of these tests improves
when they are repeated at intervals. Women in general
may subscribe to these tests. But those that benefit
most will be the women with a family history of ovarian
cancer or related cancers such as breast, bowel and
endometrial cancer. With increase awareness of ovarian
cancer, and of its tendency of delayed diagnosis, many
women simply wish to have the reassurance of evaluating