Myths about Cervical Cancer screening



Myth 1: I don’t need to screen for cervical cancer once I have the HPV vaccination

While the latest HPV vaccine covers for nine HPV strains including the two high-risk strains HPV 16 and 18, they only account for approximately 70% of cervical cancer [1]. There are over 100 HPV strains, of which several of them are cancer-causing types. In Singapore, the guidelines for cervical cancer screening are as follows [2]:

  • Pap smear every 3 years for women aged 25-29

  • HPV testing every 5 years for women aged 30-69


You are encouraged to continue screening until you are 69 years old (if you have had 3 consecutive normal pap smears or 2 consecutive negative HPV tests in the last 10 years).


Myth 2: I do not need to screen for cervical cancer as I am not sexually active

You should screen for cervical cancer if you have ever been sexually active, even if that was 20-30 years ago! You can been infected with HPV many years ago, as it may not present with symptoms until years later. The recommended screening guidelines for all women who have ever had sexual intercourse are as above.


Women who have not had sexual intercourse before need not go for screening; however, if you have experienced any symptoms (as discussed in this article before), please consult a doctor.


Myth 3: I do not need to screen for cervical cancer as I do not have any symptoms

As mentioned earlier, you may not experience any symptoms until later on. The purpose of cervical cancer screening is to detect the presence of changes at an early stage, when it is still easily treatable. By the time you have any symptoms it might be at a later stage where treatment may often be more complicated.


Myth 4: A pap smear or HPV test screens for all gynaecological cancer

This is often a common misunderstanding. A pap smear or HPV test will only screen for cervical cancer. You are still at risk of vulva, ovarian or endometrial cancers. There are different risk factors for these cancers.


Myth 5: HPV is transmitted via sharing utensils

HPV is the most common sexually transmitted disease (STD) in the world. Unlike other types of STDs, HPV is actually transmitted via skin-to-skin contact (and not via semen or saliva), and are usually infected via vaginal, anal, and oral sex. You will not be infected with HPV if you share utensils. However, therea are other strains of HPV that are not transmitted via sexual intercourse, but these are often strains that do not cause cancer. They usually cause warts on the hands and feet and are infected via broken skin.


Myth 6: A normal pap smear result means that I won’t ever have cervical cancer

Results may sometimes be falsely negative for various reasons; for example, you may have tested too soon after your exposure. The window period (or incubation period) for HPV is not known, but is largely thought to be weeks to months [3]. It is still recommended for you to follow the guidelines as above and screen regularly for cervical cancer.


Myth 7: Condoms can prevent HPV transmission

While condoms are effective barriers against most STDs such as HIV, chlamydia and gonorrhea when used correctly, they are less effective against HPV as it is transmitted via skin-to-skin contact. Moreover, condoms do not protect against infection via oral sex.


Nonetheless, condoms are still useful in lowering chances of HPV transmission. The best way is to use condoms and screen regularly for HPV. At the same time, if you are sexually active, don’t forget to screen for other STDs!


References


[1] https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer#:~:text=Cervical%20cancer%20is%20caused%20by,%2C%20vagina%2C%20penis%20and%20oropharynx.


[2] https://www.sccps.org/guidelines-and-updates/


[3] https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/human+papilloma+virus+hpv+genital+warts+related+cancers/human+papillomavirus+hpv+genital+warts+related+cancers+-+including+symptoms+treatment+and+prevention