What you need to know about HPV and cervical cancer and why the time is now to prioritise your health and book in a screening

Globally, cervical cancer is the fourth most common cancer in women and one of the leading causes of death in women, yet it is one of the most preventable cancers today thanks to vaccination, screening and early treatment. 

More than 90 percent of cervical cancer cases are caused by human papillomavirus (HPV). 

HPV is a sexually transmitted infection that almost every sexually active person will get at some point, usually without symptoms. In most cases, it is cleared from the body by the immune system. But persistent infection can lead to abnormal cells which can develop into cancer, from five up to 20 years later.

Vaccination against HPV is effective in preventing infection and cervical cancer, and is recommended to all girls from the age of nine to 14, before they become sexually active. Together with screening and treatment, it plays an essential role in the road to eliminating cervical cancer. 

Dr Tam Ching Ting, a specialist in obstetrics and gynaecology at Peaceful Women’s Clinic in Hong Kong, highlights some of the misconceptions she encounters around the topic of HPV, vaccination, cervical cancer and screenings:

• Screening is painful and embarrassing: “Women are often embarrassed or think that having a Pap smear is painful, but often when they come to see me and do a screening, they are surprised by how quick and easy it is,” says Tam.
• Cervical cancer only impacts the elderly: “My clients often think that only old people get cervical cancer. But there are two peaks of HPV infection, the first is aged 30, and the second is around age 50,” says Tam. “From my own experience, I’m increasingly seeing younger women being diagnosed with cervical cancer.”
• HPV vaccination is for the young: “I am often asked whether you can have the HPV vaccine after becoming sexually active or after giving birth. Earlier is better, but you can still be vaccinated against HPV,” says Tam, sharing that while effectiveness declines with age, she still recommends vaccination even for women in their 40s as there is evidence that for women diagnosed with pre-cancerous changes, they have a lower chance of recurrence if they have received the vaccine.

Cervical cancer is preventable. One of the key issues in Asia is that women are not getting screened.  

Take Hong Kong. More than 1.5 million Hong Kong women aged 25-45 have never had a cervical screening and are not planning on booking one according to the 2024 Roche Diagnostics Asia Pacific National Women’s Health Survey, which was carried out in December 2023, engaging women aged 25-50 in Australia, China, Hong Kong, India, Japan, South Korea, Thailand and Vietnam. 

In Singapore, current data suggests almost 90 percent of women are aware of cervical cancer screening tests yet uptake remains low. Only two in five women aged between 25 and 74 have been for a cervical screening the last three to five years. 

In the Philippines, cervical cancer is the second most common cancer among Filipino women. However, the country has one of the lowest cervical cancer screening rates in the world with only about 1 percent of women undergoing cervical cancer screening. 

The 2024 Roche Diagnostics Asia Pacific National Women’s Health Survey explored awareness and attitudes of women’s health with almost 3,000 women across Asia Pacific. The findings included four key barriers holding women back: 

• Lack of awareness and support: More than half of women in Asia-Pacific have little to no knowledge of women’s health tests and screenings, including cervical cancer diagnostic methods. The top barrier for not screening is a presumption that nothing is wrong
• Fear: More than one third of women in Asia Pacific have never had a cervical screening and are not planning to. This is due to perceived pain and discomfort (17 percent) and fear over the results (17 percent).
• Women’s health is undervalued: 71 percent of women believe limited attention is given to female diseases, which creates a barrier between women and healthcare solutions, while 61 percent agree that female-related diseases are undervalued in their healthcare system
• Women are time-poor: Almost half of women in Asia Pacific put the needs of their family before their own, often delaying or even stopping medical treatment as a result

“There’s no shame in taking care of your female health,” says Tarquini. “There’s no shame in being sexual, but you need to have precautions. Get vaccinated, get more educated, and a cervical screening can save your life. But keep calling for the results, because surely I had abnormal cells.”

She adds, “If you feel uncomfortable going to a male doctor, go to a female doctor. There are different sizes of speculum now. Advocate for your own health and be strong enough to say, ‘That’s not comfortable, can you adjust it?’ Speak to the doctor; they are human.” 

Increasingly, advancements in women’s health mean that patients can do sampling themselves at home, which can remove some of the fear and embarrassment that surrounds cervical cancer screening. However, shares Tam, “the problem is that when abnormal cells [are detected], [test providers] often don’t know how to follow up.” Self-advocacy and action in such instances are essential.  

In light of the findings of the recent Roche survey, Women’s Checkup Week is launching across Asia. The campaign, which piloted in Singapore last year, will additionally run in Hong Kong, Philippines (where it will extend for a month), Taiwan and Thailand this year with the aim to empower women to take control of their health, to foster a culture of self care, and to encourage women to take action and #MakeTheMostImportantDate, that is to book a cervical cancer screening. 

Precancers rarely have symptoms, which is why screening is so important. 

“Screening saves lives, so if you hesitate then you may miss the chance,” says Tam. She highlights a recent case with a 32-year-old woman who came to see her for vaginitis, but whose Pap smear detected cancer cells. Caught early, she was treated with minor surgery involving a small cut removing skin at the cervix. “If you have screening early and detect cancer, treatment will be much more simple,” says Tan. Later stage diagnosis may not always be so straightforward and a woman's fertility, as well as her life, is at greater risk.

Cervical cancer screening (Pap smears and HPV tests) is recommended from the age of 25 every three to five years, regardless of HPV vaccination status. Those at high risk are recommended to undertake screening more frequently and include smokers, those who were sexually active from a young age, those who have given birth to a large number of children or who were very young at first pregnancy, those taking oral contraceptives, those with a history of STIs or HIV, and those who are immunocompromised. 

“Get screened,” says Tarquini. “It’s your female health and it’s ten minutes, and that ten minutes could save your life.” 

As part of Women’s Checkup Week in Hong Kong women aged 25-64, can access special cervical cancer screening packages until 31 July. 
As part of Women's Checkup Week in Singapore, citizens and PRs can book a free cancer screening through Singapore Cancer Society.

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