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Cervical cancer (Cancer of the neck of the womb) is a common female cancer in Hong Kong . In 2008, there were 358 new cases and 120 related deaths. The process of development of cervical cancer is usually gradual and takes a long time. Regular screening for and management of abnormal changes in the cervix can curb the disease process and prevent the occurrence of cancer.
How to prevent cervical cancer Infection by the high risk types of human papillomavirus (¡§HPV¡¨ in short) is the necessary cause of cervical cancer. To reduce the chance of developing cervical cancer, women can do the following: (1) Reduce the chance of high risk HPV infection by: (1.1) Practice safer sex, including both sides having only one sexual partner and the use of condom (1.2) Avoid beginning sex at a young age (1.3) Get vaccinated against cervical cancer. The vaccines help to prevent infection by the two most common cancer-causing high-risk HPV types. They work best when given before one has initiated sex. (2) Do not smoke (active or passive smoking) (3) Healthy lifestyle and a balanced diet (4) Regular cervical screening
Cervical screening (also called ¡§Pap smear¡¨) aims to detect abnormal changes in the cells of the cervix. The procedure is simple. The woman will be asked to lie on an examination couch. The doctor or a trained nurse will pass a speculum into the vagina. After a thorough inspection, a small brush will be used to collect a sample of cells from the cervix. The sample will be sent to the laboratory for analysis. The doctor will recommend follow-up based on the laboratory result as follows: 1. Normal ¡V Repeat screening three years later. If this is the first time a woman attends screening, she will need to be screened again one year later. According to the Hong Kong College of Obstetricians and Gynaecologists guideline, screening once every three years is sufficient if past smear results have been normal. 2. Mildly abnormal (medically called ¡§ASC-US¡¨) ¡V repeat screening in 4 to 6 months. Alternatively, high risk HPV testing may be done to determine the necessary follow-up. 3. Severely abnormal ¡V a follow-up examination called colposcopy is recommended Women will be informed of their smear results by mail. If abnormal, they will be informed by telephone and to arrange necessary follow up actions.
High-risk HPV testing aims to detect if there is an active high-risk HPV infection in the cervix. The test is usually ordered in the following situations: 1. If the initial smear result is mildly abnormal (¡§ASCUS¡¨), high-risk HPV testing may be done to determine the necessary follow-up action. 2. As a follow-up test after a woman has had colposcopy or treatment for cervical abnormalities.
A colposcope is a magnifying device. When placed near the vagina, it gives a magnified view of the cervix and allows the doctor to visually inspect the area closely. In addition, the doctor may take tissue samples from the cervix for laboratory analysis. (1) The procedure Colposcopy is performed by a specially trained doctor in the clinic. It resembles a typical gynecological examination and takes about 20 minutes to complete. During the procedure, women may feel mild or moderate discomfort or pain. Staying relaxed may ease the discomfort. Women may leave after the procedure. (2) How to prepare for colposcopy examination 1. Ensure the use of a reliable contraceptive measure when having sex. 2. 24 hours before colposcopy, do not douche, use vaginal cream or pessary, or have sex. 3. If your period starts when you are due to have colposcopy, please call the clinic to reschedule the procedure. 4. Please bring a sanitary napkin with you to the clinic. (3) What may happen after colposcopy After the procedure, women may feel sore for a short while. It is also normal to have a small amount of bleeding or brownish discharge from the vagina. During this period, do not douche, use tampons or have sex. Seek medical care immediately if the following problems occur: heavy vaginal bleeding (bleeding to such a degree that one needs to change the napkin every hour), severe pain in the abdomen or fever. (4) Follow-up after colposcopy Women will be informed of their biopsy results by telephone and by mail. The doctor will recommend follow-up based on the laboratory result as follows: 1. If normal or only the mildest type of abnormalities ( CIN I) is found, treatment is not necessary for the time being as most of these abnormalities will disappear with time. However, repeat cervical screening once every six months is necessary until further notice. 2. For more severe abnormalities ( CIN II or higher), or for persistent CIN I , a simple treatment called LEEP or LLETZ may be performed. This is usually done in the day clinic under local anaesthesia and takes 10 to 20 minutes to finish. Hospitalization is not necessary. The success rate of LEEP as high as 90%. Detailed information will be given to women before treatment.Lady Helen Woo Women's Diagnostic and Treatment Centre provides a one-stop high quality service for women from cervical screening to colposcopic examination and treatment. Our centre is managed by the Department of Obstetrics and Gynaecology, The University of Hong Kong and is situated in Tsan Yuk Hospital . Service is provided by specially-trained medical and nursing staff. Screening and treatment are planned according to the guidelines of the Hong Kong College of Obstetricians and Gynaecologists, and tailored to suit the needs of individual clients. All laboratory tests are performed by the Cervical Cytology Laboratory, The University of Hong Kong. The laboratory is accredited by the College of American Pathologists ( CAP ) and provides quality laboratory service.
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| Questions and Answers for Human Papilloma Virus (HPV) Vaccine |
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 Cervical smear |  Colposcopy |