Cancer Screening

Pap Smear

A routine pap smear is the most common screening method for detecting cervical cancer. It is a painless procedure that accurately detects over 90% of cervical cancers, even before symptoms develop.

A speculum is first inserted into the vagina to properly visualize the cervix. Cells from the cervix and vagina are taken using a small brush to be examined for any abnormalities. Early pre-cancerous changes in the cervix can be detected in this way and treated, thereby preventing cancer from developing.

All women who are sexually active or have had sexual intercourse in the past should have regular Pap smears.

Pap Smear

Colposcopy with biopsy is another method for diagnosing cervical cancer and is usually performed following an abnormal pap smear. This method provides a magnified view of the abnormal cervix. During this minor procedure, acetic acid and iodine are applied to the cervix to highlight the abnormal areas, and biopsies of the abnormal areas are taken for further evaluation.

Appropriate treatment can then be performed based on test results. Treatment of pre-cancerous changes of the cervix include laser vaporization, LEEP and cone biopsy with laser or knife.

Cervarix® and Gardasil® Human Papilloma Virus (HPV) Vaccination

Cervical cancer is the 2nd most common female cancer in Asia and the 7th most common cause of cancer deaths among Singaporean women. Worldwide, 270,000 women die from cervical cancer each year, which means that a woman dies of cervical cancer every 2 minutes. Sexual activity increases the risks of cervical cancer and pre-cancer, irrespective of age and lifestyle.

Cervical cancer is closely associated with the Human Papilloma Virus (HPV). There are 100 types of HPVs but only 15 of them are categorised as “high risk types” which cause cervical cancer. The two most commonly found types are HPV types 16 and 18 which are responsible for 70% of cervical cancers. HPV infection is mainly spread through sexual intercourse and can be asymptomatic.


Gardasil® vaccine offers protection against cervical, vaginal, vulva and anal cancers, in addition to pre-cancerous changes of the cervix and vulva and genital warts caused by HPV types 6, 11, 16 and 18. The majority of infected individuals are asymptomatic and can unknowingly transmit the infection, which is why the HPV infection affects up to 50% of sexually active couples.

Both women and men can receive Gardasil®. It is best administered to persons with no previous HPV infection, although those with previous HPV exposure can still benefit from it. It consists of three doses given at 0, 2 and 6 months.

This vaccination is designed to prevent infections and not treat them. Routine Pap smear screening is still recommended post-vaccination as it is not meant to be a substitute.


Cervarix® vaccine protects against HPV types 16 and 18 that are associated with cervical pre-cancerous disease and cancer. The ASO4 adjuvant incorporated into Cervarix® induces a sustained immune response. Cervarix also provides cross protection against HPV types 45 & 31, which are the 3rd and 4th most common causes of cervical cancer globally.

The vaccination regime comprises of three doses, given at 0, 1 and 6 months. Women should still continue with their regular pap smear screening after vaccination.

LEEP (Loop Electrosurgical Excision Procedure) and Cone Biopsy

LEEP and cone biopsy are minor surgical procedures performed to remove a conical- or cylindrical-shaped piece of abnormal cervical tissue. This is achieved using an electrically-heated wire loop in LEEP and with a knife or laser in the case of a cone biopsy. Both procedures are performed using local anaesthetic or with sedation.

LEEP (Loop Electrosurgical Excision Procedure) and Cone Biopsy
LEEP (Loop Electrosurgical Excision Procedure) and Cone Biopsy
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Our Specialist
Dr Regina Zuzarte-Ng

MBBS (Singapore), MMed (O&G) (Singapore), FRCOG (UK), FAMS (Singapore)

With over a decade of experience, Dr Regina is skilled in the management of prenatal care and gynaecological conditions. A mother to two, she understands the needs of women intimately and incorporates that into her practice.

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