Early cervical cancer may have no symptoms. You should see a doctor immediately if you experience the following symptoms:
- Vaginal bleeding or the presence of abnormal discharge
- Pain during sexual intercourse
- Lower back or pelvic pain
- Painful or difficult urination and cloudy urine
- Chronic constipation and feeling of presence of stools despite having gone to the toilet
- Leaking of urine or faeces from the vagina
Carcinoma in SITU (CIS or CIN)
Carcinoma in situ (CIN) is a group of harmful pre-cancerous cells that is still ‘in situ’ or ‘on site’ and has not moved from its original position and has not spread to other parts of the body yet. In Singapore and other developed countries, the widespread use of cervical screening programmes has helped to find CIN and reduced the numbers of invasive cervical cancer.
The Pap smear test can identify CIN of the cervix, where treatment can stop the growth of cancer. It is advised that women get the test once a year after becoming sexually active. This practice should continue until they are 70 years old. If 2 – 3 Pap smear tests show normal results, the woman can reduce the frequency to once every 2 – 3 years. However, women who are at high risk should continue to undergo a Pap smear test every year.
Not all women with HPV infections develop CIN, and not all women who have CIN develop cervical cancer. Many HPV infections can be cleared by the immune system, just like any other infection.
However, certain strains of HPV can stay in the cervix for many years, changing the genetic make-up of the cervical cells over time and leading to dysplasia (abnormal development of cells). If left untreated, severe dysplasia can develop into invasive cervical cancer.
CIN usually produces no symptoms at all. This would be the best time to screen for cancer as treatment at this point tends to be the most effective.