Early cervical cancer may present 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 emptied bowels
- Leaking of urine or faeces from the vagina
Carcinoma in SITU (CIS or CIN)
Carcinoma in situ (CIN) is a cluster of malignant pre-cancerous cells that is still ‘in situ’ or ‘on site’ and has not moved from its original position and spread to other parts of the body yet. In Singapore and other developed countries, the widespread use of cervical screening programmes has helped to detect CIN and reduced the incidence of invasive cervical cancer.
The Pap smear test can identify CIN of the cervix, where treatment can prevent the development of cancer. It is recommended that women get a Pap smear test once a year after becoming sexually active. This practice should continue until they are 70 years old. If two to three Pap smear tests showed normal results, the woman can consider reducing 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, and leading to dysplasia (abnormal development of cells). In time, 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.