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Cervical Cancer

Cervical Cancer

11 December 2017

Introduction

Cervical cancer has been the seventh commonest cancer among females in Hong Kong and accounted for 3.3% of all new cancer cases in females in 2015.

Incidence

In 2015, 500 new cases of cervical cancer were diagnosed and the crude incidence rate was 12.7 per 100000 female population. The age-standardised incidence rate was 8.4 per 100000 standard population.

Number of new cases and crude incidence rate of cervical cancer, 1983-2000 (View)

Number of new cases and crude incidence rate of cervical cancer, 2001-2015 (View)

Mortality

Cervical cancer is the ninth leading cause of female cancer deaths in Hong Kong. In 2016, a total of 151 women died from this cancer, accounting for 2.6% of female cancer deaths. The crude death rate of cervical cancer was 3.8 per 100000 female population. The age-standardised death rate of cervical cancer was 2.2 per 100000 standard population. 

Number of registered deaths and crude death rate of cervical cancer, 1981-2000 (View)

Number of registered deaths and crude death rate of cervical cancer, 2001-2016 (View)

Trends of incidence and mortality

The age-standardised incidence rate of cervical cancer had a downward trend between 1983 and 2015. Also, the age-standardised death rate had a downward trend between 1981 and 2016.

Age-standardised incidence and death rates* of cervical cancer, 1981-2016

Age-standardised incidence and death rates of cervical cancer, 1981-2016

Notes:

*

Age-standardised rates are compiled based on the world standard population specified in GPE Discussion Paper Series: No.31, EIP/GPE/EBD, World Health Organization, 2001.

 

 

Data in the above charts from 1996 onwards are compiled based on the population estimates under the "resident population" approach instead of the "extended de facto" approach. Also, the 2016 Population By-census conducted from June to August 2016 provides a benchmark for revising the population figures compiled since the 2011 Population Census. Population-related figures from 2012 to 2015 have been revised accordingly.

 

 

Classification of diseases and causes of death is based on the International Statistical Classification of Diseases and Related Health Problems (ICD) 10th Revision from 2001 onwards. Figures from 2001 onwards may not be comparable with figures for previous years which were compiled based on the ICD 9th Revision.

Sources:

 

Census and Statistics Department
Department of Health
Hong Kong Cancer Registry, Hospital Authority

 

Cervical cancer corresponds to codes 180 in ICD-9 and C53 in ICD-10.

What is cervical cancer?

Cervical cancer is a cancer that starts in the cervix. Almost all cervical cancers are caused by persistent infection with one of the cancer-causing or high-risk human papillomavirus (HPV) types. HPV infection is usually found in persons who have ever been sexually active. Most people with HPV infection do not have any symptoms and will clear the infection on their own. Some females with persistent high-risk HPV infection in the cervix will develop pre-cancerous cell changes. While the majority of these changes will regress to normal, some may progress to cancer over years.

Flow chart : development of cervical cancer

What are the symptoms of cervical cancer?

Abnormal cell changes in the cervix or early stage of cervical cancer may have no symptoms at all. The most common symptom is abnormal vaginal bleeding, which includes vaginal bleeding between periods, during or after sexual intercourse, or after menopause. Other symptoms include vaginal discharge with foul smell, pelvic pain or blood in urine.

Please note that the presence of any of these symptoms does not mean that you have cervical cancer. You should consult a doctor if you develop any symptoms.

What are the risk factors of cervical cancer?

Risk factors of cervical cancer include:

  • Having multiple sexual partners or sexual partner with multiple sexual partners
  • Sexual intercourse at an early age
  • Co-infection with sexually-transmitted diseases
  • Smoking
  • Weakened immunity such as infected with Human Immunodeficiency Virus (HIV)
  • Long term use of oral contraceptive for more than 5 years (the risk returns to normal after 10 years of stopping use)
  • Increasing parity (number of babies born) or younger age at first pregnancy

Despite the above risk factors, regular cervical cancer screening and timely treatment of the detected pre-cancerous changes can prevent cervical cancer. However, the most commonly neglected risk factor is failure to get a regular cervical cancer screen.

How can I prevent cervical cancer?

Cervical cancer can be prevented by reducing the HPV infection and the progression from persistent HPV infection to cervical cancer. Here are some preventive measures:

  • Practise safer sex (such as avoid having multiple sexual partners and use condoms) to reduce the chance of HPV infection and to protect against sexually transmitted diseases
  • Avoid smoking
  • Get HPV vaccination (cervical cancer vaccination) before having sexual experience

Apart from the measures highlighted above, cervical cancer screening offers you additional protection.

What is cervical cancer screening?

Cervical smear (also named Pap smear) is a simple and quick cervical cancer screening test which can detect early abnormal changes in cervical cells. With early detection and early treatment, these abnormal cell changes could be prevented from developing into cervical cancer.

Who needs cervical cancer screening?

Cervical cancer screening is for healthy women who have no symptom.

  • Women aged 25-64 who ever had sex, irrespective of marital status, are recommended to receive regular cervical cancer screening every 3 years after 2 consecutive normal annual screens.
  • Women aged 65 years or above who ever had sex and have never had cervical cancer screening should discuss with their doctors about having a screening, even if they no longer have periods, haven't had sex for many years or had sterilization.
  • Women aged 21-24 years old who ever had sex and risk factors for cervical cancer (e.g. multiple sexual partners, smoking, etc), should consult their doctors about the need for cervical cancer screening.
  • Women who have received HPV vaccination still need regular cervical cancer screening because HPV vaccination does not protect against the HPV types not included in the vaccine, nor against existing HPV infections.
  • Women who have never had sex do not need cervical cancer screening.
  • Women who have hysterectomy with removal of cervix for benign diseases and without prior history of cervical changes can discontinue screening.

If in doubt, please consult the doctor.

Where can I have cervical cancer screening?

You may visit your family doctor, gynaecologists, non-governmental organisations, Maternal and Child Health Centres (MCHC) and Women Health Centres of the Department of Health for cervical cancer screening.

If you wish to take cervical smear at the MCHC, please call the 24-hour hotline of Cervical Screening Phone Booking Service: 3166 6631. The booking guideline can be downloaded from:

www.fhs.gov.hk/english/main_ser/woman_health/phone_booking.html

Cervical Screening Programme

The Cervical Screening Programme (CSP) is a territory-wide screening programme launched by the Department of Health in collaboration with other healthcare professionals to encourage women to have regular cervical cancer screening.

CSP has established the “Cervical Screening Information System” (CSIS) for storing data related to CSP, including participants’ personal identification data, smear results and date of next smear recommended by healthcare providers. Once you have registered with the CSP, you can login to the CSIS to view your cervical smear records and will receive a reminder when the next smear is due. You can authorize your healthcare provider to view your past smear records in order to provide better continuous care.

As individual healthcare providers who provide cervical cancer screening service may have different appointment procedures and service charges, please contact them directly to enquire about service arrangements.

Recipients of Comprehensive Social Security Assistance (CSSA) are waived from payment for their public health care (such as cervical cancer screening service provided by MCHC of the Department of Health) upon presenting the valid Certificate of Comprehensive Social Security Assistance Recipients (for Medical Waivers). Non-CSSA recipients who have financial difficulties in paying medical expenses may consider applying for medical fee waiving in public hospitals and clinics. For details, please contact the Integrated Family Service Centres or Family and Child Protective Services Units of the Social Welfare Department or Medical Social Services Units of public hospitals and clinics.

For more information about cervical cancer prevention and screening, please visit the booklet and website of the Cervical Screening Programme of Department of Health at www.cervicalscreening.gov.hk.

The booklet of the Cervical Screening Programme    The website of the Cervical Screening Programme I'm Joy. Stay healthy and happy, you should have regular cervical cancer screening!

Related information

Cancer Prevention Series 2 – Cervical Cancer Prevention and Screening

images / 圖片

You can also call our 24-hour Health Education Hotline of the Department of Health 2833 0111 for more health information. Please click here to view the full list of health topics.