FEBRUARY 23, 2022
FEBRUARY 23, 2022
Did you know there is a vaccination for cancer of the cervix?
Human Papillomavirus (HPV) is the virus that causes genital warts. Infection with HPV generally occurs through contact with infected skin, most commonly through sexual contact. There is a high rate of transmission of the infection (50– 80 percent risk) when there is unprotected sexual activity with someone who has an active HPV infection.
Infection with the genital wart virus is extremely common. It is thought that 80 percent of sexually active women will develop an HPV infection during their lives. Infections are most common in young women, and are seen most commonly in women just after they become sexually active. The more sexual partners one has, the more likely they will contract the HPV virus.
Most genital wart infections are cleared by the body within 12–24 months. In less than 10 percent of infections, the virus is not cleared by the body and persists.
When the virus infects the cervix, it can cause changes in the cells of the cervix which can be precursor changes of cervical cancer and be detected as an abnormal Pap smear.
Sometimes the changes in the cells seen with an acute HPV infection will resolve over time, in other instances, the changes may progress to more abnormal cells and cervical cancer.
Cancer of the cervix is the second most common cause of cancer in women worldwide. Pap smears endeavour to detect early changes in the cells, before they progress to become cancerous. Pap smear changes caused by HPV are highest in women less than 30 years old. In Australia, Pap smears are recommended every two years for all women between 18 and 69 years of age, starting two years after first sexual intercourse.
There are many strains of the wart virus, and it is known that several (such as HPV 16 and 18) are more likely to cause abnormal cells in the cervix and cancer of the cervix as well as cancers of the anus, penis, vulva and vagina. Other strains of the virus (such as HPV six and 11) will cause genital warts only, but do not lead to cancers of the genital tract. Approximately 10% of the population will develop genital warts in their lifetime. Genital warts are most common in the 15–24 year old age group.
Two vaccines against the common strains of HPV virus which cause genital warts and changes in the cells of the cervix have been developed: CERVARIX and GARASIL.
These vaccines are intended to prevent initial HPV infection so ideally are given before women become sexually active. In women already infected with HPV, the vaccines do not treat the infection or prevent disease caused by the strain causing the infection. In women who have not been exposed to the HPV virus, the vaccines are very effective (90–100 per cent) at preventing infection and disease.
Antibodies to the virus from the vaccination are produced in almost 100% of people vaccinated. The duration of immunity from the vaccination is not yet known so it is not clear whether booster shots will be needed.
GARDASIL is available in Singapore and is given in three doses – today, and two and six months from today. It protects against HPV strains six, 11, 16 and 18.
The vaccination is recommended for females aged 10–13 years i.e. before they become sexually active. The vaccination can also be given to girls aged 14–18 years, even though some may have commenced sexual activity, as hopefully they would not yet have been exposed to HPV virus. If given to women 18–27 years of age, it’s effectiveness will depend upon past sexual history and previous exposure to HPV. Safety and efficacy has not been studied in women older than 27 years.
HPV vaccinations are generally well tolerated. Side effects may include discomfort, swelling and redness at the injection site. Much less commonly, fainting or symptoms of allergy may occur after the vaccination.
Did you know there is a vaccination for cancer of the cervix?
Human Papillomavirus (HPV) is the virus that causes genital warts. Infection with HPV generally occurs through contact with infected skin, most commonly through sexual contact. There is a high rate of transmission of the infection (50– 80 percent risk) when there is unprotected sexual activity with someone who has an active HPV infection.
Infection with the genital wart virus is extremely common. It is thought that 80 percent of sexually active women will develop an HPV infection during their lives. Infections are most common in young women, and are seen most commonly in women just after they become sexually active. The more sexual partners one has, the more likely they will contract the HPV virus.
Most genital wart infections are cleared by the body within 12–24 months. In less than 10 percent of infections, the virus is not cleared by the body and persists.
When the virus infects the cervix, it can cause changes in the cells of the cervix which can be precursor changes of cervical cancer and be detected as an abnormal Pap smear.
Sometimes the changes in the cells seen with an acute HPV infection will resolve over time, in other instances, the changes may progress to more abnormal cells and cervical cancer.
Cancer of the cervix is the second most common cause of cancer in women worldwide. Pap smears endeavour to detect early changes in the cells, before they progress to become cancerous. Pap smear changes caused by HPV are highest in women less than 30 years old. In Australia, Pap smears are recommended every two years for all women between 18 and 69 years of age, starting two years after first sexual intercourse.
There are many strains of the wart virus, and it is known that several (such as HPV 16 and 18) are more likely to cause abnormal cells in the cervix and cancer of the cervix as well as cancers of the anus, penis, vulva and vagina. Other strains of the virus (such as HPV six and 11) will cause genital warts only, but do not lead to cancers of the genital tract. Approximately 10% of the population will develop genital warts in their lifetime. Genital warts are most common in the 15–24 year old age group.
Two vaccines against the common strains of HPV virus which cause genital warts and changes in the cells of the cervix have been developed: CERVARIX and GARASIL.
These vaccines are intended to prevent initial HPV infection so ideally are given before women become sexually active. In women already infected with HPV, the vaccines do not treat the infection or prevent disease caused by the strain causing the infection. In women who have not been exposed to the HPV virus, the vaccines are very effective (90–100 per cent) at preventing infection and disease.
Antibodies to the virus from the vaccination are produced in almost 100% of people vaccinated. The duration of immunity from the vaccination is not yet known so it is not clear whether booster shots will be needed.
GARDASIL is available in Singapore and is given in three doses – today, and two and six months from today. It protects against HPV strains six, 11, 16 and 18.
The vaccination is recommended for females aged 10–13 years i.e. before they become sexually active. The vaccination can also be given to girls aged 14–18 years, even though some may have commenced sexual activity, as hopefully they would not yet have been exposed to HPV virus. If given to women 18–27 years of age, it’s effectiveness will depend upon past sexual history and previous exposure to HPV. Safety and efficacy has not been studied in women older than 27 years.
HPV vaccinations are generally well tolerated. Side effects may include discomfort, swelling and redness at the injection site. Much less commonly, fainting or symptoms of allergy may occur after the vaccination.
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Introduction
Resident Physician Dr Elizabeth Heah graduated from the University of Manchester in 2018. She has since been practicing in Singapore, with experience from Singapore restructured hospitals in the departments of General Surgery, Internal Medicine and Obstetrics and Gynaecology. She is passionate about preventative medicine and adopts a holistic approach to healthcare. Outside of medicine she enjoys practicing yoga, interior design and pottery. |
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Introduction
Consultant Radiologist He was awarded the Singapore Armed Forces Medical Scholarship in 2001 to study Medicine at the National University of Singapore and attained his MBBS in 2006. Dr Low then trained and obtained his post-graduate qualifications in Diagnostic Radiology FRCR (UK) and MMed (Spore) in 2012. In 2016, he was awarded the Health Manpower Development Program (HMDP) fellowship by the Singapore Armed Forces to train in Musculoskeletal and Interventional Radiology at Vancouver General Hospital and the University of British Columbia in Canada. Under the mentorship of Prof Peter Munk, Prof Bruce Forster and Prof Hugue Ouellette, the fellowship centred on advanced musculoskeletal imaging, sports imaging and musculoskeletal interventions. Upon his return to Singapore and during his tenure as Consultant at Tan Tock Seng Hospital, he started several interventional programmes for tumour ablations (for both palliative and benign), vertebroplasties, hydrodilatation clinics for adhesive capsulitis and other musculoskeletal ultrasound-guided procedures. |
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Introduction
Consultant Radiologist Clinical Interest & Subspecialty: Neuroradiology (Brain, Head & Neck, Spine) and Neurointervention Dr Santhosh Raj is a Consultant Radiologist with 20 years of experience in radiology. He graduated from Universiti Sains Malaysia in 2002 and obtained the Fellowship of the Royal College of Radiologists (U.K.) in 2008. Upon completing the Advanced Specialist Training (AST) in Singapore in 2013, he joined the Neuroradiology subspecialty team at Singapore General Hospital. In 2015, he completed his training in Neurointervention at the National Institute of Clinical Neurosciences in Budapest, Hungary, through the SingHealth Health Manpower Development Program (HMDP) fellowship. In addition to his routine work, Dr Santhosh also reports MRI Brain Volumetry scans that are used to assess structural brain degeneration, particularly Alzheimer’s disease and related dementias (ADRD). He also reports Ultra Low-Dose (Submilisievert) CT Lung, which allows lung screening at doses lower than routine lung screening CT scans. Other innovative imaging scans that he developed in the past include Intracranial Vessel Wall Imaging (3T MRI), an optimized CT Arterio-Venography (CTAV) of the brain, and an optimized Multiphasic CT Angiography of the Neck and Brain (acute stroke management). His past appointments include Deputy Director of Vascular and Interventional Radiology (SGH), and Director of Radiology Training (SGH). He was also Clinical Lecturer at the Yong Loo Lin School of Medicine (NUS), and Adjunct Assistant Professor at Duke NUS. Dr Santhosh is particularly interested in imaging informatics and artificial intelligence (AI). He is passionate about teaching and developing innovative imaging scans. He also loves to walk and spend quality time with his family. |