Cervical Cancer Singapore.

Cervical Cancer Singapore: Cervical cancer clinic, Singapore. Private and confidential service. Definitions, references, and latest news.

Table of Contents

• HPV (human papillomavirus)
• HPV Symptoms / Genital Warts / Penile Warts / Vaginal Warts / Anal Warts
• Cervical Cancer
• HPV Screen / HPV Screening / HPV Test / HPV Testing / HPV Check / HPV Checking
  • Digene®
• HPV Treatment / Genital Warts Treatment / Genital Warts Removal
• HPV vaccine / Cervical Cancer Vaccine
  • Gardasil®
  • Cervarix®
  • V503

Cervical cancer

• 100% of cervical cancers is caused by HPV (human papillomavirus).
• 70% of cervical cancers is caused by HPV types 16 & 18. Which may be prevented by vaccination with Gardasil® or Cervarix®.
• 90% cervical cancers is caused by HPV types 16, 18, 31, 33, 45, 52, and 58. Which may be prevented by vaccination with V503. It may be available by 2013.

HPV vaccine (previously known as cervical cancer vaccine) types:

• Gardasil® [HPV (Human Papillomavirus) Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant]
• Cervarix® [HPV (Human Papillomavirus) Bivalent (Types 16 and 18) Vaccine, Recombinant]
• V503 [HPV (Human Papillomavirus) Nonavalent (Types 6, 11, 16, 18, 31, 33, 45, 52, and 58) Vaccine, Recombinant]

References

• PROFESSIONAL O&G GUIDELINES ON HPV VACCINATION IN SINGAPORE

Gardasil® [HPV (Human Papillomavirus) Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant]

• 2006 June 8th - US FDA approves use in females aged 9 to 26 years
• 2006 - Singapore HSA approval
• 2008 September 12th - US FDA approves use to prevent vulvar and vaginal cancer
• 2009 October 16th - US FDA approves use to prevent genital warts in males aged 9 to 26 years
• 2010 December 22nd - US FDA approves use to prevent anal cancer in males and females aged 9 to 26 years
• 2010 December 22nd - Singapore HSA approves use to prevent genital warts in males aged 9 to 26 years
• 2011 April 5th - US FDA approves information on women 27 through 45 years of age
• 2011 December 20th Singapore HSA approves use to prevent anal cancer in males and females aged 9 to 26 years

References

• Gardasil.com
• Gardasil® @ US FDA

Cervarix® [HPV (Human Papillomavirus) Bivalent (Types 16 and 18) Vaccine, Recombinant]

• 2007 - Singapore HSA approval
• 2009 October 16th - US FDA approves use in females aged 10 to 25 years
• 2011 July 19th - US FDA approves use in females as young as 9 years of age
• 2011 August 3rd - Singapore HSA approves use for the prevention of persistent infection, premalignant cervical lesions and cervical cancer

References

• Cervarix.com
• Cervarix® @ US FDA

V503 [HPV (Human Papillomavirus) Nonavalent (Types 6, 11, 16, 18, 31, 33, 45, 52, and 58) Vaccine, Recombinant] - to be released in 2013

• 2007 October 12th - Broad Spectrum HPV (Human Papillomavirus) Vaccine Study in 16-to 26-Year-Old Women (V503-001)
• 2009 July 21st - A Study of V503 in Preadolescents and Adolescents (V503-002)
• 2010 May 11th - The Phase III trial is ongoing and Merck anticipates filing a Biologics License Application (BLA) in 2012
• 2010 July - Merck is recruiting for Phase III clinical trials of a nine-valent vaccine

STD vaccine / hepatitis vaccine shot/jab/injection to prevent some STDs

HPV test for men/women.

• Digene® High-Risk HPV DNA Test
  • QIAGEN - digene HC2 High-Risk HPV DNA Test - For detection of human papillomavirus infections using Hybrid Capture 2 technology
  • Detects 13 high-risk HPV types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68.
  • Unable to differentiate which types are positive.
  • Cost is SG$200/=
• Digene® HPV DNA Test
  • QIAGEN - digene HC2 HPV DNA Test - For detection of human papillomavirus infections
  • Detects 13 high-risk HPV types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68. And 5 low-risk types: 6, 11, 42, 43, and 44.
  • Unable to differentiate which types are positive.
  • Not available in Singapore. Unlikely to be available in the future.
• Digene® HPV Genotyping PS Test
  • QIAGEN - Researchers Say Identification of Women with HPV Types 16, 18 and 45 Could Improve Early Intervention to Stop Cervical Cancer
  • Specifically identifies the presence of types 16, 18 and 45.
  • If the High-Risk HPV DNA Test is positive, then the Genotyping PS Test is done free of charge.
• Hybribio®
  • HPV GenoArray Test Kit
  • Detects 15 high-risk HPV types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, and 68. And 6 low-risk HPV types: 6, 11, 42, 43, 44, CP8304
  • Able to differentiate which types are positive.
  • May be available in Singapore soon.
• Cobas® HPV Test
  • Cobas® HPV Test
  • Detects 14 high-risk HPV types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68
  • The test specifically identifies (types) HPV 16 and HPV 18, while concurrently detecting the rest of the high risk types (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68)
  • Cost is SG$200/=
• LINEAR ARRAY® HPV Genotyping Test
  • LINEAR ARRAY® HPV Genotyping Test
  • Identifies 37 high-risk HPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, 73 (MM9), 82 (MM4) low-risk HPV genotypes 6, 11, 26, 40, 42, 53, 54, 55, 61, 62, 64, 67, 69, 70, 71, 72, 81, 83 (MM7), 84 (MM8), IS39, and CP6108
• INNO-LiPA HPV Genotyping Extra
  • INNO-LiPA HPV Genotyping Extra
  • Identifies 15 high-risk HPV genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, 82) 3 probable high-risk HPV genotypes (26, 53, 66) 7 low-risk HPV genotypes (6, 11, 40, 43, 44, 54, 70) and some additional types (69, 71, 74).
• PapilloCheck®
  • PapilloCheck®
  • Identifies 24 hiv-risk HPV types 16 18 31 33 35 39 45 51 52 53 56 58 59 66 68 70 73 82 and low-risk HPV types 6 11 40 42 43 44

HPV / human papillomavirus.

• 120 known human papillomavirus (HPV)
• 51 HPV types, and 3 subtypes are genital HPV as they infect the genital mucosa.
• 31 genital HPV types are low risk
• 6 genital HPV types are intermediate risk
• 17 genital HPV types are high risk

They cause

• 100% of genital warts
• 100% of cervical cancers in females,
• 90% of anal cancers in males & females
• 40% of penile cancers in males,
• - vulvar cancers in females,
• - vaginal cancers in females,
• 25% of oropharyngeal cancers (upper throat)
• 3% of oral cancers (mouth)

Genital HPV types, cancer risk, vaccine and test coverage

Legend: 71 (CP 8061), 73/MM9, 81 (CP 8304), 82 (MM4), 82 (IS 39), 83 (MM7), 84 (MM8), 89 (CP 6108)

References

Genital warts: penile warts / vaginal warts / anal warts / anogenital warts / venereal warts / condyloma / condylomata acuminata / "cauliflower" sex disease.

References

• Genital warts pictures

Genital warts appear within 3 months after sexual contact with an infected person.

Genital warts:

• are usually soft, pink cauliflower-like growths or flesh-coloured bumps on the sex organs
• may also be hard and smooth
• occur alone or in groups
• tend to recur after treatment
• increase the risk of cervical cancer in women.

An infected woman may infect her newborn during childbirth.

A person with genital warts can infect others through sexual contact.

Genital warts treatment / HPV treatment

• Physical methods of Genital warts removal
  • Freezing: cryotherapy / cryosurgery with liquid nitrogen.
  • Cutting: Curettage
  • Burning: Electrocautery
• Immune response modifier: Imiquimod