Cervical cancer was once one of the “top killers” among women in Hong Kong. Although its incidence rate has significantly decreased with medical advancements and heightened awareness of prevention, it remains a threat to women’s health that cannot be ignored. According to the latest data from the Hong Kong Cancer Registry, cervical cancer ranks as the seventh most common cancer among women in Hong Kong, with hundreds of new cases reported annually. The most alarming aspect of this cancer is its “silent” nature—early-stage lesions often present with absolutely no symptoms. This article will guide Hong Kong women to deeply understand the impact of cervical cancer, the screening process, and exactly how the crucial “colposcopy” is performed when abnormalities are detected.
The Impact of Cervical Cancer on Hong Kong Women
In Hong Kong, the age of onset for cervical cancer is relatively broad. While it is most common among women aged 40 to 60, the trend of younger patients cannot be overlooked. The vast majority of cervical cancer cases are caused by persistent infection with high-risk types of the Human Papillomavirus (HPV). Due to the fast-paced lifestyle in Hong Kong, many working women often neglect regular check-ups because of their busy schedules. This leads to some cases being diagnosed at middle to late stages, increasing the difficulty of treatment.
However, cervical cancer is one of the few cancers that can be “detected early and prevented early” through screening. Through the “Cervical Screening Programme” promoted by the government, women can intercept the disease before lesions transform into cancer via a simple cell test (Pap smear).
The First Line of Defense: Cervical Screening (Pap Smear and HPV Testing)
Currently, the mainstream screening methods in Hong Kong include the Pap smear and HPV testing.
• Pap Smear: A doctor or nurse uses a sampling brush to collect cells from the surface of the cervix to observe if there are any abnormal cells.
• HPV Testing: Directly tests the sample to see if it contains high-risk HPV viral genes.
If the report indicates “normal,” it is usually recommended to undergo screening every three years. However, if the report shows “Atypical Squamous Cells of Undetermined Significance (ASC-US)” or “Low-grade/High-grade Squamous Intraepithelial Lesion (LSIL/HSIL),” you will need to proceed to the next critical step: Colposcopy.
The Key When Lesions Are Suspected: What is a Colposcopy?
When a screening report shows abnormalities, it does not mean you already have cancer. At this point, the doctor will arrange a colposcopy to further confirm the condition of the cervix.
1. The Examination Process: Does it hurt? Many women feel fearful when they hear the word “endoscopy,” but in reality, the process of a colposcopy is very similar to a Pap smear. During the examination, the woman lies on an examination bed, and the doctor inserts a speculum to dilate the vagina. Then, a specially designed magnifying glass (colposcope) is used outside the vagina to observe the cervix.
To make the abnormal tissue clearer, the doctor will apply diluted acetic acid or iodine solution to the cervix. At this time, you may feel a slight cooling or stinging sensation, but there will be no severe pain.
2. Biopsy If suspicious areas are found under the colposcope, the doctor will immediately remove a small piece of tissue (about the size of a grain of rice) and send it to the laboratory. This process might feel a bit like a small “pinch,” followed by possible light vaginal bleeding, which is a normal phenomenon.
Interpreting the Results: Understanding Cervical Intraepithelial Neoplasia (CIN)
The biopsy results from a colposcopy are usually graded as “Cervical Intraepithelial Neoplasia (CIN)”:
• CIN 1 (Mild Dysplasia): This usually represents mild changes after an HPV infection. About 60-80% of cases will heal on their own. Doctors typically recommend regular follow-up observations.
• CIN 2 (Moderate Dysplasia): The degree of cellular atypia is higher, and the risk of transforming into cancer increases.
• CIN 3 (Severe Dysplasia / Carcinoma in Situ): This is already a severe precancerous lesion. If left untreated, there is a very high chance it will develop into invasive cancer.
Follow-up Treatment: How to Deal with CIN 2 or CIN 3?
For moderate to severe precancerous lesions (CIN 2/3), the healthcare system in Hong Kong usually adopts active treatment to completely remove the affected tissue. The most common method is:
Loop Electrosurgical Excision Procedure (LEEP / LLETZ) This is currently the most popular minimally invasive treatment method. The doctor uses an electrified wire loop to remove the abnormal tissue from the cervix. The surgery is usually performed under local anesthesia, takes about 15-20 minutes, and the patient can go home the same day. The advantage of LEEP is that it can simultaneously remove the lesion and preserve the sample for final laboratory testing to ensure clean margins.
Other methods include Laser Therapy or Cryotherapy. The doctor will make the most appropriate recommendation based on the extent and depth of the lesion.
Prevention is Better Than Cure
Cervical cancer is entirely preventable. In addition to regular screening, receiving the HPV vaccine is also an important protective measure. In Hong Kong, the government has provided school-based vaccination programs for eligible girls, and adult women can also consult their doctors for catch-up vaccinations.
When facing abnormal examination results, staying calm and actively cooperating with the colposcopy is key. With early detection and early treatment, the cure rate for cervical precancerous lesions is extremely high. To all Hong Kong women, please include cervical screening in your annual health checklist to protect your health and future.
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