About HPV and Cervical Cancer
What is HPV?
HPV stands for Human Papillomavirus. It is the most common sexually transmitted infection worldwide that can infect both men and women. It is estimated that eight out of 10 people will get HPV infection at some point in their lifetime. There are more than 200 known types of HPV, and some are more dangerous than others. High-risk HPV strains are associated with cervical, vaginal, vulvar, oral, anal, and penile cancer. Other low-risk strains may lead to genital, oral, or other skin warts.
What is cervical cancer?
Cervical cancer is a type of cancer that starts in the cells of the cervix, the lower part of the uterus (womb) that connects to the vagina. Most cases are caused by long-lasting infections of high-risk HPV strains. Cervical cancer often develops slowly, it can take 10 to 15 years for abnormal cells to turn into cancer. Cervical cancer is the 10th most common cancer among women in Singapore despite being highly preventable.
What are the symptoms of cervical cancer?
Early-stage cervical cancer usually causes no signs or symptoms, making routine screening essential. When symptoms do appear, you may experience abnormal vaginal bleeding and/or discharge, and pelvic discomfort.
How are HPV and cervical cancer connected?
Almost all cervical cancer cases (over 99%) are caused by a persistent infection with high-risk types of HPV. While the majority of HPV infections clear on their own, a small percentage of persistent, long-term HPV infections can cause normal cells on the cervix to turn abnormal and develop into cancer if they are not found and treated in time. You cannot see or feel HPV or these cell changes on your cervix. That is why it is important to take preventive measures against HPV and go for regular cervical cancer screening.
Who is at risk of developing cervical cancer?
Anyone with a cervix who has been sexually active may be at risk. The risk is higher when a high-risk HPV infection persists, and for people with weakened immune systems, including those living with HIV. Regular screening is important even if you feel healthy and have no family history of cervical cancer.
Can HPV affect men as well?
Yes, HPV affects men as well. Certain HPV strains can cause genital warts and cancers affecting areas such as the anus, penis and back of the throat. HPV vaccination can help prevent infections associated with several of these conditions.
HPV Transmission and Symptoms
How is HPV transmitted?
HPV is primarily transmitted through intimate skin-to-skin contact, most commonly during vaginal, anal, or oral sex, or non-penetrative sexual contact. You cannot get HPV from toilet seats or casual contact like hugging and sharing food.
How do I know if I have HPV?
Most HPV infections do not have visible signs or symptoms, especially high-risk HPV infections that cause cancer. Symptoms only appear much later if the infection progresses into a full-blown cancer. The good news is, regular cervical cancer screening can either help to detect changes in the cervical cells caused by HPV infection or to identify high-risk HPV cancer-causing strains. There is currently no standard test for men who do not have symptoms, but men can protect themselves and their partners by getting vaccinated.
Can condoms prevent HPV transmission?
Condoms lower the risk of transmission but they do not completely prevent HPV. HPV spreads through skin-to-skin contact not just bodily fluids, and condoms do not cover all genital skin.
Can I get HPV even if I have only had one sexual partner?
Yes. HPV can be transmitted through contact with an infected partner, even if you have had only one sexual partner. Having HPV does not indicate that someone has had many partners or engaged in irresponsible behaviour.
Can HPV be transmitted even if my partner has no symptoms?
Yes. Most HPV infections do not cause noticeable symptoms, so a person may transmit HPV without knowing they have it.
Does having HPV mean that my partner has been unfaithful?
No, a positive result cannot be used to determine whether a partner has been unfaithful. HPV can remain undetected for months or years before it is discovered. Medical tests cannot determine when you contracted HPV or who passed it to you.
HPV Treatment and Prevention
Can HPV be cured?
Like all other viruses, there is no direct cure for HPV. However, for most of us, the body's immune system can fight off the infection and clear the virus within 2 years without the need for treatment. But for some people, the HPV infection can linger and over time can cause abnormal changes to the cells that can develop into cancer if left untreated. Treatment is directed at HPV-associated conditions such as pre-cancerous lesions, cancer or genital warts.
What can I do to reduce the risks of HPV infection and cervical cancer?
- Get the HPV vaccine. The best way to reduce the risk of HPV infection is through vaccination. It is most effective to receive the vaccine before becoming sexually active. - Go for regular cervical cancer screening. Even if you are vaccinated, you still need regular check-ups because vaccines do not cover 100% of cancer-causing HPV types. - Practice safe sex. Barrier contraception can help to reduce the rate of HPV transmission but it does not eliminate it completely. - Watch out for abnormal symptoms such as abnormal vaginal bleeding, discharge, and pelvic or back pain, although HPV infections and early stages of cervical cancer usually cause no symptoms. - Avoid smoking. Smoking increases the risk of persistent HPV infection and cervical cancer as it weakens your immune system.
HPV Vaccination
Do I need to get the HPV vaccine?
You are strongly recommended to get the HPV vaccine if you are between the ages 9 to 45 as it significantly lowers the risk of cervical, vaginal, anal, throat, and other cancers, as well as genital warts. The vaccine is most effective if given before first sexual exposure, though sexually active individuals can still benefit from protection against strains they have not yet contracted. Females aged 9 to 26: Strongly recommended by the Ministry of Health (MOH) and included in the National Childhood Immunisation Schedule (NCIS) and National Adult Immunisation Schedule (NAIS). Under the Health Promotion Board’s school-based HPV vaccination programme, HPV vaccinations are currently provided to Secondary 1 and 2 female students at no charge. Individuals aged 27 to 45: You can still benefit from catch-up vaccination, you should speak with your doctor to assess your individual risk. Adults over 45: The vaccine is not licensed or routinely recommended for adults aged 45 and older, as most people in this age group have already been exposed to the virus.
Who should NOT be vaccinated?
The HPV vaccination may not be suitable for you if: - You are pregnant. The vaccine is not recommended for pregnant women as research on pregnant individuals is limited, and the vaccine offers no immediate benefit during pregnancy. If a woman is found to be pregnant during the HPV vaccination, it is recommended that the remaining dose(s) be postponed until after delivery. - You are sensitive or allergic to any of the vaccine components. - You have an acute infectious illness. Please wait until you have recovered from the illness. Always consult a doctor if you are unsure about your vaccination eligibility.
What are the HPV vaccines available?
The vaccines approved for use in Singapore are Cervarix (HPV2) and Gardasil 9 (HPV9). 1. Cervarix (HPV2): - Cervarix protects against 2 high-risk HPV types 16 and 18 responsible for 70% of cervical cancers. - Approved for females aged 9 to 26 only. - Vaccination schedule: â—¦ Females aged 9 to 14: 2 doses at 5 to 13 months apart â—¦ Females aged 15 to 26: 3 doses Dose 2: 1 to 2.5 months after the first dose Dose 3: 5 to 12 months after the first dose 2. Gardasil 9 (HPV9): - Gardasil 9 protects against 9 HPV strains: 7 high-risk HPV types 16, 18, 31, 33, 45, 52, and 58 responsible for 90% of cervical cancers, plus types 6 and 11 which cause genital warts. - Approved for both males and females from age 9 to 45. - Vaccination schedule: â—¦ Females and males aged 9 to 14: 2 doses at 6 to 12 months apart â—¦ Females and males aged 15 to 45: 3 doses Dose 2: 2 months after the first dose Dose 3: 4 months after the second dose
Which HPV vaccine should I get?
You should generally choose Gardasil 9 (HPV9) for the widest protection against 9 HPV strains responsible for 90% of cervical and related cancers, as well as genital warts. In comparison, Cervarix (HPV2) provides protection against 2 high-risk HPV strains responsible for 70% of cervical cancers. While you had to pay full price for Gardasil 9 (HPV9) in previous years, starting from 1 January 2027, Gardasil 9 (HPV9) will be added to the National Childhood Immunisation Schedule (NCIS), National Adult Immunisation Schedule (NAIS) and Subsidised Vaccine List (SVL), and eligible Singaporean and Permanent Resident females will be able to receive the Gardasil 9 (HPV9) vaccine at subsidised rates.
How much do the HPV vaccines cost?
For both Cervarix (HPV2) and Gardasil 9 (HPV9) vaccines, government subsidies are available for females aged 9 to 26 who have not gotten the HPV vaccine, at both CHAS GP clinics and polyclinics for Singapore Citizens (SC), and polyclinics only for Permanent Residents (PR). These eligible groups can pay for any out-of-pocket expenses using MediSave at both CHAS GP clinics and polyclinics. Visit https://vaccine.gov.sg/hpv for more detailed cost breakdown.
Are the HPV vaccines safe and effective?
Yes, HPV vaccines are safe and highly effective. The vaccines do not contain any live viruses or infectious material. This means you cannot become infected with HPV from the vaccines. Clinical trials and decades of global monitoring show that they prevent most targeted HPV infections and significantly lower the risk of cervical and other cancers.
Are there any side effects to the HPV vaccine?
Possible side effects are local reactions such as pain, swelling, redness at the injection sites, and fever. You can resume your daily activities after vaccination with no downtime period.
How do I book an appointment for HPV vaccination?
Eligible individuals can book HPV vaccination appointments at participating CHAS GP clinics through https://vaccine.gov.sg/hpv or make an appointment at polyclinics. Healthier SG enrollees are encouraged to book their vaccination appointment at their enrolled clinic. Vaccination with Gardasil 9 (HPV9) will be available for booking from 1 January 2027.
Do I need any booster shots after I have completed my vaccination dose?
There is currently no recommendation for additional doses or booster shots.
I have started my Cervarix (HPV2) vaccination but I have not completed all my doses. Can I switch to Gardasil 9 (HPV9) to complete my vaccination?
Yes. If you have started your vaccination series with the Cervarix (HPV2) or Gardasil 4 (HPV4) vaccine and are pending further doses, you may complete your vaccination series by receiving the Gardasil 9 (HPV9) vaccine. Studies have shown that such mixed HPV vaccination schedules are safe and provide protection against the HPV strains covered by both vaccines.
Can I get the Gardasil 9 (HPV 9) vaccine if I have already completed a previous vaccination series with Cervarix (HPV2) or Gardasil 4 (HPV4)?
If you have completed your recommended HPV vaccination schedule with either the Cervarix (HPV2), Gardasil 4 (HPV4), or Gardasil 9 (HPV9) vaccines, the Expert Committee on Immunisation (ECI) does not recommend you receive additional Gardasil 9 (HPV9) vaccine doses. However, you may wish to consult your doctor on any further HPV vaccination needs. Do note that those who have completed the recommended doses will not be able to utilise the vaccination subsidies or MediSave for additional doses of Gardasil 9 (HPV9).
School-Based HPV Vaccination Programme
What is the national school-based HPV vaccination programme?
Since 1 April 2019, MOH offers fully-subsidised (free) HPV vaccination to all female Secondary 1 and 2 students as part of Health Promotion Board’s school-based health programme.
Why did the vaccine type under the school-based HPV vaccination programme change in 2027?
The school-based HPV vaccination programme follows the recommendations under the National Childhood Immunisation Schedule (NCIS). In line with updates to the NCIS in 2027, the vaccine used under the school-based programme will change from Cervarix (HPV2) to Gardasil 9 (HPV9). While both vaccines provide comparable protection against HPV types 16 and 18, which are responsible for 70% of cervical cancers, the Gardasil 9 (HPV9) vaccine also protects against HPV types responsible for an additional 20% of cervical cancers, providing broader coverage than the Cervarix (HPV2) vaccine.
Which HPV vaccine will my daughter receive as part of the school programme?
From 1 January 2027, the Gardasil 9 (HPV9) vaccine will replace the Cervarix (HPV2) vaccine for female students who have yet to start or complete their vaccination series. Female students who have received the Cervarix (HPV2) vaccine as the first dose in 2026 (i.e. the 2026 Secondary 1 cohort) will be scheduled to complete their series in schools in 2027 with the Gardasil 9 (HPV9) vaccine as the second dose. Female students who have completed their HPV vaccination series are not eligible for further Gardasil 9 (HPV9) doses under the school-based HPV vaccination programme.
When will my daughter receive the HPV vaccination in school?
The Health Promotion Board’s Youth Preventive Health Service will work with your child’s school to schedule the HPV vaccination. If your daughter is unable to receive the HPV vaccination during the school visit, an appointment will be scheduled for her to receive her HPV vaccination at a designated clinic.
Cervical Cancer Screening
What is cervical cancer screening?
Cervical cancer screening is a medical test that checks the health of the cervix to prevent cervical cancer before it starts. It is not a test for active cancer, but a way to spot early cell changes or viral infections. The two main tests are the Pap test/Pap smear and the HPV test. Screening can identify changes early, when they are often easier to manage or treat.
What happens during a cervical cancer screening?
During a cervical cancer screening (Pap test or HPV test), the doctor or nurse gently inserts a speculum into the vagina to view the cervix, then uses a small brush or spatula to collect a small sample of cells, and sends the sample to the laboratory for further examination. The test is quick but you may feel some pressure and slight discomfort.
What is the difference between a Pap test and an HPV test?
Both tests are collected the same way during a pelvic exam—using a soft brush or spatula to gently take a sample of cells from the cervix, and can even be done using the same swab (called co-testing). The main difference is what each test looks for: a Pap test checks for abnormal or precancerous changes in your cervical cells, while an HPV test looks for the presence of high-risk cancer-causing strains of HPV.
Do I get the Pap test or HPV test?
If you are 25 to 29 years old, a Pap test is recommended. At this age, your immune system will likely be able to clear HPV infections naturally at a faster rate. Testing for HPV in this younger age group can lead to anxiety and unnecessary follow-up procedures for temporary infections. Instead, a Pap test can be used to detect the presence of any precancerous abnormal cell changes in the cervix. If you are 30 years and above, an HPV test is recommended. HPV infections that persist past age 30 carry a higher risk of turning into pre-cancer or cervical cancer. An HPV test is used to detect the presence of high-risk cancer-causing strains.
​Do I still need to go for regular cervical cancer screening after getting the vaccine?
Yes, you do. The HPV vaccine protects against 70% to 90% of high-risk HPV strains that cause cervical cancer, but it does not cover all cancer-causing types. Furthermore, the vaccine does not treat an HPV infection or cellular changes that may already be present before vaccination. Once you are eligible for cervical cancer screening, you will still need to go for your regular screening.
When should I go for cervical cancer screening?
Ages 25–29: A Pap test every three years Ages 30–69: An HPV test every five years Your doctor may recommend a different schedule depending on your medical history, previous results or individual risk factors.
I was screened and didn't have HPV. Does that mean I’m not at risk of cervical cancer?
It means that your risk of developing cervical cancer in the near future is very low. However, one negative screening will not protect you from cervical cancer forever. This is why it is important that you go for regular cervical cancer screening.
I tested positive for my Pap test/HPV test. Does that mean I have cervical cancer?
Testing positive for a Pap test or HPV test does NOT mean you have cervical cancer. Instead, it indicates an increased future risk for cell changes that require monitoring or follow-up testing.
I’ve never had sex. Should I go for cervical cancer screening?
No, you don't have to. If you have never had sex before, you do not need to go for cervical cancer screening. This is because your exposure to cancer-causing HPV is very low. However, you should consider the HPV vaccine because the best time to get a HPV vaccine is when you have never had sex yet. Talk to your doctor to see if you are eligible for the HPV vaccine.
I am younger than the recommended age for cervical cancer screening. Can I still get myself tested?
If you are younger than 25 years old and sexually active, you do not need to go for screening. Wait until you are 25 years old to go for your first screening.
How much does cervical cancer screening cost?
For eligible Singapore Citizens (SC), you can go for subsidised screening at a nominal fee of $5 or lower at CHAS GP clinic: - $0 for Pioneer Generation (PG) - $2 for Merdeka Generation (MG) / CHAS Blue Card / CHAS Orange Card - $5 for CHAS Green Card/ eligible SC - Check your eligibility here: https://book.health.gov.sg/healthiersg-screening Healthier SG enrolled Singapore Citizens will enjoy special subsidies (i.e. pay $0) for Healthier SG Screening at your enrolled Healthier SG clinic. For Permanent Residents, please check in with your preferred CHAS GP clinic on the screening test rates offered under the Healthier SG Screening. Alternatively, the Singapore Cancer Society offers free cervical cancer screening for eligible Singaporean women at their dedicated screening centres.
Where can I go for cervical cancer screening?
You can go for cervical cancer screening at public polyclinics, participating CHAS GP clinics or Healthier SG clinics, private medical centres, or specialist women's clinics, at varying costs. For Singapore Citizens, you may check your eligibility for subsidies and book your appointment here: https://book.health.gov.sg/healthiersg-screening
I am not comfortable with the cervical cancer screening procedure, are there other options to test for HPV?
Yes, you may consider HPV self-sampling as an alternative. Instead of a doctor or nurse using a speculum and brush to collect the sample, you use a small, soft swab yourself in a private room or at home.
HPV Self-Sampling
What is HPV self-sampling?
HPV self-sampling is a private, non-invasive method for cervical cancer screening that lets you collect your own cell sample using a soft swab or brush, without needing a speculum examination or a pelvic exam by a doctor. An HPV self-sampling is generally less painful and more comfortable than a traditional clinician-collected Pap test/HPV test. The HPV self-samping test works the same as a traditional HPV test where it tests for the presence of high-risk strains of HPV.
How is HPV self-sampling done?
- Receive a kit: You get a self-sampling kit containing a collection device (swab or brush) and a specimen tube with clear instructions. - Collect the sample: You gently insert the swab or brush a short distance into your vagina, rotate it to collect cells, and place it into the provided container. - Send to the lab: You seal the sample and return it to your healthcare provider, clinic, or testing program to be analyzed in a laboratory for high-risk HPV strains.
Is HPV self-sampling new in Singapore? I haven’t heard of it before.
HPV self-sampling for cervical cancer screening in Singapore was first piloted in local clinical studies around late 2022, and The Society for Colposcopy & Cervical Pathology of Singapore updated its guidelines to recognize HPV self-sampling as an alternative option in 2025. In May 2025, we at the Alliance for Active Action Against HPV (A4HPV) were also honoured to have the Singapore Cancer Society (SCS) partner with us to trial its first-ever community-based implementation of HPV self-sampling. While HPV self-sampling is relatively new in Singapore, it has been available and used worldwide for much longer. We are currently working hard to increase the awareness and accessibility of HPV self-sampling in Singapore.
How accurate is HPV self-sampling?
Research has shown that self-collected samples are as accurate as samples collected by a healthcare professional via a traditional HPV or Pap test.
Do all clinics offer HPV self-sampling tests?
Not at the moment. It is currently available in some GP and OB-GYN specialist clinics, Singapore Cancer Society (SCS) and National University Hospital (NUH). We are working on making it available everywhere in Singapore, including polyclinics, but not yet.
How often should I go for HPV self-sampling?
The HPV self-sampling test is a type of HPV test, the recommendations for the HPV self-sampling test are the same as the HPV test. Women aged 30 and above are recommended to get a HPV test done once every 5 years.
How much does HPV self-sampling cost?
The cost of an HPV self-sampling test ranges from $0 for eligible individuals at free cervical cancer screenings offered by the Singapore Cancer Society, to roughly between $128 and $200 at private clinics. HPV self-sampling is not subsidised under Healthier SG Screening.