For all women undergoing screening for cervical or uterine cancer

*See below for age limitation for each screening

What is screening for cervical or uterine cancer?

There are 2 types of cancer that affect the uterus: cervical cancer which affects the entrance to the uterus known as the cervix and uterine cancer which affects the uterine body. Cervical cancer, predominantly caused by (a sexually transmitted) infection) with the human papilloma virus (HPV), is on the decrease in Japan due to factors such as effective screening procedures etc., however, uterine cancer which has also been linked with obesity, high blood pressure and type 2 diabetes is on the increase.

While cervical cancer was the second most common cause of death in women fifty years ago after stomach cancer, today it has dropped to sixth place with around 5000 women dying of it each year. However, uterine cancer is on the increase and has risen from 10% of cancers affecting the uterus to 30%.

What are the symptoms of cervical and uterine cancer?

While there are almost no symptoms in the early stages of cervical cancer, with uterine cancer, 90% of women have irregular vaginal bleeding.

How is screening performed?

Cervical cancer: A small brush or brush-like device will be wiped over the entrance to the uterus (the cervix) to pick up some cells. While there may be a little bleeding, it shouldn’t hurt.

Uterine cancer: Because a long brush is inserted into the uterine body to collect some cells, there may be some pain and bleeding. While it differs from person to person, if the cervical canal is narrow the doctor may not be able to perform the procedure due to severe pain or the brush not being able to enter the uterus.

Who is eligible for screening?

From 2005, Sapporo city extended cervical cancer screening to all women aged 20 and over. It is offered every consecutive year, i.e. to women aged 20, 22, 24, e.t.c. Since it is caused by a virus that is transmitted sexually, all sexually experienced women are invited to participate.

With regards to uterine cancer “screening”, as mentioned previously, 90% of women with uterine cancer will experience irregular vaginal bleeding. Furthermore, the peak age of onset is in women in their fifties. Thus women eligible for “screening” are:

Women who have experienced irregular vaginal bleeding in the past 6 months and meet one of the following criteria:

(1) Are aged 50 years or older

(2) Have reached menopause

(3) Have never been pregnant or have experienced menstrual irregularities

* Note: Even if you do not meet any of the above criteria, you may be asked to undergo the procedure if your doctor deems it necessary.

At present the effectiveness of screening for uterine cancer has not been proven. “Effectiveness” means that screening is highly effective (in discovering cancer in the target population) and early detection contributes to an overall decrease in deaths from the disease.

Since uterine cancer screening involves some “pain” and “bleeding”, please decide if you would still like to have the procedure after carefully reading the explanation above.

Kaori Nagashima M.D.

Please refer to Cervical cancer vaccine.