Cervical screening in foreign domestic workers in Singapore

Abstract

Introduction: Globally, cervical cancer is the fourth most common cancer in women, with about 85% occurring in low-middle income countries (LMIC) and an age-standardised incidence rate of more than 15 per 100,000. It is largely preventable through HPV vaccination and cervical cancer screening. In Singapore, 18% of the foreign domestic workforce hail from Indonesia, the Philippines, Myanmar, and India. However, there is no data on preinvasive cervical disease and cervical cancer in foreign domestic workers (FDWs) and the aim of this pilot programme is to determine the baseline screen positive rate of high-grade intraepithelial in this population. Methodology: A total of 322 FDWs were offered HPV screening through the Helping Our Helper (HOH) pilot programme. Data from this pilot program was analysed and reported using simple descriptive statistics. Results: Out of the 322 FDWs who registered for HPV screening, 68.6% participated. There was a 22.2% screen-positive rate; 10% of those who screened positive for high-risk HPV had histologically confirmed high-grade cervical intraepithelial neoplasia. This result is similar to other data on cervical cancer screening in Singaporeans. This pilot project screened less than 1% of the eligible FDWs in Singapore. Discussion: The findings of this pilot program suggest that there is public health value in providing cervical cancer screening to FDWs. Improving cervical cancer screening by increasing awareness and including routine cervical cancer screening as part of the employment medical examination should be studied. Keywords: Cervical cancer, CIN 2, colposcopy, HPV, HSIL, LSIL