As health-conscious ladies, we make it a priority to safeguard our bodies and our wellbeing. Whether it is eating right, working out or practising some good ol’ self care, we make time for these things that matter.
As bleak as it sounds, sickness and disease can sometimes be unpredictable. Even if we are actively living the healthiest life we can. The singular most helpful thing we can do to protect ourselves from this is to schedule in health checks.
We get it, health checks sound boring – it’s one of those things we know is good for us but we just don’t prioritise it. Out of sight, out of mind right? After all, we’re at the peak of our health and we feel just fine – fantastic, even.
Many studies have deduced that women live longer than men. But does this longevity privilege extend to illnesses and diseases as well? Probably not.
Women are no less likely to suffer from diseases than men. In fact, we are found to be more prone to suffer from certain diseases such as osteoporosis and colorectal cancer as well as being at risk of various female-related diseases like breast cancer and cervical cancer. 
Like a safety net, female health screening tests can help give us a peace of mind that our bodies are truly well and in order. Granted, going for these health checks are no fun but these health checks can make all the difference in the world if a medical problem do arise. It will ensure that the disease is diagnosed early and thus treated early, helping to safeguard our health and even our lives.
For example, if you have high blood pressure, you may not know it as you are unable to feel it, apart from experiencing slight headaches from time to time that you’d probably dismiss as an inconvenience. If your blood pressure continues to rise without detection, it can be dangerous as it places extra stress on your heart, potentially leading to serious stuff like coronary heart diseases, kidney disease and stroke.  That will be exponentially harder to deal with and recover from.
Oftentimes, us women also take on fundamental roles in our families and coming down with a debilitating disease can be equally devastating to our family unit. Health checks can help safeguard our families, too.
“Let’s start with the basics: what are the fundamental health screening tests?”
The standard health screening – if you are healthy with no known medical conditions – is made up of four basic health markers:
- A medical check-up by a doctor to note your medical history and lifestyle
- A physical examination, such as height, weight, BMT
- A blood glucose test, to test for diabetes
- A blood cholesterol test, to test for heart disease
More comprehensive health screenings will allow you to test for things like:
- Your blood pressure
- Your heart activity and condition, via an ECG test
- Your blood count
- Your kidney condition, via a urine test
- Your lung condition, via a chest X-ray
As we age, the number of health screening tests we need to go for increases as we become more at risk of diseases. The frequency of going for these checks also increases. There are also additional women health screening tests we will need to go for – the two main female health screenings are to test for cervical cancer and breast cancer.
Here is a brief guide to basic health screening tests:
|Age bracket||Screen for||Screening test||Frequency|
|18 to 39 years old||Obesity||BMI test||Once every 2 years|
|Hypertension (high blood pressure)||Blood pressure test|
|Cervical cancer*||Pap test||Once every 3 years|
|HPV test||Once every 5 years|
|40 to 50 years old||All above tests apply||Refer above||Refer above|
|Diabetes mellitus||Fasting blood glucose test||Once every 3 years|
|Hyperlipidaemia (high blood cholesterol)||Fasting lipids
|Heart condition and activity||ECG test|
|Kidney condition||Urine test|
|50 years old and above||All above tests apply||Refer above||Refer above|
|Colorectal cancer||Faecal Immunochemical Test (to test for blood in stools)||Once a year|
|Glaucoma||Eye test||Once every 2 years|
|Breast cancer*||Mammogram||Once every 2 years|
Basic health screening tests 101, adapted from HealthHub
*These are important female health screenings to undertake. Breast cancer and cervical cancers are two of the most deadly cancers for women. Cervical cancer tests apply if you have had sexual intercourse.
Guide to women-related health screening:
|Screen for||Screening test||Screening frequency|
|Cervical cancer||Pap smear test||Once every 3 years|
|HPV test||Once every 5 years|
|Breast cancer||Breast self-examination|
(We describe how to do this in detail below!)
|Once every month|
|Mammogram||Once every 3 years|
|Osteoporosis||Bone mineral density test||When advised by doctor|
Also read: Family Health Screening Guide in Singapore (2020) for a 101 guide and price breakdown on health screening tests for the whole family (from newborns, teens, adults to the elderly).
“Top four health diseases affecting females”
- Cervical cancer
- Breast cancer
- Colorectal cancer
“#1. Cervical cancer”
The main cause of cervical cancer is the human papillomavirus (HPV), which is also a type of STD. Other risk factors include sexual intercourse at an early age, multiple sexual partners, tobacco smoking, those who immune deficiencies, infection from other STDs such as herpes, chlamydia and gonorrhoea.  Some symptoms of cervical cancer include inter-menstrual bleeding, post-menopausal bleeding as well as offensive vaginal discharge. 
How we can prevent and safeguard ourselves against cervical cancer:
Go for the HPV vaccine: The HPV immunisation reduces our risk of getting cervical cancer by protecting us against certain strains of HPV viruses. There are more than 100 known strains of HPV virus, and about 40 strains can affect the genital area. The most common high-risk strains which cause cervical cancer are 16 and 18, accounting for a whopping 70% of cervical cancer cases.  Thus, HPV vaccines in Singapore all protect against HPV strains 16 and 18. Even if we are HPV vaccinated, it’s still necessary to go for cervical cancer screenings (i.e. pap smears) as the immunisation only protects us against high risk strains.
Pap smears: A pap smear involves the doctor reaching into the vagina to scrape cells from the cervix, a passageway between the vagina and uterus. If abnormal cells are found, they can be removed before the cells turn cancerous. Singapore Cancer Society recommends that women aged 25 to 69 years old go for regular pap smears. They also provide FOC (!) pap smears and HPV tests if you are a Singaporean or PR in the above age bracket and have engaged in sexual intercourse. Sexually active women should go for a pap smear once every three years.
HPV Test: The difference between a pap smear and HPV test is that a pap smear tests cells in the cervix for any abnormalities while the HPV test detects specifically HPV strain 16, 18 (which account for 70% of cervical cancer cases). A HPV test is important because your cells may appear normal in a pap smear even with a presence of high risk HPV strains in your cervix. Sexually active women should go for a HPV test once every five years.
Things to take note of two days before your pap smear or HPV test: 
- You should not rinse the vagina using water or another fluid
- You should not have sexual intercourse
- You should not use a birth control foam or jelly
- You should not use a tampon
- You should not apply any medicine or cream in the vagina
“#2. Breast cancer”
All women are at risk of getting breast cancer and as we age, we are more at risk of it. Risk factors include a family history of breast cancer, having your first child after 30 years old, having fewer children or never having children, as well as age (above 50 years old). 
There are usually no symptoms for early breast cancer. That’s why a mammogram screening is important for women above the age of 50. If you have breast cancer, you may experience changes to your breast such as lumping or thickening of the breast, nipple discharge, pulled in nipple, dimpling, skin changes and irritation.
The idea of the breast self-examination is to help familiarise ourselves with our own breasts thus be able to detect any changes to them. Doing this simple exercise once a month can help you detect abnormal lumps in your breasts early. In fact, 40% of breast cancer cases are discovered by women who felt a lump in their breast. 
How to do a breast examination by yourself: 
1) In front of a mirror, assume Poses 1 to 3 in diagram consecutively and repeat the following steps:
- Turn your body slowly from side to side
- Look for any puckering, dimpling or visual changes in your breast and nipples
2) When showering, assume Pose 4 in diagram place your left hand on your hip or raise the left arm, and then examine your left breast and underarm area.
- Feel your left breast with the opposite hand and check for lumps
- Repeat with the other side to check your right breast.
3) Assume Pose 5 and 6 consecutively.
- Press your left breast with opposite hand (right) gently and cover the whole breast area to feel for any changes
- Using the flat surfaces of your three middle fingers, press and alternate pressure between light, medium and firm pressure to check for lumps or any pain
- Move on to your left underarm. Start in the hollow of your armpit and move towards your breast, making small, overlapping circular motions.
- Repeat process with right breast.
It is good practice to perform this simple breast examination exercise once a month religiously, even if you are pregnant, breastfeeding or have had breast implants done. Remember, early detection can greatly help restore our health and even save our lives.
Breast cancer screening: Mammogram
A mammogram test is a breast X-ray that screens the body for changes and abnormalities in the tissues of the breast, which can spread rapidly to other parts of the body. Breast cancer is also ranked as one of the most common cancers amongst women, affecting 1 in 11 women in their lifetime. Females above 50 years old start becoming more at risk of breast cancer, so start scheduling in your mammogram tests once every two years once you are in this age group. 
It is estimated that 1 in 3 women will get a osteoporosis fracture in their lifetime.  Women are also three times more likely to get a bone fracture from osteoporosis than men, especially after menopause. Osteoporosis is a condition that is common in women as we age and lose bone mass. Those suffering from osteoporosis has low bone mass, porous bone and experience structural deterioration. 
At risk groups include women who have eating disorders, rheumatoid arthritis, are underweight and/or physically inactive. The first symptom is typically a bone break after a minor fall.
This disease is debilitating in more ways than one. Not only is a fracture from osteoporosis painful and disabling for the patient, it also affects quality of life negatively both physically and psychologically. Women suffering from osteoporosis also tend to lose their self-confidence and stability.
How to test for osteoporosis (bone mineral density test): A dual-energy X-ray absorptiometry test is done to measure bone mineral density, typically at your hip and your spine. It looks for signs of bone thinning (osteopenia) or full-blown osteoporosis.
Women after menopause who experience bone breaks should see a doctor to get it checked for osteoporosis.
“#4. Colorectal cancer”
Also one of the deadliest diseases, colorectal cancer involves malignancies of the colon and rectum, arising from abnormal growths called polyps growing on the inside of the large intestine. If diagnosed early, these abnormal growths can be removed while it is still benign and not cancerous yet. Even when the growth has become cancerous, if diagnosed in time, you can get it removed before it spreads and wreaks havoc on other parts of the body.
Colonoscopy test: A colonoscopy involves your doctor inserting a small optic tube fitted with a camera into the colon via the anus. If a polyp is found, it can be removed. This method of testing can detect very early colorectal cancer and nip the problem in the bud before it affects your health. 
“Cost of female health screening tests in Singapore”
In general, there is a preconceived notion that health screening tests for women are often extremely expensive. Fact: these female health screening tests like a HPV test or a mammogram can be very affordable due to government programs and subsidies.
For example, under HPB’s Screen for Life programme, basic health screening can cost nothing for Pioneer Generation (PG) cardholders to only $5 for Singapore Citizens when you do it at CHAS GP clinics. Just locate your nearest CHAS GP clinic and book your appointments there. This screening cost covers one screening test and one additional follow-up consultation.
Note: HPB’s Screen for Life programme only covers specific health screening test, such as cervical cancer, breast cancer and colorectal cancer.
|Basic Health Screening Test||$0 to $5, under Screen for Life programme (*See detailed cost breakdown here)|
|Test for cervical cancer||$147.66, HPV Self-Test Kit - Delphi Screener|
|HPV Test (Test for cervical cancer)|
Note: For women 25 years old and above only
|Screen for Life at Polyclinics:
$22.50 (Singapore citizens)
Screen for Life at CHAS GP clinics:
$0 (Pioneer Generation)
$2 (CHAS cardholders)
$5 (Singapore Citizens)
|Mammogram (Test for breast cancer)|
Note: For women 50 years old and above only
|Screen for Life at CHAS GP clinics:
$25 (Pioneer Generation)
$37.50 (Merdeka Generation)
$50 (Singapore citizens)
You can also use Medisave to pay for your mammogram screening at these healthcare institutions.
|Faecal Immunochemical Test (FIT) or Colonscopy (Test for colorectal cancer)||Screen for Life at CHAS GP clinics:
$0 (Pioneer Generation)
$2 (Merdeka Generation)
$5 (Singapore Citizens)
|Bone Mineral Density Test* (Test for osteoporosis)||$50 - $200 at a private clinic or orthopaedic specialist clinic|
*Osteoporosis screening is NOT included in HPB’s subsidised Screen for Life programme. You can get a bone mineral density test at a private clinic or with an orthopaedic specialist.
So ladies, an ounce of prevention is worth a pound of cure. Early diagnosis and treatment are your best bets at restoring your health if something does go wrong (touch wood).
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 [Health Xchange Singhealth. Diagnostic Tests for Cancer. Retrieved from https://www.healthxchange.sg/cancer/prevention-screening/diagnostic-tests-for-cancer
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