Selangor Journal
Picture by LUIS MELENDEZ/UNSPLASH

Fighting a silent killer

By Ashwin Kumar

THE lifetime risk of a Malaysian woman developing cervical cancer is one in 116, with about two-thirds or 76 per cent of women getting diagnosed in the later stages of the disease, according to recent data from the World Health Organisation.

From 2007 to 2010, data obtained from the Malaysian National Cancer Registry recorded 103,507 new cervical cancer cases. Of the total, 64,275 have succumbed to the disease.

Almost all cases of cervical cancer are caused by HPV or Human Papillomavirus.

Revolutionary HPV test

In 2019, Deputy Prime Minister Datuk Seri Dr Wan Azizah Wan Ismail launched the Rose Foundation, an initiative that started as a research project by the University of Malaya and the Health Ministry.

As a program, Rose — acronym for Removing Obstacles to cervical Screening — is revolutionary in its approach. It empowers women by letting them collect a cell sample using a small swab instead of having to undergo a pelvic examination by a doctor.

Test kits are available from government clinics. The samples, once collected, are sent for HPV testing instead of the conventional pap smear test. After three days, the result of the test is privately communicated back to the women via text messaging.

Prince Court Medical Centre Obstetrics and Gynaecologist Dr Maiza Tusimin said the program embodies safety, and privacy through self-sampling, encouraging more women to willingly participate in screening in a timely manner.

Rose ambassador and Permatang Pauh MP Nurul Izzah Anwar said cervical cancer is the third most common cancer among Malaysian women, at 7.7 per cent, after breast cancer (32.1 per cent) and colorectal cancer (10.7 per cent).

“Under Programme Rose, it is our vision to see a cervical cancer-free future for all women in Malaysia.

“In fact, it is the world’s first. This evidence-based approach can save lives and spare women and families from the suffering and financial hardship associated with cervical cancer,” she said in a healthcare talk organised by Healtopedia Healthcare in Ampang recently.

By delivering the results to mobile phones, Nurul Izzah said there would be less need for clinic visits and it would also eliminate the embarrassment and fear associated with a pap smear, which previously was the only tool used for early detection.

Awareness is still lacking, she noted, especially among women in rural areas.

Government support

Oncologists have suggested several measures that could be taken by women to stop the spread of the potentially deadly cancer. They opined that proper screening of the cervix, which is the lower part of a woman’s uterus, as well as vaccination, are key measures for prevention and early detection..

Dr Maiza said that HPV is easily detected by conducting a yearly check of the reproductive system, commonly known as a pap smear.

“I encourage women to do an annual pap smear. This disease is one of the slowest growing cancers as it takes around three to ten years to develop.

“Many women are being diagnosed with cervical cancer annually, yet only a small number in the country undergo screening for HPV, the leading cause of cervical cancer,” she said during a talk on cervical cancer awareness here on Jan 16.

Dr Maiza explained that abnormal bleeding — such as bleeding between menstrual periods, after sex, after a pelvic exam, or after menopause — and discharge that is unusual in amount, colour, consistency, or smell or the need to urinate more frequently — are among the symptoms of cervical cancer.

Many women in the country do not come forward for conventional screening largely because of fear of the process, with some citing embarrassment, a previous painful experience, or the inconvenience of regular testing.

“Most women are advised to start getting regular pap smears at the age of 21, but many are hesitant to do so,” she added.

Dr Maiza pointed out that as caregivers themselves, women should not neglect their own health..

She encouraged all women in the country to go for free HPV screening and vaccination provided by the National Population and Family Development Board.

Mid last year, the Federal government allocated RM20 million for women to undergo three types of screening.

They are the subsidised mammogram test (RM11.4 million), the HPV vaccination programme (RM5 million) and the cervical cancer screening pilot programme (RM3.6million).

Typically, HPV vaccines would cost about RM600 to RM700 if done at private clinics.

“If you still want to get vaccines from private clinics or hospitals, you may do so. If you ask me if it is worth it to spend money on the screenings and vaccine, I would say yes,” she added.

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What is HPV?

HPV is a very common infection that is spread through sexual activity.

Both women and men can be infected by HPV.

Since HPV infection is often without symptoms, it can be passed on without a person’s knowledge.

Some risk factors for developing cervical cancer are:

— a weakened immune system

— cigarette smoking

— history of precancerous cervical lesions or a previous cervical cancer diagnosis

— having more than one sexual partner

— sexual intercourse before age 18.

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