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Adapting the Australian System: Is an Organised Screening Program Feasible in Malaysia? - An Overview of the Cervical Cancer Screening in Both Countries

  • Abdul Rashid, Rima Marhayu (Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya) ;
  • Dahlui, Maznah (Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya) ;
  • Mohamed, Majdah (Family Health Development Division, Ministry of Health Malaysia) ;
  • Gertig, Dorota (Victoria Cervical Cancer Registry)
  • Published : 2013.03.30

Abstract

Cervical cancer is the third most common form of cancer that strikes Malaysian women. The National Cancer Registry in 2006 and 2007 reported that the age standardized incidence (ASR) of cervical cancer was 12.2 and 7.8 per 100,000 women, respectively. The cumulative risk of developing cervical cancer for a Malaysian woman is 0.9 for 74 years. Among all ethnic groups, the Chinese experienced the highest incidence rate in 2006, followed by Indians and Malays. The percentage cervical cancer detected at stage I and II was 55% (stage I: 21.0%, stage II: 34.0%, stage III: 26.0% and stage IV: 19.0%). Data from Ministry of Health Malaysia (2006) showed a 58.9% estimated coverage of pap smear screening conducted among those aged 30-49 years. Only a small percentage of women aged 50-59 and 50-65 years old were screened, 14% and 13.8% coverage, respectively. Incidence of cervical cancer was highest (71.6%) among those in the 60-65 age group (MOH, 2003). Currently, there is no organized population-based screening program available for the whole of Malaysia. A pilot project was initiated in 2006, to move from opportunistic cervical screening of women who attend antenatal and postnatal visits to a population based approach to be able to monitor the women through the screening pathway and encourage women at highest risk to be screened. The project was modelled on the screening program in Australia with some modifications to suit the Malaysian setting. Substantial challenges have been identified, particularly in relation to information systems for call and recall of women, as well as laboratory reporting and quality assurance. A cost-effective locally-specific approach to organized screening, that will provide the infrastructure for increasing participation in the cervical cancer screening program, is urgently required.

Keywords

Cervical cancer;screening;prevention;Malaysia;Australian model

References

  1. Abdullah F, Su TT (2010). Enhancement of the cervical cancer screening program in Malaysia: a qualitative study. Asian Pac J Cancer Prev, 11, 1359-66.
  2. Adab P, McGhee SM, Yanova J, et al (2004). Effectiveness and efficiency of opportunistic cervical cancer screening:comparison with organized screening. Med Care, 42, 600-9. https://doi.org/10.1097/01.mlr.0000128007.04494.29
  3. Akker-van Marle ME, van Ballegooijen M, van Oortmarssen GJ, et al (2002). Cost-effectiveness of cervical cancer: comparison of screening policies. J National Cancer Institute, 94, 193-204. https://doi.org/10.1093/jnci/94.3.193
  4. Alliance for Cervical Cancer Prevention (2007). 10 Key Findings and Recommendations for Effective Cervical Cancer Screening and Treatment Programs. Available at http://www.alliance-cxca.org/files/ACCP_recs_2007_factsheet_final.pdf
  5. Australian Institute of Health and Welfare and The Australian Government Department of Health and Ageing (2009). Cervical Screening in Australia 2006-2007. Cancer Series Number 47, National Cervical screening Program.
  6. Australian Institute of Health and Welfare and The Australian Government Department of Health and Ageing (2012). Cervical Screening in Australia 2009-2010. Cancer series number 67, National Cervical screening Program .
  7. Boardman CH, Matthews Jr KJ, Warner KH, et al (2012). Cervical Cancer : Pathophysiology. Retrieved 28 July, 2012. Available from: http://emedicine.medscape.com/article/253513-overview.
  8. BreastScreen Victoria Coordination Unit. (2009). BreastScreen Victoria Annual Report 2008-2009. Available from http://www.breastscreen.org.au/About-Us/Reports-and-Statistics/Annual-Reports/200809ar.
  9. Castellsague X, de Sanjose S, Aguado T, et al (2007). HPV and Cervical Cancer in the World 2007 Report. Available from http://www.who.int/hpvcentre/publications/HPVReport2007.pdf.
  10. Creighton P, Lew JB, Clements M, et al (2010). Cervical cancer screening in Australia: modelled evaluation of the impact of changing the recommended interval from two to three years. BMC Public Health, 10, 734. https://doi.org/10.1186/1471-2458-10-734
  11. Dillner J (2000). Cervical cancer screening in Sweden Eur J Cancer, 36, 2255-9. https://doi.org/10.1016/S0959-8049(00)00320-8
  12. Division of Family Health Development (2004). Guideoookfor Pap Smear Screening. MOH Malaysia.
  13. Division of Family Health Development (2009). Teknik Pengambilan Pap Smear. Ministry of Health Malaysia.
  14. Division of Family Health Development (2010). VIA for Pap Smear Screening in Sik, Kedah. MOH Malaysia.
  15. Domingo EJ, Noviani R, Noor MR, et al (2008). Epidemiology and prevention of cervical cancer in Indonesia, Malaysia, the Philippines, Thailand and Vietnam. Vaccine, 26, 71-9. https://doi.org/10.1016/j.vaccine.2008.05.039
  16. Family Health Development Division Malaysia (2009). Teknik Pengambilan Pap Smear. Ministry of Health Malaysia.
  17. Ferlay J, Bray F, Pisani P, et al (2004). GLOBOCAN 2002. Cancer Incidence, Mortality and Prevalence Worlwide Version 2.0. IARC CancerBase No.5.
  18. Ferlay J, Shin HR, Bray F, et al (2008). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-917.
  19. Jacob M, Levin V, Luciani S, et al (2006). Comprehensive Cervical Cancer Control: A Guide to Essential Practice. WHO. Available online at http://whqlibdoc.who.int/publications/2006/9241547006_eng.pdf.
  20. Jemal A, Bray F, Melissa M, et al (2011). Global Cancer Statistics. Ca Cancer J Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
  21. Lewis H, Baker S, Kaminetska Z et al (2005). Cervical Screening in New Zealand. A Brief Statistical Review of the First Decade. Available from http://www.nsu.govt.nz/files/NCSP/NCSP_statistical_review.pdf.
  22. Mohamed M (2008). SIPPS (Sistem Informasi Program Pap Smear): An Innovation For Population-based Cervical Cancer Screening. Family Health Development Division, Ministry of Health Malaysia.
  23. Mitchell H (2000). Cervical Screening in Australia - Changing from Opportunistic to Organised., Victorian Cancer Registry, Australia. Available online at http://www.hinz.org.nz/journal/380
  24. National Cancer Intelligence Network (2010.) Cervical Cancer Incidence and Screening Coverage. Available online at http://www.ncin.org.uk/publications/data_briefings/cervical_incidence_and_screening.aspx
  25. National Pathology Accreditation Advisory Council Australia and Commonwealth of Australia (2006). Perfomance Measures for Australian Laboratories Reporting Cervical Cytology. Available online at http://www.health.gov.au/internet/main/publishing.nsf/Content/ECDB9D2396440CEOCA256F1800469975/$File/PerformCervCyt.pdf.
  26. Omar ZA, Ali ZM, Tamin NSI (2006). Malaysian Cancer Statistics - Data And Figure Peninsular Malaysia 2006. Available from http://www.makna.org.my/PDF/MalaysiaCancerStatistics.pdf
  27. Omar ZA and Tamin NSI (2011). National Cancer Registry Report. Malaysia Cancer Statistics - Data and Figure 2007.
  28. Pierce M, Lundy S, Palanisamy A, et al (1989). Prospective randomised controlled trial of methods of call and recall for cervical cytology screening. Br Med J, 299, 160-2. https://doi.org/10.1136/bmj.299.6692.160
  29. Sherris J, Wittet S, Kleine A, et al (2009). Evidence-based, alternative cervical cancer screening approaches in low-resource settings. Int Perspectives on Sexual and Reproductive Health, 35, 147-52. https://doi.org/10.1363/3514709
  30. Veerus P, Arbyn M, Amati C et al (2010). Impact of implementing a nationwide cervical cancer screening program on female population coverage by pap-test in estonia. Tumori, 96, 524-8.
  31. Victorian Cytology Service Incorporated (2009). Victorian Cervical Cytology Registry Statistical Report 2008. Available from: http://www.vccr.org/downloads/VCCR_sta_report_2008_FINAL_.pdf.page 5
  32. Victorian Cytology Service Incorporated (2010). Victorian Cytology Service Annual Report 2009. Available from http://www.vcs.org.au/downloads/AnnuaReport2009webbased.pdf.
  33. Victorian Government Department of Human Services Melbourne and Victoria (2009). Victoria's Cancer Action Plan 2008-2011 - A Victorian Government Initiatives. Available online at http://docs.health.vic.gov.au/docs/doc/CBB656E851DA3A98CA2578E700203991/$FILE/vcactionplan.pdf.
  34. WHO (2005). IARC Handbooks of Cancer Prevention. Lyon, France. Volume 10. Available online at http://www.iarc.fr/en/publications/pdfs-online/prev/handbook10/HANDBOOK10.pdf.

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