Cervical screening test is important to check the health of your cervix. This test helps to find any abnormal changes before they turn into cancer.
Therefore, this test is an important tool to help prevent cervical cancer. In Malaysia, cervical cancer is the 3rd commonest cancer among women and ranks 7th among the population.
The incidence of cervical cancer has increased from 6.5 to 10.5 per 100000 population in 2018. Its risk increases at 35 years and peaks between 50-74 years.
Cervical cancer is caused by persistent infection by oncogenic strains of Human papillomavirus (HPV). Once infected with the oncogenic strain of HPV, it can take close to 10 years to convert healthy cervical cells into cancerous cells.
Before diving further into the topic, knowing what the cervix is is important. The cervix is also known as the ‘neck of the uterus’. It is a small canal which connects the uterus and the vagina. During childbirth, the cervix widens to allow the baby to pass through. A powerful gatekeeper.
The cervix is the most vulnerable site for HPV infections causing cell changes which further lead to cervical cancer.
In Malaysia, there is still a lack of awareness among women when it comes to understanding about reproductive health.
One of the common reasons is due to limited health literacy which is associated with low compliance and poor clinical outcome.
Common issues with cervix:
- Cervicitis: Inflammation of the cervix caused by STI or other infections.
- Cervical Cancer: Caused by HPV
- Cervical polyp & fibroids: Harmless growth in the cervix
Who is at risk of cervical cancer?
If you have a cervix with exposure to sexual contact with a man or a woman. HPV can be transmitted through:
- Vaginal fluid
- Skin-to-skin contact of the genitalia
- Sharing sex toys
- Multiple pregnancies
- Smoking which further weakens the immune system
Signs and symptoms of cervical cancer:
- Keep in mind that patients with cervical cancer can be asymptomatic
- Vaginal bleeding between periods
- Bleeding after sexual intercourse
- Pelvic pain
- Pain during intercourse
- Heavy menstrual bleeding heavier than usual
Why is cervical screening important?
Pap smear screening in Malaysia was initiated by MOH in 1969. Cervical screening helps prevent cancer from developing and saves thousands of lives.
Benefits of screening:
We can detect:
- HPV before it causes abnormal cells in the cervix
- Abnormal cell changes before symptoms develop
- Abnormal cell changes when they are easier to treat
HPV is the main cause of cervical cancer. Detecting this early is the best way to save lives.
There are three primary types of cervical cancer screening tests, each serving a specific purpose:
1. Human Papillomavirus (HPV) Test:
This test involves analysing cervical cells to identify the presence of the human papillomavirus, a common virus linked to the development of cervical cancer.
2. Papanicolaou Test (Pap Smear):
Commonly referred to as a “Pap smear,” this test involves collecting a sample of cervical cells and examining them under a microscope.
The aim is to identify any cellular changes caused by HPV infection. Regular Pap smears are an effective way to catch abnormalities at an early stage, enabling timely intervention.
3. Pap smear + HPV test:
This test combines the strength of both the HPV test and the Pap smear. This comprehensive approach checks for the presence of high-risk HPV strains and assesses any cervical cell changes.
Don`t fear the smear. Our doctors at Universal Clinic have conducted numerous cervical screening tests successfully. We’re here to guide you through this screening test with utmost care and courtesy.
When should you get screened?
As per MOH recommendation, the cervical smear should be done by all sexually active women between the ages of 21 and 65 years. However, those who are sexually active but less than 30 years old are encouraged to go for screening as well.
Screening interval
The initial screening interval is yearly for two years. If the results are normal, then a 3-yearly Pap smear screening is indicated.
If cytology and HPV testing were done together and both results were negative, then the cervical screening interval is 5 years. Exceptions to the cervical cancer screening guidelines and more frequent screening is required if you:
- are HIV positive
- have a weakened immune system
- were exposed before birth to a medicine
- had a recent abnormal cervical screening test or biopsy result
- have had cervical cancer
Cervical cancer is preventable.
Cervical cancer is highly preventable and highly curable if caught early. Nearly all cervical cancers could be prevented by HPV vaccination routine cervical cancer screening, and appropriate follow-up treatment when needed.
Prevention by using condoms during sexual intercourse prevents some sexually transmitted diseases, and can decrease the risk of HPV transmission.
Barriers raised by most women for cervical screening are mainly fear, embarrassment, lack of awareness and difficulty in finding the nearest healthcare facility for the test.
At our women’s health clinic, we provide specialised care for women undergoing cervical screening. We walk each step of this journey with our patients with care to normalise the procedure as a routine.
We strongly encourage women to make cervical screening a priority.
