Let us talk about cervical cancer for this month. Since the availability of HPV immunization to young women in effort to prevent cervical cancer, there are so much confusion, misunderstanding and scare about the vaccination programme. People especially parents are sceptical about the benefits of vaccinating young girls. Some people say it might encourage promiscuity and some say it is harzardous.
In order to get the correct information one must refer to the best available evidences that support or refute the practice or recommendation for vaccination. Before we come to that, let us understand the burden of cervical cancer on our population and the rationale of it prevention.
Worldwide, every two minutes a woman dies of cervical cancer. In another word in one hour 30 women die of cervical cancer. Up to 80%, it occurs in less developed regions where there is lack of effective cervical screening programme (Ferlay J et al Globocan 2002). For comparison, in developed country like USA, there are about 14500 new cases of cervical cancer diagnosed annually and 6000 deaths due to cervical cancer. Where as in Asia including Malaysia about 266 000 new cases detected and 143 000 deaths annually. Why is such a big different? This is because a developed country like USA, has an effective cervical cancer screening programme that pap smear is compulsory for every sexually active women annually. Therefore, most of the cervical infection and pre cancerous conditions are treated before it progress to become a cancer.
On the other hand, in Malaysia and most of Asian countries has no proper screening programme and cervical smear is done as an opportunistic test. It means that whenever the woman come to see gynae doctor for some reason, it is an opportunity to offer/do pap smear. If not, it is up to the woman's level of awareness to request for a pap smear. WHO health survey in 2001/2002 reported only 20 % of Malaysian women have had a regular pap smear and the majority of them are from a low risk group of getting cervical cancer.
What Causes Cervical Cancer?
Cervical cancer is the only cancer that is sexually transmitted. How? Follow my next posting.
In order to get the correct information one must refer to the best available evidences that support or refute the practice or recommendation for vaccination. Before we come to that, let us understand the burden of cervical cancer on our population and the rationale of it prevention.
Worldwide, every two minutes a woman dies of cervical cancer. In another word in one hour 30 women die of cervical cancer. Up to 80%, it occurs in less developed regions where there is lack of effective cervical screening programme (Ferlay J et al Globocan 2002). For comparison, in developed country like USA, there are about 14500 new cases of cervical cancer diagnosed annually and 6000 deaths due to cervical cancer. Where as in Asia including Malaysia about 266 000 new cases detected and 143 000 deaths annually. Why is such a big different? This is because a developed country like USA, has an effective cervical cancer screening programme that pap smear is compulsory for every sexually active women annually. Therefore, most of the cervical infection and pre cancerous conditions are treated before it progress to become a cancer.
On the other hand, in Malaysia and most of Asian countries has no proper screening programme and cervical smear is done as an opportunistic test. It means that whenever the woman come to see gynae doctor for some reason, it is an opportunity to offer/do pap smear. If not, it is up to the woman's level of awareness to request for a pap smear. WHO health survey in 2001/2002 reported only 20 % of Malaysian women have had a regular pap smear and the majority of them are from a low risk group of getting cervical cancer.
What Causes Cervical Cancer?
Cervical cancer is the only cancer that is sexually transmitted. How? Follow my next posting.
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