Displaying publications 1 - 20 of 70 in total

Abstract:
Sort:
  1. Affandi MZ, Dun T, Mantuano V, Sidhu R, Lumplugh C, Telisinghe PU
    Acta Cytol., 1993 Mar-Apr;37(2):175-80.
    PMID: 8465637
    During the five-year period from January 1985 to December 1989 a total of 27,208 women, representing 44.0% of the total female population over age 15 years in Brunei Darussalam, underwent a cytologic examination. The majority of them were Malays (62.32%), followed by Chinese (22.23%), while the remainder were the expatriate population living in the country. High grade squamous intraepithelial lesion (moderate dysplasia) was detected in 88 women (3.3/1,000), high grade squamous intraepithelial lesion (carcinoma in situ) was seen in 32 women (1.22/1,000), and invasive carcinoma was found in 43 women (1.37/1,000). The overall detection rate for cervical cancer was 2.79/1,000 women in the population screened. In Brunei Darussalam Malay women marry at an early age, 44% by the age of 19 years, leading to sexual contact before the age of 20. However, the incidence of cervical cancer is low among them. This could be because they belong to the Orthodox Muslim Society, in which promiscuity is not permitted. Hence, multiple sex partners could be an important factor in the etiology of cervical cancer, confirming the current trend of thought that cervical cancer is a sexually transmitted disease. A comparison of the epidemiologic risk factors among the various races living in Brunei Darussalam is made.
    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control
  2. Seow A, Lee HP
    Ann Acad Med Singap, 1994 May;23(3):342-7.
    PMID: 7944247
    A cross-sectional survey of 568 married women aged 21-65 years in the Pasir Panjang Constituency was conducted to determine the prevalence of cervical cancer screening in the community and the factors affecting acceptance of this screening test. Results show that 309 (54.4%) of the respondents had ever had a Pap smear. The women who reported having had a smear were more likely to be below 45 years of age (prevalence ratio 1.47, 95% confidence interval 1.15 to 1.88), Chinese and of a higher socioeconomic status (1.68, 1.33 to 2.12). They were also more likely to have married at a later age (1.68, 1.21 to 2.31) than women who had not had a smear. Age and socioeconomic status remained independent predictors on multivariate analysis. The findings suggest that an important task of public health practitioners is to increase the uptake of screening among older and socially disadvantaged women who are known to be at the highest risk of cervical cancer. In addition, strategies to encourage younger women to continue regular attendance at screening clinics beyond their childbearing years will be important for the future.
    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*
  3. Kwang NB, Yee CM, Shan LP, Teik CK, Chandralega KN, Abdul Kadir AK
    Asian Pac J Cancer Prev, 2014;15(21):9117-23.
    PMID: 25422188
    BACKGROUND: To evaluate the knowledge, perception and attitudes towards human papilloma virus (HPV) among pre-university students in Malaysia.

    STUDY DESIGN: In this cross sectional study, between November 2013 to March 2014, in a public university, a convenient sampling method was used. A total of 716 respondents were recruited and interviewed with a set of standard questionnaires for assessment of knowledge, perception and attitudes towards HPV and predictor variables associated with level of knowledge.

    RESULTS: Almost half (48.9%) of the respondents scored less than 5 and were categorised as having poor knowledge. Three hundred and twelve (43.6%) respondents had moderate knowledge and only 54 (7.5%) respondents exhibited good knowledge with the score of 11 and above. Only 142 (20%) students perceived themselves to be vulnerable to HPV infection though 560 (78.2%) students thought that HPV infection is a serious disease. Perceived benefits and desire to be vaccinated were significantly associated with gender (p=0.000) and knowledge of HPV vaccine and cervical cancer (p=0.000).

    CONCLUSIONS: The level of knowledge regarding HPV among the pre-university students was low. However, student intention for vaccination increased with increasing level of knowledge. Thus, efforts to improve knowledge and awareness should be prioritised to increase uptake of the HPV vaccination programme and hence reduce morbidity and mortality from consequences of HPV infection, including cervical carcinoma.

    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control
  4. Baskaran P, Subramanian P, Rahman RA, Ping WL, Mohd Taib NA, Rosli R
    Asian Pac J Cancer Prev, 2013;14(12):7693-9.
    PMID: 24460355
    AIMS: A main reason for increasing incidence of cervical cancer worldwide is the lack of regular cervical cancer screening. Coverage and uptake remain major challenges and it is crucial to determine the perceived susceptibility to cervical cancer, as well as the benefits of, and barriers to, cervical cancer screening among women.

    MATERIALS AND METHODS: A cross-sectional survey was conducted among 369 women attending an outpatient centre in Malaysia and data were collected by administering a self-report questionnaire.

    RESULTS: The majority of the participants (265, 71.8%) showed good level of perception of their susceptibility to cervical cancer. Almost all responded positively to four statements about the perceived benefits of cervical cancer screening (agree, 23.1% or strongly agree, 52.5%), whereas negative responses were received from most of the participants (agree, 29.9%or strongly agree, 14.6 %) about the eleven statements on perceived barriers. Significant associations were observed between age and perceived susceptibility(x2=9.030, p=0.029); between employment status (p<0.001) as well as ethnicity and perceived benefits (p<0.05 [P=0.003]); and between education and perceived barriers to cervical cancer screening (p<0.001).

    CONCLUSIONS: Perceived susceptibility, including knowledge levels and personal risk assessment, should be emphasized through education and awareness campaigns to improve uptake of cervical cancer screening in Malaysia.
    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control
  5. Abdul Rashid RM, Mohamed M, Hamid ZA, Dahlui M
    Asian Pac J Cancer Prev, 2013;14(10):5901-4.
    PMID: 24289597
    OBJECTIVE: To compare the effectiveness of different methods of recall for repeat Pap smear among women who had normal smears in the previous screening.
    DESIGN: Prospective randomized controlled study.
    SETTING: All community clinics in Klang under the Ministry of Health Malaysia.
    PARTICIPANTS: Women of Klang who attended cervical screening and had a normal Pap smear in the previous year, and were due for a repeat smear were recruited and randomly assigned to four different methods of recall for repeat smear.
    INTERVENTION: The recall methods given to the women to remind them for a repeat smear were either by postal letter, registered letter, short message by phone (SMS) or phone call.
    MAIN OUTCOME MEASURES: Number and percentage of women who responded to the recall within 8 weeks after they had received the recall, irrespective whether they had Pap test conducted. Also the numbers of women in each recall method that came for repeat Pap smear.
    RESULTS: The rates of recall messages reaching the women when using letter, registered letter, SMS and phone calls were 79%, 87%, 66% and 68%, respectively. However, the positive responses to recall by letter, registered letter, phone messages and telephone call were 23.9%, 23.0%, 32.9% and 50.9%, respectively (p<0.05). Furthermore, more women who received recall by phone call had been screened (p<0.05) compared to those who received recall by postal letter (OR=2.38, CI=1.56-3.62).
    CONCLUSION: Both the usual way of sending letters and registered letters had higher chances of reaching patients compared to using phone either for sending messages or calling. The response to the recall method and uptake of repeat smear, however, were highest via phone call, indicating the importance of direct communication.
    Study site: Klinik Kesihatan, Kelang, Selangor, Malaysia
    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*
  6. Ezat SW, Hod R, Mustafa J, Mohd Dali AZ, Sulaiman AS, Azman A
    Asian Pac J Cancer Prev, 2013;14(5):2991-9.
    PMID: 23803068
    BACKGROUND: Introduction of the HPV vaccine is a forefront primary prevention method in reducing the incidence of carcinogenic human papillomavirus (HPV) and cervical cancer. The Malaysia government has implemented the National HPV immunisation programme since 2010, supplying HPV vaccine free to targeted 13 year olds. This study aimed to explore the level of knowledge among mothers on cervical cancer, HPV, HPV vaccine and National HPV (NHPV) immunisation programme since its' implementation. It also assessed acceptance of mothers towards HPV vaccine being administered to their daughter, son or themselves.
    MATERIALS AND METHODS: A cross sectional study was conducted on 155 respondents using self-administered questionnaires; conducted in December 2012 at the Obstetrics and Gynaecology Clinic in a teaching hospital in Kuala Lumpur. Respondents were selected using a multistage sampling technique.
    RESULTS: A response rate of 100% was obtained. Overall, 51.0% of mothers had good knowledge, with 55% having good knowledge of cervical cancer, 54.2% for both HPV and the National HPV immunisation programme and 51.0% for the HPV vaccine. Regression analyses showed that ethnicity was associated with knowledge on cervical cancer (p=0.003) while education was associated with knowledge on HPV (p=0.049). Three factors are associated with knowledge of the National HPV immunisation programme; ethnicity (p=0.017), mothers' education (p=0.0005) and number of children (p=0.020). The acceptance of HPV vaccine to be administered among daughter was the highest at 87.1%, followed by for mothers themselves at 73.5%, and the least is for sons 62.6%.
    CONCLUSIONS: This study found that the overall level of knowledge was moderate. Adequate information on cervical cancer, HPV, HPV vaccination and the National HPV immunisation programme should be provided to mothers in order to increase acceptance of the HPV vaccine which can reduce the disease burden in the future.
    Study site: O&G clinic, Pusat Perubatan Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*
  7. Rashwan H, Ishak I, Sawalludin N
    Asian Pac J Cancer Prev, 2013;14(4):2545-9.
    PMID: 23725172
    Cervical cancer is one of the most frequent cancers in women worldwide. Persistent infection with a human papillomavirus (HPV) is the main cause for cervical cancer. Vaccination and Pap smear screening are the best methods for prevention of the disease. The objective of this cross-sectional study was to assess the knowledge and views of upper secondary school female students in Kuala Lumpur, Malaysia, toward prevention of cervical cancer. This study was conducted from April 2009 to September 2009 in 8 schools in Kuala Lumpur area using pre-tested and validated questionnaires. Results indicated that the respondents had low knowledge of cervical cancer and its prevention although the majority of students (80.4%) had heard about the disease. The level of knowledge of cervical cancr and its prevention was significantly higher among students from the science stream (p<0.001) compared to students from the art stream. Most students (69.3%) agreed to take the vaccination if the service was available in schools. A high percentage of students (82.2%) agreed that the vaccination should be compulsory to the students. In conclusion, most students had low knowledge of cervical cancer and its prevention but they had positive attitude toward vaccination and agreed that vaccination should be compulsory. Therefore, suitable educational programmes should be developed to improve the knowledge of secondary school students on the prevention of cervical cancer.
    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*
  8. Al-Naggar RA, Bobryshev YV, Al-Jashamy K, Al-Musli M
    Asian Pac J Cancer Prev, 2012;13(8):3835-40.
    PMID: 23098480
    OBJECTIVE: The objective of this study is to determine the practice and associated factors of HPV vaccine among school girls in Melaka, Malaysia.

    METHODOLOGY: A total number of 612 secondary school girls participated in this study. The questionnaire consists of 38 questions which included 3 sections. The first section is about socio- demography. The Second section is about knowledge and awareness of HPV vaccines. The third section is about practices with associated barriers of HPV vaccination. Verbal consent was obtained from all participants, and data were analyzed using SPSS 13.

    RESULTS: A total number of 612 secondary school girl students participated in this study. The mean age was 13.93 ± SD (1.09); minimum age was 13 years old and maximum was 17 years old. The majority of them was Malay, from rural areas and had a family monthly income of RM 3000 or less (91.8%, 53.1%, 69.6%; respectively). The majority of the parents of the school girls were with secondary education level (56.4%). The majority of the participants did not have a family history of cervical cancer (99.0%). The prevalence of HPV vaccination was 77.9% among school girls in Melaka. The majority of the participants were vaccinated in their schools (77.0%). About 69% knew about cervical cancer and 77.6% had ever heard about HPV vaccine. Regarding the factors that influence the practice of uptake HPV vaccine, they were age, race, income, parents' education, knowledge about cervical cancer, heard about HPV vaccine and place of getting the vaccine (p<0.001).

    CONCLUSION: The prevalence of HPV vaccine among school girls is high. Age, race, income, parents' education, knowledge about cervical cancer, heard about HPV vaccine and place of getting the vaccine were the significant factors that influence the practice of uptake HPV vaccine among school girls.

    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*
  9. Alsaad MA, Shamsuddin K, Fadzil F
    Asian Pac J Cancer Prev, 2012;13(3):879-83.
    PMID: 22631665
    Cervical cancer is caused by HPV infection and can be prevented by early vaccination.

    OBJECTIVE: To assess Syrian women's level of knowledge and determinants of good knowledge of cervical cancer, HPV infection and its vaccines.

    METHODS: A cross sectional survey was undertaken among mothers with daughters in sixth grade classes enrolled in primary schools in Aleppo city, Syria. Samples were selected through cluster sampling and data collected using a self-administered questionnaire.

    RESULTS: Less than a third of the mothers had heard of HPV infection and vaccines against cervical cancer and levels of knowledge were generally low. Good knowledge was associated with high education level, higher family monthly income, having few--less than four children, positive history of cervical cancer screening, and working or having relatives working in the medical field. The main source of information was television and few reported health care providers as a source of knowledge on HPV infection and vaccine.

    CONCLUSION: Since knowledge of HPV infection and its connection with cervical cancer and its vaccine are low, more efforts must be made to educate Syrians prior to introduction of any HPV vaccination programme. Public health efforts must focus on educating mothers, the public as well as health care providers.

    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*
  10. Rashwan HH, Saat NZ, Abd Manan DN
    Asian Pac J Cancer Prev, 2012;13(5):2279-83.
    PMID: 22901207
    Human Papillomavirus (HPV) infection is one of the most common sexually transmitted infections and oncogenic HPV is the main cause of cervical cancer. However, HPV vaccination is already available as the primary preventive method against cervical cancer. The objective of this study was to determine the level of knowledge, attitude and practice of HPV vaccination among Universiti Kebangsaan Malaysia (UKM) and Universiti Malaya (UM) students. This study was conducted from March until August 2009. Pre-tested and validated questionnaires were filled by the third year UKM (n=156) and UM (n=149) students from medical, dentistry and pharmacy faculties. The results showed that the overall level of knowledge on HPV infection, cervical cancer and its prevention among respondents was high and the majority of them had positive attitude towards HPV vaccination. Medical students had the highest level of knowledge (p<0.05). Very few students (3.6%) had already taken the vaccine with no significant difference between the two Universities (p=0.399). In conclusion, the knowledge and attitude of the respondents were high and positive, respectively. Only few students took HPV vaccination. Thus, more awareness campaigns and HPV vaccination services should be provided at universities' campuses with the price of the HPV vaccine reduced for the students.
    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*
  11. Al-Naggar RA, Bobryshev YV
    Asian Pac J Cancer Prev, 2011;12(8):2045-9.
    PMID: 22292648
    OBJECTIVE: This study was performed to determine the practice of HPV vaccine among Malaysian women in the general population.
    METHODOLOGY: A cross-sectional study was conducted among 233 women during the Academic Year 2010/2011. Written consent was obtained from the participants and written information about the study was given enclosed with the questionnaire form, consisting of questions on socio-demographic characteristics, knowledge about HPV and practice of HPV vaccination. The protocol was approved by the ethics committee of Management and Science University (MSU). Data were analyzed using Statistical Package for Social Sciences (SPSS) version 13. The T-test and ANOVA test were used to explore the relation between socio-demographic characteristics and the practice of HPV vaccine.
    RESULTS: The majority of the participants were from the age group 17-30 years old, Malay, single and having tertiary education (67.8, 62.7, 62.2, 86.3%; respectively). As for knowledge, the majority of them heard about HPV (82.4%), knew that multiple sex partners increase the risk (71.7%). Regarding the practice of HPV vaccine among respondents, slightly more than half had been vaccinated (51.5%). Regarding the factors that influenced the practice of HPV vaccine among general population; age, marital status and family monthly income were significant (p=0.001, p=0.001, p=0.001; respectively).
    CONCLUSION: Age, marital status and income significantly influence the practice of HPV vaccine. Therefore promotion of HPV vaccine and inclusion in the national vaccination program is very important for primary prevention of cervical cancer among women.
    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*
  12. Rashwan H, Lubis SH, Ni KA
    Asian Pac J Cancer Prev, 2011;12(7):1837-41.
    PMID: 22126576
    Cervical cancer is the third most common cancer in women in peninsular Malaysia and very prevalent worldwide. HPV vaccination and routine Pap smear testing are the best preventive measures. The objective of this study was to determine the knowledge level of secondary school students from Sarawak, East Malaysia regarding cervical cancer and its prevention. Multistage random sampling with various methods in each step was employed to select the sample of 76 students. Results showed that 61.8% had poor knowledge level of cervical cancer and its prevention. There were 60.5% of students who were aware of cervical cancer with Chinese and form four students showing significantly the highest awareness (p<0.05). The main source of cervical cancer information was from their parents (25.9%). HPV vaccination acceptance among students was 22.3% and an association was found between knowledge of cervical cancer with race and HPV vaccination acceptance (p<0.05). In conclusion, the students had poor knowledge level of cervical cancer, its prevention and HPV vaccination acceptance. More efforts should be made to improve cervical cancer knowledge and awareness of the public especially secondary school students in Sarawak. This in turn will enhance the practice of prevention against cervical cancer among students.
    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*
  13. Khoo CL, Teoh S, Rashid AK, Zakaria UU, Mansor S, Salleh FN, et al.
    Asian Pac J Cancer Prev, 2011;12(6):1429-33.
    PMID: 22126476
    INTRODUCTION: As the second most common cancer in women worldwide, cervical cancer causes major health and economic burdens. Recent introduction of HPV immunization program locally has been encouraging but vaccine uptake remains poor. In addition, no study has been conducted to explore the people' s awareness and knowledge on cervical cancer, HPV and its vaccine in a rural setting in Malaysia after the inception of the HPV vaccination program.
    OBJECTIVE: This study was conducted to determine the awareness of cervical cancer, HPV vaccination and its affordability among people in a rural area in Malaysia.

    METHOD: A cross-sectional study was conducted among 116 participants in a village in Penang. All consenting female villagers aged 13 years and above, and males who were married were interviewed using a questionnaire.
    RESULTS: Most participants (88.8%) had heard of cervical cancer, however only 29.3% and 42.2% of them had heard of HPV and HPV vaccination respectively. Only 5.2% knew the actual market price for the vaccine. They were willing to pay an average of RM 96.7 (USD $27.7) for the full course of vaccination if it is not given to them for free, whereas the market price is RM1200 (USD $342.85).
    CONCLUSION: Awareness among the Malaysian population in a rural setting on HPV and HPV vaccination is low. Educating the public on the infection can help control the illness. Cost of the HPV vaccine is a serious barrier to the success of the vaccination program in Malaysia.
    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*
  14. Abdullah F, Aziz NA, Su TT
    Asian Pac J Cancer Prev, 2011;12(5):1347-52.
    PMID: 21875295
    INTRODUCTION: The Pap smear test has been regarded as a promising cervical screening tool since 1940s. Yet its importance has been overlooked by beneficiaries in Malaysia. This underlines the need to identify the prevalence of Pap smear practice and influencing factors towards the practice among educated working women.

    METHODS: A survey was conducted with 403 female teachers from 40 public secondary schools in Malaysia selected by cluster random sampling. Data were collected from January to March 2010 using a self-administered questionnaire. Multivariate logistic regression was performed to identify the factors related to the Pap smear practice.

    RESULTS: The rate for participants who ever had Pap test was only 38% and poor practice of was significantly higher among: those with aged less than 35 years; those practicing hormonal contraceptive method; and individuals perceiving barriers to the Pap smear screening test. In contrast, the findings were significantly lower in women with longer duration of teaching service; higher income groups; ever pregnant; having chronic diseases; health insurance coverage; and who had perceived benefit of Pap smear screening.

    CONCLUSION: Barriers towards practicing Pap smear exist even among educated career women. Tailor-made health promotion and education on cervical cancer and the benefit of Pap smear screening are essential to change the behavior of the study population.
    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*
  15. Aljunid S, Zafar A, Saperi S, Amrizal M
    Asian Pac J Cancer Prev, 2010;11(6):1551-9.
    PMID: 21338196
    BACKGROUND: An estimated 70% of cervical cancers worldwide are attributable to persistent infection with human papillomaviruses (HPV) 16 and 18. Vaccination against HPV 16/18 has been shown to dramatically reduce the incidence of associated precancerous and cancerous lesions. The aims of the present analyses were, firstly, to estimate the clinical and economic burden of disease attributable to HPV in Malaysia and secondly, to estimate long-term outcomes associated with HPV vaccination using a prevalence-based modeling approach.

    METHODS: In the first part of the analysis costs attributable to cervical cancer and precancerous lesions were estimated; epidemiologic data were sourced from the WHO GLOBOCAN database and Malaysian national data sources. In the second part, a prevalence-based model was used to estimate the potential annual number of cases of cervical cancer and precancerous lesions that could be prevented and subsequent HPV-related treatment costs averted with the bivalent (HPV 16/18) and the quadrivalent (HPV 16/18/6/11) vaccines, at the population level, at steady state. A vaccine efficacy of 98% was assumed against HPV types included in both vaccines. Effectiveness against other oncogenic HPV types was based on the latest results from each vaccine's respective clinical trials.

    RESULTS: In Malaysia there are an estimated 4,696 prevalent cases of cervical cancer annually and 1,372 prevalent cases of precancerous lesions, which are associated with a total direct cost of RM 39.2 million with a further RM 12.4 million in indirect costs owing to lost productivity. At steady state, vaccination with the bivalent vaccine was estimated to prevent 4,199 cervical cancer cases per year versus 3,804 cases for the quadrivalent vaccine. Vaccination with the quadrivalent vaccine was projected to prevent 1,721 cases of genital warts annually, whereas the annual number of cases remained unchanged with the bivalent vaccine. Furthermore, vaccination with the bivalent vaccine was estimated to avert RM 45.4 million in annual HPV-related treatment costs (direct+indirect) compared with RM 42.9 million for the quadrivalent vaccine.

    CONCLUSION: This analysis showed that vaccination against HPV 16/18 can reduce the clinical and economic burden of cervical cancer and precancerous lesions in Malaysia. The greatest potential economic benefit was observed using the bivalent vaccine in preference to the quadrivalent vaccine.

    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control
  16. Al-Naggar RA, Al-Jashamy K, Chen R
    Asian Pac J Cancer Prev, 2010;11(6):1515-21.
    PMID: 21338190
    OBJECTIVE: The objective of this study is to explore the perceptions and opinions of young women about human papilloma virus (HPV) vaccination and associated barriers.

    METHODOLOGY: This qualitative in-depth interview study was conducted in January 2010 with 30 university students from different faculties, i.e.:International Medical School (IMS), Faculty of Health and Life Sciences (FHLS), Faculty of Business Management and Professional Studies (FBMP) and Faculty of Information Sciences and Engineering (FISE) of the Management and Science University (MSU), Shah Alam, Malaysia. After consent was obtained from all participants, the interviewer wrote down the conversations during the interview sessions. The data obtained were classified into various categories and analyzed manually.

    RESULTS: The majority of participants 25 (83%) had heard about cervical cancer, while 16 (53.3%) have never heard of HPV. Only five participants (17%) mentioned that HPV is the cause of cervical cancer. Ten participants (33.3%) did not know any causes. The majority 16 (53.3%) did not know the mode of HPV transmission. The majority of participants 22 (73.3%) mentioned that they had not been vaccinated against HPV. Out of 22, 16 (53.3%) agreed to be vaccinated in the future to protect themselves from cervical cancer and five (17%) participants mentioned they are not willing because of the uncertain safety of the available vaccines and their side effects.

    CONCLUSION: This study showed relatively poor knowledge about HPV and its vaccines, pointing to urgency of educational campaigns aimed at students in the public and government universities to promote HPV vaccination among this highly eligible population.

    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control
  17. Abdullah F, Su TT
    Asian Pac J Cancer Prev, 2010;11(5):1359-66.
    PMID: 21198293
    INTRODUCTION: Cervical cancer has long been known as a preventable disease. Yet it still is a prime women's health issue globally. In Malaysia, the current cervical cancer screening program, introduced in the 1960s, has been found to be unsuccessful in terms of Pap smear coverage. The aim of this study is to determine providers perceptives on the program and the feasibility of practicing an organized cervical screening program in Malaysia.

    METHODS: 11 key informant interviews were conducted with policy makers and health care providers from the Ministry of Health in Malaysia from October 2009 to May 2010. Interviewees' perceptions were explored on current and organized cervical screening program based on their expertise and experience.

    RESULTS: The results highlighted that the existing cervical screening program in Malaysia faced flaws at all levels that failed to reduce cervical cancer morbidity and mortality. The identified weaknesses were poor acceptance by women, lack of commitment by health care providers, nature of the program, an improper follow-up system, limited resources and other competing needs. Complementarily, all interviewees perceived an organized cervical screening program as an alternative approach both feasible and acceptable by women and government to practice in Malaysia.

    CONCLUSION: Better screening coverage depends on an effective screening program that incorporates a behaviour-based strategy. A new program should be focused in the policy-making context to improve screening coverage and to effectively combat cervical cancer.

    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*
  18. Ezat SW, Aljunid S
    Asian Pac J Cancer Prev, 2010;11(4):943-51.
    PMID: 21133606
    OBJECTIVES: Cervical cancer (CC) had the second highest incidence of female cancers in Malaysia in 2003-2006. Prevention is possible by both Pap smear screening and HPV vaccination with either the bivalent vaccine (BV) or the quadrivalent vaccine (QV). In the present study, cost effectiveness options were compared for three programs i.e. screening via Pap smear; modeling of HPV vaccination (QV and BV) and combined strategy (screening plus vaccination). A scenario based sensitivity analysis was conducted using screening population coverages (40-80%) and costs of vaccines (RM 100-200/dose) were calculated.

    METHODS: This was an economic burden, cross sectional study in 2006-2009 of respondents interviewed from six public Gynecology-Oncology hospitals. Methods included expert panel discussions to estimate treatment costs of CC, genital warts and vulva/vagina cancers by severity and direct interviews with respondents using costing and SF-36 quality of life questionnaires.

    RESULTS: A total of 502 cervical cancer patients participated with a mean age at 53.3±11.2 years and a mean marriage length of 27.7±12.1 years, Malays accounting for 44.2%. Cost/quality adjusted life year (QALY) for Pap smear in the base case was RM 1,215 and RM 1,100 at increased screening coverage. With QV only, in base case it was RM 15,662 and RM 24,203 when the vaccination price was increased. With BV only, the respective figures were RM 1,359,057 and RM 2,530,018. For QV combined strategy cost/QALY in the base case it was RM 4,937, reducing to RM 3,395 in the best case and rising to RM 7,992 in the worst case scenario. With the BV combined strategy, these three cost/QALYs were RM 6,624, RM 4,033 and RM 10,543. Incremental cost-effectiveness ratio (ICER) showed that screening at 70% coverage or higher was highly cost effective at RM 946.74 per QALYs saved but this was preceded by best case combined strategy with QV at RM 515.29 per QALYs saved.

    CONCLUSIONS: QV is more cost effective than BV. The QV combined strategy had a higher CE than any method including Pap smear screening at high population coverage.
    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*
  19. Al-Dubai SA, Alshagga MA, Al-Naggar RA, Al-Jashamy K, Baobaid MF, Tuang CP, et al.
    Asian Pac J Cancer Prev, 2010;11(4):887-92.
    PMID: 21133596
    A cross-sectional study was conducted among 300 Malaysian women in the obstetrics and gynecology outpatient clinic in a selected hospital in Bangi, Selangor to determine the level of knowledge of HPV and HPV vaccines, attitudes toward HPV vaccination and barriers of being vaccinated. Factors associated with knowledge and attitudes were also addressed with a questionnaire. Seventy eight women (26%) had heard about the HPV virus and 65 about HPV vaccines (21.7%). Marital status was associated significantly with awareness of HPV and HPV vaccine (p=0.002, p=0.002; respectively), in addition to level of education (p=0.042). The percentages of women who reported correct answers for the questions on knowledge of HPV and HPV vaccine ranged from 12% to 25%. One hundred fifty nine respondents (53%) had a positive attitude toward HPV vaccination. Age, marital status, and level of education were associated significantly with attitude (p<0.001, p<0.001, p=0.002; respectively). The most important barriers reported were 'unawareness of the vaccine' 'concerned about side effects' and 'afraid of needles'. This study found a very low level of knowledge of HPV and HPV vaccine. Education of population is highly recommended and barriers to being vaccinated should be dealt with seriously.
    Study site: Hospital, Bangi, Selangor, Malaysia
    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control
  20. Al-Naggar RA, Isa ZM
    Asian Pac J Cancer Prev, 2010;11(2):435-40.
    PMID: 20843130
    OBJECTIVE: the objective of this study is to explore the perceptions of medical students regarding the Pap smear test.

    METHODOLOGY: Focus group discussion was held with twenty three medical students. The students were divided into three focus groups; two groups of female participants consisting of 9 and 8 students; respectively. The third group consisted of 6 male students. Questions regarding Pap smear testing included barriers that prevented women from taking the test, gender preference for the physician to conduct the cervical screening test, willingness to suggest Pap smear test to the family or friends. The data obtained were classified into various categories and analyzed manually.

    RESULTS: Most of the study participants mentioned that the main barriers for women to not perform Pap smear test is lack of awareness 16 (70%), followed by shyness 12 (52%) and the cost of the test 12 (52%). Most agreed that the gender of the physician will affect the women decision to do Pap smear test. All mentioned that the advantage of a regular Pap smear test is to detect the abnormality at the early stage of cervical cancer. Some of the participants 9 (39%) mentioned that the disadvantages are expense, possible injury in the vagina due to the test procedures 8 (35%), associated infection 7(30.4%) and pain 7(30.4%) . The majority, 20 (87%) mentioned that the most effective prevention methods for cervical cancer are having sex only after getting married with the spouse only, HPV vaccination 15 (65%) and Pap smear 14 (61%).

    CONCLUSION: The main barriers for women to not perform Pap smear test is lack of awareness, shyness and the cost of the test. Gender of the physician will affect the women decision to do Pap smear test.
    Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links