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A new, integrated, technology-based screening approach will allow women to be tested for cervical cancer in the comfort of their own home – an innovative effort to detect cervical cancer in its infancy.
ROSE (Removing Barriers to Cervical Cancer Screening), the first cervical cancer screening program in the world with self-sampling by women themselves, is a human papillomavirus (HPV) DNA test – rather than a cervical smear diagnostic test – based on online health platform.
On January 14, 2019, Deputy Prime Minister Datuk Seri, Dr. Wan Azizah Wan Ismail, launched the program. It indicates that the lifetime risk that a Malaysian woman develops cervical cancer is one in 116, with about two-thirds (76%) later stages of the disease, that is, say stages two, three and four.
The ROSE program, she says, will help many women overcome barriers to testing and encourage more people to voluntarily participate in screening as soon as possible.
Healthcare professionals will be able to both record and transmit screening results to women via their mobile phone.
This will result in fewer visits to the clinic and will eliminate the embarrbadment and fear badociated with the Pap smear, which must be done by a clinic doctor.
Dr. Wan Azizah encourages more women to be screened early for cervical cancer because early prevention is the key to stopping the disease.
She notes that despite the country's national immunization program – which provides free HPV vaccinations to 13-year-old girls – reaching more than 90% coverage in this group, cervical cancer screening among Malaysian women is well below that of the World Health Organization (WHO). goal of 70%.
"We only managed to reach a rate of 12.8%, far from the WHO target. The challenge is to get women to pretend to be screeners, "she says.
HPV vaccination protects young girls against the main types of HPV that cause cervical cancer.
Dr. Wan Azizah, who is also Minister of Women, Family and Community Development, said that cervical cancer was the third most common cancer (7.7%) after bad cancer (32.1%). %) and colorectal cancer (10.7%) in Malaysia.
ROSE is an innovation of Universiti Malaya (UM) and the VCS Foundation (VCSF) of Australia to accelerate the fight against cervical cancer in Malaysia.
A Memorandum of Understanding between UM and VCSF was signed on the same day by the Dean of Medicine's Faculty of Medicine, Dr. Adeeba Kamarulzaman, Director, and Associate Professor Marion Saville, to create a non-profit joint venture. a cervical cancer screening program in Malaysia.
Health Minister Datuk Seri, Dzulkefly Ahmad, and Deputy Minister of Women, Family and Community Development Hannah Yeoh were also present at the launch.
Dr. Wan Azizah said the HPV DNA test was recommended to women over 30, adding that he could detect HPV DNA with a high risk of cervical cancer. .
She also said that the implementation of the program by the National Council for Population and Family Development (LPPKN) should benefit 14,000 people in the B40 group.
"As the LPPKN currently has limited funds and facilities, I am told that the goal is to first target the B40 people because the M40 has other means of control," she says.
Adapt the screening program
At the same time, Dr. Dzulkefly explains that the Pap smear was previously the only tool available for early detection of cervical cancer.
"He was introduced to family planning services in 1969 and eligible women are encouraged to take the test once every three years, or about 15 screens in their lifetime," he says.
He adds that the department's target for smear testing, which is set at 40% of eligible women, has averaged only 25% over the last five years.
"Poor coverage is due to a number of factors, including lack of money and manpower, such as cytoscreeners (a laboratory scientist specializing in cytology, the study of cells).
"Many Malaysians also do not attend screening because of their embarrbadment, their fear or because they do not have sufficient information," he says.
Dr. Dzulkefly stated that the adoption of the ROSE program as a primary screening program would require the Ministry of Health to restructure and strengthen its strategies, as well as reorganize its current programs to meet the goals of the program. # 39; disposal.
With the success of the national HPV vaccination program, he said the ministry recognized the need to review its national cervical cancer screening program.
"Although HPV vaccination does not eliminate the need for cervical screening, there is a need to move to a more effective screening modality, aligned with current international evidence," he said.
He adds that recent advances in screening and testing technology have led the WHO to recommend the use of HPV testing as a screening tool.
"The introduction of new technologies nationwide will be a daunting challenge because the introductory costs will be high.
"The ministry needs to carefully establish the implementation plan to ensure that every woman will benefit from and benefit from the new technology," he said.
He added that the new technology would be ineffective if women did not show up for examination.
Dr. Dzulkefly is optimistic that the country will be able to achieve the goals set by the WHO to eradicate cervical cancer from the uterus.
"We have already achieved an HPV vaccination rate of over 90% for teenagers.
"We are now going to work on HPV testing in 70% of eligible women aged 35 to 45 and offer them the appropriate treatment," he said.
Women over age 30 in the B40 group can enroll in the screening program at the country's 49 LPPKN clinics.
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