Abdullah Fauziah, Su Tin Tin
Centre for Population Health, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Asian Pac J Cancer Prev. 2010;11(5):1359-66.
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.
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.
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.
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.
宫颈癌长期以来一直被认为是一种可预防的疾病。然而，它仍然是全球主要的女性健康问题。在马来西亚，20世纪60年代引入的现行宫颈癌筛查计划在巴氏涂片检查覆盖率方面并不成功。本研究的目的是确定提供者对该计划的看法以及在马来西亚实施有组织的宫颈癌筛查计划的可行性。
2009年10月至2010年5月，对马来西亚卫生部的政策制定者和医疗服务提供者进行了11次关键 informant访谈。根据受访者的专业知识和经验，探讨了他们对当前和有组织的宫颈癌筛查计划的看法。
结果强调，马来西亚现有的宫颈癌筛查计划在各个层面都存在缺陷，未能降低宫颈癌的发病率和死亡率。已确定的弱点包括女性接受度低、医疗服务提供者缺乏承诺、计划的性质、后续跟进系统不当、资源有限以及其他竞争需求。作为补充，所有受访者都认为有组织的宫颈癌筛查计划是一种可行且为女性和政府所接受的替代方法，可在马来西亚实施。
更好的筛查覆盖率取决于一个有效的筛查计划，该计划应纳入基于行为的策略。一个新的计划应在政策制定背景下加以重点关注，以提高筛查覆盖率并有效抗击宫颈癌。
