Rashid Rima Ma, Dahlui Maznah, Mohamed Majdah, Gertig Dorota
Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Asian Pac J Cancer Prev. 2013;14(3):2141-6. doi: 10.7314/apjcp.2013.14.3.2141.
Cervical cancer is the third most common form of cancer that strikes Malaysian women. The National Cancer Registry in 2006 and 2007 reported that the age standardized incidence (ASR) of cervical cancer was 12.2 and 7.8 per 100,000 women, respectively. The cumulative risk of developing cervical cancer for a Malaysian woman is 0.9 for 74 years. Among all ethnic groups, the Chinese experienced the highest incidence rate in 2006, followed by Indians and Malays. The percentage cervical cancer detected at stage I and II was 55% (stage I: 21.0%, stage II: 34.0%, stage III: 26.0% and stage IV: 19.0%). Data from Ministry of Health Malaysia (2006) showed a 58.9% estimated coverage of pap smear screening conducted among those aged 30-49 years. Only a small percentage of women aged 50-59 and 50-65 years old were screened, 14% and 13.8% coverage, respectively. Incidence of cervical cancer was highest (71.6%) among those in the 60-65 age group (MOH, 2003). Currently, there is no organized population-based screening program available for the whole of Malaysia. A pilot project was initiated in 2006, to move from opportunistic cervical screening of women who attend antenatal and postnatal visits to a population based approach to be able to monitor the women through the screening pathway and encourage women at highest risk to be screened. The project was modelled on the screening program in Australia with some modifications to suit the Malaysian setting. Substantial challenges have been identified, particularly in relation to information systems for call and recall of women, as well as laboratory reporting and quality assurance. A cost-effective locally-specific approach to organized screening, that will provide the infrastructure for increasing participation in the cervical cancer screening program, is urgently required.
宫颈癌是马来西亚女性中第三大常见癌症。2006年和2007年的国家癌症登记处报告显示，宫颈癌的年龄标准化发病率（ASR）分别为每10万名女性12.2例和7.8例。马来西亚女性患宫颈癌的累积风险在74岁时为0.9。在所有种族群体中，华人在2006年的发病率最高，其次是印度人和马来人。I期和II期检测出的宫颈癌百分比为55%（I期：21.0%，II期：34.0%，III期：26.0%，IV期：19.0%）。马来西亚卫生部（2006年）的数据显示，在30 - 49岁人群中进行的巴氏涂片筛查估计覆盖率为58.9%。50 - 59岁和50 - 65岁的女性中只有一小部分接受了筛查，覆盖率分别为14%和13.8%。宫颈癌发病率在60 - 65岁年龄组中最高（71.6%）（卫生部，2003年）。目前，马来西亚全国没有有组织的基于人群的筛查项目。2006年启动了一个试点项目，从对参加产前和产后检查的妇女进行机会性宫颈癌筛查转向基于人群的方法，以便能够通过筛查途径监测妇女，并鼓励高危妇女接受筛查。该项目以澳大利亚的筛查项目为蓝本，并做了一些修改以适应马来西亚的情况。已经发现了重大挑战，特别是在女性呼叫和召回信息系统以及实验室报告和质量保证方面。迫切需要一种具有成本效益的针对当地情况的有组织筛查方法，为增加宫颈癌筛查项目的参与率提供基础设施。
