KUALA LUMPUR, August 10 — As Malaysia heads toward the elimination of cervical cancer, the government said today it was hopeful that the full adoption of the human papillomavirus (HPV) testing would be achieved by 2023 and phase out Pap smear tests.

Deputy Health Minister Datuk Dr Noor Azmi Ghazali said this in his Parliament in reply to a supplementary question by June Leow Hsiad Hui (Hulu Selangor-PH) on the government’s effort apart from awareness campaign to curb the spread of cervical cancer amongst women in the country.

“To date the government has approved another screening method, that is to adopt HPV testing which has been conducted in pilot stages since September 2019 in four states. 

“The encouraging results (from HPV testing) we obtained from these four states will be retained and the government is with the hope that we will be able to fully adopt (HPV testing) by 2023,” he said in the Dewan Rakyat here.

According to Dr Noor Azmi, cervical cancer is the third most common cancer among Malaysian women and ninth most common in the country.

Citing the National Health and Morbidity survey 2019, Dr Noor Azmi said 60 per cent of women had not performed a Pap smear in the past three years and 25 per cent had no knowledge of other screening methods. 

“So we are worried about whether women are not informed or choose to ignore such matters. Why is this happening? We know this disease is preventable with treatments and vaccinations. I think the problem lies in the screening method.

“As a doctor, I have received numerous complaints from women expressing their fears, embarrassment, being uncomfortable and some may not care either,” he said.

Conventionally, cervical cancer is diagnosed through a Pap smear, where a speculum is inserted into the vagina.

The doctor then uses a swab to collect a sample to detect any cellular changes on the wall of the cervix.

Unlike a Pap smear which is done every three years, a negative result on a HPV test requires the patient to be tested again only after five years.

Dr Noor Azmi then briefly demonstrated the use of a flocked swab in a painless self-sampling method which a patient carries out on her own in a HPV test.

Earlier, Low had asked the Health Ministry to state the feasibility of providing Pap smear check-ups for women who are eligible for the Healthcare Protection Scheme for low-income B40 group (PeKa B40).

Dr Noor Azmi explained that Pap tests were not included as part of the programme as the ministry gave priority to breast cancer because it was more common among women in the country.

“Even though cervical cancer is the ninth highest in Malaysia, the incident rate is low at 6.2 per 100,000 population as compared to breast cancer at 34.1 per 100,000 population.

“Therefore breast cancer screenings were prioritised under the PeKa B40 package. Coupled with the starting allocation of RM20 million (under Budget 2019), the government had to limit the type of benefits according to the needs and interests,” he said.

Later, in a question to Datuk Azizah Mohd Dun (Beaufort-Bersatu) on the government’s target for 2020, Dr Noor Azmi said the government intended to phase out Pap smear tests and replace cervical cancer screenings with HPV tests as the four pilot study areas — Kedah, Kelantan, Putrajaya and Kuala Lumpur — had shown very encouraging results.