- Cervical cancer is the third most common cancer among females in Malaysia with around 554 women diagnosed yearly.
- The incidence of cervical cancer increases for a woman from 35 years old onwards and peak between 50-74 years old.
- The lifetime risk of contracting cervical cancer is 1 in 144 females in Malaysia. Chinese women were found to have the highest incidence of cervical cancer followed by Indian and Malay.
- In 2010, the HPV Immunization Programme was launched by the Ministry of Health in schools as a part of the National Immunization Programme (NIP).
Cervical Cancer
Cervical cancer is a type of cancer that develops when abnormal cells grow in the tissues of the cervix.
The cervix connects the uterus to the vagina in the female reproductive system.
The surface of the cervix is covered by two types of cells. The cell your cervical cancer develops from determines the type of cervical cancer you have:
Squamous cells
These cells line the outer surface of the cervix (ectocervix). Cancer that develops from squamous cells is known as squamous cell carcinoma and is the most common type of cervical cancer (accounting for 70% of cases).
There are also some other rare carcinomas of the cervix, such as small cell carcinomas, cervical sarcoma, clear cell adenocarcinoma and mixed carcinomas (adenosquamous) which contain both squamous and glandular cells.
Glandular cells
These cells line the inner surface of the cervix (cervical canal or endocervix). Cancer of these cells is called adenocarcinoma. Adenocarcinoma is less common (25% of cases) than squamous cell carcinoma.
As signs and symptoms for cervical cancer can be similar to other common conditions, it’s important to see your GP or healthcare professional if you experience any of the symptoms below. Discussing anything concerning with your doctor as soon as possible can help give you peace of mind and offer the best chance of successful treatment if you receive a cervical cancer diagnosis.
Symptoms include:
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Vaginal bleeding between periods
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Pain or bleeding during or after sexual intercourse
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Changes in vaginal discharge
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Menstrual bleeding that is longer or heavier than usual
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Vaginal bleeding after menopause
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Pelvic pain
A cervical screening test can determine if there are any abnormal or cancerous cells in the cervix.
The TNM system is used to stage cervical cancer, and it helps doctors plan your treatment. The TNM stands for:
- Tumour (T) – The degree to which the tumour has affected other tissue, for example how much of the cervix and surrounding tissue has been affected
- Nodes (N) – Is a measure of whether lymph nodes have been affected
- Metastasis (M) – Whether the cancer has spread to other parts of the body
The TNM information, along with other tests, helps determine the stage of your cervical cancer using the classifications below:
Stage I
The cancer is confined to the tissue of the cervix.
Stage II
The cancer has spread out of the cervix to the upper two-thirds of the vagina or other tissue next to the cervix.
Stage III
The cancer may also have spread to the pelvic side wall, or the tumour is causing obstruction to the kidney(s). The cancer has spread to the pelvic or abdominal lymph nodes.
Stage IVa
The cancer has spread to surrounding pelvic organs, including the bladder or rectum.
Stage IVb
The cancer has spread to beyond the pelvis, such as to the lungs, liver or bones.
There are many different types of treatment for cervical cancer. Your treatment will depend on you and your cancer. Learn more
There is no known genetic cause of cervical cancer.
The majority of cervical cancers are caused by infection with human papillomavirus (HPV). Although you can’t inherit cervical cancer, you may still have an increased risk of developing cervical cancer because of your genes. For example, women with a mother or sister who had the disease may have a higher risk of developing it themselves. It’s not currently understood if this is caused by an inherited condition that makes some women more vulnerable to HPV infection than others.
Almost all cases of cervical cancer are caused by persistent infection (an infection that doesn’t go away) with the human papillomavirus (HPV). This is the greatest risk factor for cervical cancer.
Other risk factors can include smoking, having a weakened immune system, long term use of the oral contraceptive pill (the pill). In the past, some women were prescribed diethylstilbestrol (DES) during pregnancy. This hormone is associated with a particular type of cervical or vaginal cancer in their children.
It’s important to discuss any concerns you may have with your doctor as your risk factors will depend on your individual circumstances.
Approximately 80% of women will become infected with genital HPV at some point in their lifetime if they are sexually active. However, the majority of women with HPV infection will not get cervical cancer.
In Malaysia, one in 144 women has a lifetime risk of being diagnosed with cervical cancer. Majority of the cervical cancer diagnoses are found at Stage II (35.3%).
In 2010, the HPV Immunization Programme was launched by the Ministry of Health (MOH) in schools, targeting 13 years old females as a part of the National Immunization Programme (NIP).
Participating in the HPV Immunization Programme by MOH or getting the Human Papilloma Virus (HPV) vaccine are both important ways you can help prevent and ensure the early detection of cervical cancer.
There are a number of lifestyle-related factors you may also consider to reduce your risk of developing cervical cancer, including:
- Regular exercise – Cancer Australia recommends at least 30 minutes of moderate-intensity exercise each day
- Avoiding smoking – Smoking increases the risk of cervical cancer in women who have HPV
- Reduce your alcohol intake – If you choose to drink, try to limit your alcohol intake to no more than two standard drinks a day
- Eat a healthy, balanced diet – Eat a fibre-rich diet from grain and legume sources, as well as enjoying a variety of fruit (two serves) and vegetables (five serves) per day, limiting your intake of salt and saturated fats, and avoiding all processed meat
For more information on cervical cancer screening and HPV vaccination, you can have a look at the National Cancer Society Malaysia’s website and MyHEALTH Kementerian Kesihatan Malaysia.
ReferencesReferences
- Institute Kanser Negara. (2023). Summary of Malaysian National Cancer Registry Report 2012-2016. Retrieved on 4 October 2023 from https://nci.moh.gov.my/index.php/ms/pengumuman/789-summary-of-malaysian-national-cancer-registry-report-2012-2016
- Kementerian Kesihatan Malaysia. Action Plan Towards the Elimination of Cervical Cancer in Malaysia, 2021 to 2030. Retrieved on 23 November 2023 from https://www.moh.gov.my/moh/modules_resources/bookshelf/Action_Plan_Towards_The_Elimination_of_Cervical_Cancer_in_Malaysia_2021-2030_(ISBN)_comp/Action_Plan_Towards_The_Elimination_of_Cervical_Cancer_in_Malaysia_2021-2030_(ISBN)_comp.pdf
- Ministry of Health Malaysia. Guidelines for Primary HPV Testing in Cervical Cancer Screening in Malaysia 2019. https://hq.moh.gov.my/bpkk/images/3.Penerbitan/2.Orang_Awam/5.Kesihatan_Dewasa/2.PDF/3Guidelines_For_Primary_HPV_Testing_In_Cervical_Cancer_Screening_in_Malaysia.pdf
- Cancer Council. (2021). Cervical Cancer. Retrieved on 8 November 2021 from https://cancer.org.au/about-cancer/types-of-cancer/cervical-cancer.html?_ga=2.107198658.1791040564.1569977015-345937469.1569977015#jump_1
- Cancer Council. (2021). Types of Cancer – Cervical Cancer. Retrieved on 8th November 2021 from https://www.cancer.org.au/cancer-information/types-of-cancer/cervical-cancer
- Cancer Council. (2019). Understanding Cervical Cancer: A guide for people with cancer, their families and friends. Retrieved on 01 October 2019 from https://cancer.org.au/content/about_cancer/ebooks/cancertypes/Understanding_cervical_cancer_booklet_September_2019.pdf#_ga=2.107198658.1791040564.1569977015-345937469.1569977015
- Cancer Council Victoria (2021). Cervical cancer. Retrieved on 18 November 2021 from https://www.cancervic.org.au/cancer-information/types-of-cancer/cervical_cancer/cervical-cancer-overview.html
- American Cancer Society. (2019). Cervical Cancer Stages. Retrieved on 03 October 2019 from https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/staged.html
- Australian Government, Cancer Australia. (2021). Cervical cancer – diagnosis. Retrieved on 15 November 2021 from https://www.canceraustralia.gov.au/affected-cancer/cancer-types/cervical-cancer/how-cervical-cancer-diagnosed
- American Cancer Society. (2021). Risk Factors for Cervical Cancer. Retrieved 18 November 2011 from https://www.cancer.org/cancer/cervical-cancer/causes-risks-prevention/risk-factors.html
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