Th e HEALTH | MARCH, 2019
ISSUE: CERVICAL CANCER
14
“Diff erent societies often have diff erent reasons to
avoid screening. I believe in Malaysia, embarrassment is
one of the greatest barrier. Secondly, it’s often the fear of
discomfort – those who had one or two bad experiences
would not want to go back to the doctor again. Th irdly,
the poor knowledge that they need to be screened every
couple of years.”
“Our healthcare service is overstretched – speak to
the nurses or women and they will tell you that it can
occasionally take up to 3- 4 hours. And that’s made
worse if you have a child with you. Th e Ministry of
Health campaigned aplenty for cervical cancer screening
but we have so many other targets to achieve; abstaining
diabetes, cardiac diseases and other chronic illnesses.”
Collaboration
Eliminating fear for
cervical screening
University Malaya develops innovative screening program for
women to prevent cervical cancer, dubbed Project ROSE
E
VERY year, 2,145 Malaysian women are diag-
nosed with cervical cancer. Cervical cancer
is quite common in Malaysia, and Health
Minister Datuk Seri Dr Dzulkefl y Ahmad
stated that the number of cases is expected
to increase in the near future.
Women don’t even need to get cervical cancer, with
vaccination and screening, it can be prevented.
With the recent collaboration led by University
Malaya (UM) and VCS Foundation (VCSF) of Australia,
signifi cant reduction and elimination of cervical cancer
might just be possible in Malaysia. Professor Dr Woo Yin
Ling, Consultant Obstetrician and Gynaecologist at UM
who heads Project ROSE shares her views and indulge
us with more information.
The reality of cervical cancer
“Cervical cancer is the third most common cancer
among women in Malaysia, with three out of four
diagnosed with the disease aged less than 64 years.
Th is is absolutely appalling in my books because it is
a completely preventable cancer and if detected early,
completely curable,” laments Dr Woo.
Dr Woo and her team of ROSES.
TOWARDS CERVICAL CANCER
ELIMINATION IN MALAYSIA
In Malaysia, cervical cancer is among top
3 most
common cancer among women.
6 new cases of cervical cancer diagnosed every day.
99% of cervical cancer cases are caused by high-risk Human
Every 2 minutes,
1 woman dies
of cervical cancer
somewhere in the world
Papillomavirus (HPV) types.
BARRIERS to a successful screening program related
to the conventional screening method, Pap smear
Fear
Embarrassment
Inconvenience
Lack of awareness of
Poor infrastructure
Lack of dedicated
resources/staff
cervical screening
What is R.O.S.E.?
Pilot Project R.O.S.E. *
Removing Obstacles to cervical ScrEening
Self-
sampling by
women, no
more pelvic
examination!
HPV testing,
instead of a
pap smear
Secure digital e-health
platform to register and
have results and follow
up sent to the women’s
mobile phone
AIM:
To assess the
acceptability,
feasibility and
reach of a novel
cervical screening
strategy, R.O.S.E.
4188
women screened
5%
KLINIK KESIHATAN
Done in
5 klinik kesihatan
kementerian in 2018
are HPV positive
91%
engaged in care
called
initiated
Highlights
within the
call
for %
5 %
91 % 5 % 67 % 91 the
% 63
% 67
63 % same day
Designed for Malaysian women with local needs and
follow up
of receiving
results.
challenges in mind.
5 %
67
91 %
5 % % 63
67 % 63 %
91 %
Evidence-based tool and approach to cervical cancer
with
participants
said:
screening.
97 % Surveys
99 % 97
% 1000
99
%
Driven by empathy for women’s screening experience.
would repeat
recommend
97 % would
97 % 99 % R.O.S.E.
Embodies safety, privacy and dignity through
to 99
their % friends
self-sampling.
Empowers women to undergo cervical screening and
Why R.O.S.E.?
navigate healthcare.
• It’s simple, quick, self-performed
Enables healthcare professionals to track the progress
• fast results through phone!
of every woman screened through their lifetime.
Want to know more? Find us on:
together for:
Join us
#ROSEagainstcervicalcancer
#CervicalCancerFreeMalaysia
#MalaysiaCervicalCancerElimination
Facebook:
https://www.facebook.com/ProjectROSE.my
Or scan the QR code
Website:
https://programrose.wixsite.com/rose
Or scan the QR code
*data based on preliminary data as at December 2018
“Th ere are 21 countries which are part of the Asia-
Pacifi c Economic Cooperation (APEC) – what they’ve
done is identifying cervical cancer as an economical
threat. I met Assoc. Prof Marion Saville, the executive
director of VCS Foundation at an APEC meeting. Th ey
have been operating for over 50 years in Australia and
wanted to expand their services. Th at was how the
collaboration happened! We met on 29 March 2017.
Th rough crowdfunding, working with the government,
NGOs, corporate sectors, and individuals, we managed
to complete recruitment and analysis within 2 years,”
notes Dr Woo.
In 2017, Australia was the fi rst country to introduce
HPV testing as a replacement for pap smears for cervical
cancer prevention in the new National Cervical Screen-
ing Program.
What is Project ROSE?
Th e ROSE solution has three components to it:
Self-testing – Th is means women are able to perform
the test on their own. Th ere would be no need for an
uncomfortable speculum examination.
HPV testing instead of a pap smear – Th e more
traditional pap smear test is an uncomfortable test. It
could very well be the cause for women to be shameful
in doing it. Moreover, the interpretation of the cells are
not always 100 percent accurate. Project ROSE instead
implement HPV testing, which detects the presence
of HPV, the virus that causes cervical cancer, in your
system. Certain types of HPV — including types 16 and
18 — increase your cervical cancer risk.
Mobile technology empowered – When the women
go to the clinics, the health care professionals do not
have to fi ll up multiple forms associated with one Pap
smear test. Registration is just a few clicks using one’s
IC and the results will come back in a SMS. If there’s any
queries, there’s even a person you can speak to. From
the pilot project of the four thousand women who par-
ticipated, 99 percent of them had a mobile phone – all
we need is an SMS service.
Getting tested
“Among women who have received HPV vaccination,
when they reach the age of 30, a pap test will not be
suffi ciently sensitive. Th ey need to have HPV test for
cervical screening,” says Dr Woo.