All You Need to Know About Cervical Cancer in Malaysia

According to TheStar, cervical cancer is the second most common cancer that accounts for 12.9% of all women cancers in Malaysia. The main cause is the human papillomavirus (HPV), which lingers in the body over time and turns normal cells cancerous.

The Malaysian National Cancer Registry Report (2003) ranks the most common women cancer in Malaysia to be breast cancer. Cervical cancer ranks second, followed by colon cancer, ovarian cancer, leukaemia, and lung cancer. 

Cervical Cancer accounts for 12.9% of all women cancers in Malaysia. Nonetheless, a study conducted among secondary school students in Kuala Lumpur found that only 80.4% have heard about cervical cancer.

Cervical cancer is caused by the human papillomavirus (HPV) lingering in the cervix over time and turning normal cells cancerous. The most common type (about 90%) starts in the cells on the outer surface covering of the cervix (squamous cell carcinoma), and the less common type that starts in the glandular cells that line the lower birth canal (adenocarcinoma). Both are equally as dangerous and fatal.

What is HPV?

There are more than 150 different strains of HPV. Low-risk types cause harmless warts on the surface of your skin, while high-risk types are closely linked to cancers. The HPV strains closely linked with cervical cancer are HPV16 and HPV18.

HPV infections are mainly transmitted through sexual activity. Here’s a not-so-fun fact: most people who are sexually active may have had an HPV infection before — it’s just that their immune system got rid of it quickly enough before it caused any damage. 

What are the symptoms of cervical cancer?

Different stages of cervical cancer
Illustration by Enamul Karim through ResearchGate

Depending on the stage the cancer is at, some women may experience more severe symptoms than others. Some of the most common symptoms are:

  • Spotting or unusual light bleeding in between periods
  • Increased vaginal discharge than normal
  • Unusually longer and heavier menstrual bleeding
  • Pain during intercourse
  • Persistent backache or pelvic pain
  • Bleeding even after menopause

To date, there are no definitive symptoms for precancer of the cervix. It’s harder to detect in the earlier stages unless the individual takes specialised tests like the HPV or Pap smear tests. Early detection helps improve the chances of successful treatments by stopping abnormal cervical cells from turning cancerous and spreading to nearby cells and organs.

Am I at risk of developing cervical cancer?

Several factors determine whether or not a woman has a higher risk of developing cervical cancer. 

HPV infection

HPV infections usually clear out by themselves within 2 years for most women. Not all HPV strains cause cancer, however, the World Health Organization (WHO) says individuals with persistent high-risk HPV infections have a higher risk of developing cervical cancer. 

Sexual history

As HPV infections occur mainly through sexual contact, sexually active individuals with more than 3 sexual partners are more vulnerable. This is also particularly true for females who are sexually active even before the age of 17.

A couple in bed
Photo by jcomp on Freepik

Sexually-Transmitted Diseases (STD)

There are two types of STDs that increase the risk of developing cervical cancer: herpes and chlamydia.

Herpes is a common STD that causes sores or blisters on your mouth or genital area. The virus is spread from skin-to-skin contact with infected areas during sex and stays in the body forever because there is no cure for it. It is not dangerous to health, but it does increase the chances of the individual developing cervical cancer.

On the other hand, individuals infected with chlamydia don’t show any symptoms and may never know about their infection until they take a test. Besides causing pelvic inflammation that leads to infertility in women, chlamydia also helps HPV thrive in the cervix, leading to an increased risk of cancer.

Immune system deficiency

Individuals with a weakened immune system are more prone to infections and illnesses, and it works the same way for cervical cancer too. The body may not be able to fight off early cancer due to immune suppression, either from certain medications, treatments, operations, or even from the human immunodeficiency virus (HIV).

Age group

Cervical cancer is less likely to occur in females younger than 20 years old, however, the risk increases significantly between her 20’s and mid-30’s. Women in that age category are highly encouraged to go for regular test screenings such as the HPV test and the Pap smear test, especially if she has frequent sexual activity.

Smoking habits

Women who smoke are twice as likely to get cervical cancer than it is for women who don’t smoke. The tobacco in those products is believed to damage the DNA of cervix cells, contributing to the rise of abnormal cells in the cervix and leading to cancer. Besides, smoking also greatly reduces the efficiency of the immune system in fighting off HPV infections.

Pregnancy history

If a woman gets pregnant in her late teens or early twenties, she is more susceptible to cervical cancer than a woman who conceives in her late twenties. Moreover, women who have had more than 7 full-term pregnancies are also at a higher risk. The reason is due to hormonal changes and weaker immunity during pregnancy that spurs HPV infection.

What can I do to prevent cervical cancer?

A speculum used in Pap smear tests to detect early cervical cancer
Photo by Faihan Ghani through Star Media Group Berhad

Cervical cancer is actually a highly preventable disease that has a high infection and mortality rate. These are the 3 modalities of cervical cancer prevention, based on many studies done in Malaysia:

  • Primary prevention: Preventing HPV infection, sexual abstinence and living a healthy lifestyle, and HPV vaccination.
  • Secondary prevention: Detection and treatment of precancerous/preinvasive lesions.
  • Tertiary prevention: Detection and treatment of the early cancer stage.

Get vaccinated against HPV

The HPV vaccine works the best if it’s given before the individual is exposed to HPV. This is because HPV vaccination doesn’t treat existing infections, only preventing new ones. The vaccination is typically given in 2 or 3 doses, depending on the age. The younger the recipient, the more effective the vaccine will be; girls as young as 9 years old can already start getting vaccinated against HPV.

Nonetheless, even if an individual has received the HPV vaccine, she should still regularly get screened for cervical cancer.

Practise safe sex

Use condoms when having sex. HPV infections may still occur in places where they aren’t protected by the condom due to bodily and sexual fluids. However, using condoms greatly reduces the chances of developing cervical cancer. 

Also, if possible, limit your sexual partners. Keep track of their sexual health before engaging in intercourse with them, keeping an eye out for STDs like herpes and chlamydia that may go undetected. Most importantly, if you think you might have been exposed to infections, get tested as soon as you can.

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