In the year 1940, the predominant cause of death of women in the childbearing age was cervical cancer. Dr. George Nicholas Papanicolaou and Dr. Herbert F Traut collaborated together to explain how normal and abnormal vaginal and cervical cells could be identified through a microscope and how they can be categorized. The straightforward procedure is now famous as the Pap smear test which became the gold standard in the early diagnose of cervical cancer or cervical cancer screening. (Tan & Tatsumura, 2015)
Cervical cancer was the third most prevalent cancer in females. The life expectancy risk was 1 in 116. The incidence rate for Chinese was higher followed by Indian and Malay. The rate of incidence over the five years was decreased from 8.4 to 6.5. About 60% of cervical cancer cases were diagnosed at stage I and II. (Azizah, Nor Saleha, Noor Hashimah, Asmah, & Mastulu, 2016)
Pap smear is a test to detect cervical cancer which is one type of cancer that happens in the cells located at the lower part of the uterus which links to the vagina. This type of cancer becoming one of the most recurrent worldwide malignant cancer in women and a significant common health problem. Furthermore, the cancer is typically asymptomatic in the early stage and also known as “silent” cancer. In Malaysia, Cervical cancer is the second most common malignancy in women which consists of 12.9% of total female cancers. (Seng, L. M., Rosman, A. N., Khan, A., Haris, N. M., Mustapha, N. A. S., Husaini, N. S. M., & Zahari, N. F., 2018) The neoplasm cells can be easily diagnosed if the women regularly having Pap smear screening test. (Nor Hayati, 2002)
The etiology of the cervical cancer is genital human papillomavirus (HPV) infection. This infection is very common among women that is sexually active with multiple partners which lead to benign and malignant cancer of the cervix. (Koutsky, 1997) However, the early diagnosis and therapy of preneoplastic lesion stage progression to cervical cancer can be prevented. (Burd, 2003)
There are various programs that were established by the Ministry of Health Malaysia involving public health programs that control and curb cervical cancer. Those programs including free screening of Cervical intraepithelial neoplasia (CIN) via Pap smear test, campaign and advertisement, as well as free Human Papilloma Virus (HPV) vaccination to the student of the age 14. (Seng et al., 2018)
It is a prime concern for sexually active women who are more than 35 years old, have children, have been doing contraception for more than five years for family planning, and sexually transmitted diseases patients are recommended to undergo Pap smear test annually in the first two years and followed by once in three years. (Chee, Rashidah, Shamsuddin, & Intan, 2003)
Free pap smear preliminary test, through TouchPoint Wellbeing of Women (WOW) helps the woman overcomes cervix cancer. Datuk Dr Siti Norlasiah Ismail, the director of the board of Penduduk dan Pembangunan Keluarga Negara (LPPKN), stated that the National Health Morbidity Studies 2006, shows that even when the woman knew about cancer, but only 47.3 percent had undergone the test. She added, the research done by LPPKN on 2003, shows that 90.3 percent of the woman knew, but only 23 percent thought that the test is not necessary since no symptoms arise.(Nor Afzan, 2018)