HPV Screening

Corporate Social Responsibility (CSR) Initiative by
Hibiscus Petroleum Berhad

Registration Number: 200701040290 (798322-P)

in collaboration with

INTRODUCTION

Sabah, the second largest state in Malaysia, covers an area of about 73,619 km2 and is divided into five divisions and 27 districts. Due to its large size and geographical conditions, the reach of health services in Sabah is still one of the most challenging in the country. Projects aimed towards broadening the reach of health services to the lower income groups, particularly in the more inaccessible areas of the state, are therefore important to ensure that these communities are not left behind.

This CSR is initiated by Hibiscus Petroleum Berhad to sponsor human papillomavirus (HPV) screenings to Malaysian women that fall under the B40 group, aged from 30 to 65 years old. The objective of this CSR is to decrease cervical cancer incidence in Sabah by assisting the B40 women in Sabah with screening and early detection of cervical cancer. Financial constraints, a lack of awareness and accessibility have been key deterrents to B40 women undertaking HPV screening, particularly in remote areas of Sabah. 

This CSR initiative is implemented in collaboration with a public agency (Sabah State Health Department), private individuals (general practitioners), academic institutions (Hospital Universiti Malaysia Sabah) and civil societies (Malaysia Medical Association, and Obstetrical and Gynaecological Society of Malaysia). Hibiscus Petroleum Berhad is looking at sponsoring up to RM2.5 million for this CSR initiative over a five-year period, starting from 2021. 

BACKGROUND

Globally, according to the World Health Organization (WHO), an estimated 570,000 women were diagnosed with cervical cancer worldwide and about 311,000 women died from the disease in 2018. According to the Malaysia National Cancer Registry Report for the 2012-2016 period and published in 2019, cervical cancer was the third most common cancer in females and ranked ninth among all cancer types in Malaysia. Meanwhile in Sabah, cervical cancer was reported as the second most common cancer in females. Data from Sabah Cancer Registry (Figure 1) reported 473 cervical cancer cases in 2006-2010, and the number of cases increased to 570 in the 2012-2016 report, despite the number of cases falling in Malaysia as a whole. Based on this trend, it can be assumed that the cases will keep on increasing if no preventive step is taken to combat cervical cancer in Sabah.

Figure 1: Number of cervical cancer cases reported in Sabah and Malaysia in the 2006-2010 and 2012-2016 periods. Sources: Sabah Cancer Registry Report 2012-2016 & Malaysia National Cancer Registry Report 2012-2016

Out of the 570 cases in Sabah, staging was reported for 440 cases (77.2%). Of the 440, unfortunately, 33.6% were detected at a late stage (stages III & IV) and 66.4% were detected at stages I and II.

The cervical cancer incidence rate, as shown in Figure 2, starts to increase from the 30-34 year age group and peaks between the ages of 50 to 69. 

Figure 2: Comparison of age-specific incidence rate by year in Sabah. Source: Sabah Cancer Registry Report 2012-2016 

Cervical cancer is both preventable and curable if it is detected early. Since patients with cervical cancer are usually asymptomatic in the early stages, primary prevention and screening are extremely vital in reducing the risk of it developing to a more severe stage. The main causative agent of cervical cancer is HPV, which is found in a majority of sexually active people. While most HPV cases are of low-risk infections and would usually resolve itself within two years, HPV 16 and 18 strains are the most commonly found HPV in invasive cervical cancer and account for over 75% of reported cases.

The primary prevention steps of cervical cancer involve early identification of high-risk HPV lesions through HPV screening tests and Pap smears. HPV test is a screening test that was first introduced in 1999. The test collects cell samples from the cervix to detect the presence of the virus. Pap smear or Pap test also uses the same sample collection technique but is used to detect any abnormal changes on the cells, which can later be treated and therefore prevent cervical cancer. HPV test has high sensitivity and specificity. This method may replace the current cervical cancer screening pap smear method. The screening interval with HPV test will be every 5 years for those that tested HPV negative. In the United States and other developing countries, most efforts to combat cervical cancer are directed towards early identification of HPV. Developed countries with established screening programs have recorded around 80% success in eliminating the cancer. These cases would have been incurable had it not been detected early on.

In May 2018, an initiative to fully eliminate cervical cancer was kick-started by the WHO. A total of 194 countries agreed to play their part in ensuring the necessary tools are accessible to support the notion. By November 2018, the WHO officially launched their elimination strategy. There are three key pillars and their corresponding targets to achieve this mission:

1. Vaccination: 90% of girls fully vaccinated with the HPV vaccine by the age of 15;
2. Screening: 70% of women screened using a high-performance test by the age of 35, and again by the age of 45; and
3. Treatment: 90% of women with pre-cancer are treated and 90% of women with invasive cancer are managed.  

The WHO says that each country should meet the 90-70-90 targets by 2030 to get on the path to eliminate cervical cancer within the next century. Hibiscus Petroleum Berhad, through this collaborative initiative with the Sabah State Health Department, Hospital Universiti Malaysia Sabah, Malaysia Medical Association, Obstetrical and Gynaecological Society of Malaysia, and other general practitioners, hopes to play our part in this global effort to eliminate cervical cancer from our community.

The eligibility criteria for the sponsorship of the HPV screening are as follows: 

• B40 Malaysian women (Household monthly income <RM4,850);
• Aged 30-65 years old;
• Sexually active;
• Not done pap smear test in the last 1 year;
• Not had a hysterectomy; and 
• Not pregnant.

For the list of participating Sabah clinics, please refer below. 

Sabah State Health Department Public Clinics

Hospital University Malaysia Sabah Clinics and Private Clinics