Cervical cancer is one of the most common cancers in women worldwide, causing deaths among women worldwide.
Almost all cervical cancer is caused by Human Papillomavirus (HPV).
At least 14 types of HPV are known to cause cervical cancer, which can be cured if detected early.
One of the ways to prevent cervical cancer is through cervical screening, which tests for HPV.
To screen for Cervical Cancer, we offer self-sampling technique via self-collection and clinician-collected sampling.
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All cervical screening participants now have the choice to self-collect their own Cervical Screening Test sample. A self-collected sample is taken from the vagina and is checked for human papillomavirus (HPV) – a common infection that causes almost all cervical cancers.
If you are eligible and want to collect your own sample, your healthcare provider will give you a swab and instructions.
A self-collected sample is taken from the vagina so you don’t need to worry about reaching the cervix or ‘getting the right spot’. All you need to do is insert a swab a few centimetres into your vagina and rotate it for 20 to 30 seconds.
You will be given a private space, such as a bathroom, to collect your sample.
The swab can take from Pathology Lab for walk in patient.
Swab type: Floqswabs Copan 552C
The specimen swab can send back to Laboratory within 3 days at room temperature around 30 Celsius.
Self-collection is available to all people eligible for a Cervical Screening Test – that is people who:
When due, you should get a Cervical Screening Test even if you:
Because self-collection looks for HPV only – not cervical cell abnormalities – it is generally not appropriate for people who have symptoms of cervical cancer or if you are experiencing unusual bleeding, pain or discharge.
You should speak to your doctor about whether self-collection for Cervical Screening Test is the right option for you.
You should speak to your healthcare provider about your cervical screening options. If you decide collecting your own sample is the best option for you, your healthcare provider will give you a swab and instructions on how to collect your sample.
Self-collection is an option. You can choose either self-collection or clinician-collection for your Cervical Screening Test.
You can continue to have your Cervical Screening Test done by your chosen healthcare provider using a speculum examination.
If you think you may have difficulty collecting a vaginal sample by yourself and would prefer a sample be collected without the use of a speculum, you can also ask your healthcare provider to help you do a self-collected Cervical Screening Test.
Healthcare providers play a critical role in supporting patients with cervical screening, including for self-collection.
If you choose self-collection you will be given a private space to collect the sample, for example behind a curtain or in a bathroom.
Having a healthcare provider involved in the process is important because they can:
The Cervical Screening Test detects HPV before it has the chance to develop into abnormal or cancerous cells. HPV can be detected from inside the vagina, so there is no need to access the cervix.
Your healthcare provider can give you the support you need to ensure that the test is performed correctly.
The health professional will ideally explain the difference between self-collection and a clinician-collected speculum examination. When patients lack mobility, a clinician can assist with the vaginal sample and use a swab. We have also found that people with large body sizes may find it difficult to take their own samples and may need assistance.
Self-collect HPV PCR test and self-collection kit with flocked swabs (Copan FLOQ swab 552C or 553C.80) can be ordered from LWE Pathology.
Yes, self-collected samples are as accurate as clinician-collected specimen for the detection of CIN2+.
If HPV Types 16 or 18 are detected – and they are responsible for 70-80% of cancers – then the patient needs to be referred to a specialist for a colposcopy, regardless of the collection method. We expect to detect Types 16/18 in around 2% of patients, and other types of HPV will be detected in 6-8% of patients.
Detection of the other HPV types is highly age-dependent, with detection more likely in younger patients. For those who had a clinician-collected cervical sample, the next step would be for the lab to do reflex Liquid-based cytology (LBC) to determine whether immediate referral is required or if a repeat test in a year is required.
Those who have collected their own sample will be advised to return to a health professional for a clinician-collected cervical test to LBC.
Self-collection should not be used in any setting where a co-test (both an HPV test and LBC, regardless of the result of the HPV test) is indicated. This includes anyone who has symptoms that might suggest the presence of cervical cancer, such as postcoital, intermenstrual or post-menopausal bleeding, or unexplained, persistent or unusual vaginal discharge, anyone currently undergoing test of cure following treatment for high-grade intraepithelial lesions or anyone who has ever been treated for adenocarcinoma in situ.
1. Guidelines for Primary HPV testing in clinical cancer screening in Malaysia (2019, MOH.)