In Malaysia, cervical cancer is the third most common cancer in women, and about 95% of the cases are due to persistent high-risk HPV infection. It is widely known that both HPV DNA and pap-smear tests are the standard screening methods to assess cervical cancer risk. However, do you know what are the differences between these two tests? Are these tests required for every woman?
在马来西亚，宫颈癌是第三最常见的女性癌症。约95% 的宫颈癌病例都是由持续的高危型人乳头状瘤病毒（HPV）所引起的。众所周知，HPV基因检测和子宫颈抹片检查都是评估宫颈癌风险的标准筛检方法。然而，您是否知道这两种筛检方法之间有什么区别吗？是否每位女性都有必要检测？
HPV DNA and pap-smear tests are done using similar method, that is by collecting cervical cell sample through cervical swab. However, the findings of these tests differ. Pap-smear test detects cervical cell changes, either low grade or high grade, that may be cancerous, or that can progress to cancer. It can also help to determine other conditions such as bacterial or fungal infection and inflammation. HPV DNA test, on the other hand, detects high-risk (cancer-causing) and low-risk (cause warts) HPV DNA strains, even if there are no changes to the cervical cell. This test can also be used as a reflex test for further investigation when pap-smear test shows changes to cervical cells. However, HPV DNA test cannot detect other conditions that can be detected by pap-smear test.
HPV基因检测和子宫颈抹片检查采用类似的方法，即通过宫颈拭子采集宫颈细胞样本。然而，它们检测的结果有所不同。子宫颈抹片检测宫颈细胞的变化，分为低级别或高级别，可能是癌变的，或有可能发展为癌症。它还有助于确定其他状况，如细菌或真菌感染以及炎症。另一方面，HPV基因检测能够检测高危型（可致癌）和低危型（引起疣）的人乳头状瘤病毒株，即使宫颈细胞没有变化。当子宫颈抹片检查显示宫颈细胞有变化时，这个检测可以作为进一步调查的反射测试。然而，HPV基因检测无法检测子宫颈抹片检查所能发现的其他状况（细菌、真菌感染和炎症）。
According to the current guidelines by the Ministry of Health Malaysia (MOH 2023) and the US Preventive Services Task Force (USPSTF 2023), women younger than 30 years can screen for cervical cancer through pap-smear tests once a year for 2 years. If the results were normal, at least once every three years is indicated. For sexually active female within age 30 to 65 years old, HPV test is recommended, either in combination with pap-smear test every 5 years, or separately, with pap-smear for every 3 years and HPV DNA test every 5 years. Screening for those above 65 years old is not indicated, unless if there is no prior history of routine screening. These guidelines, however, only apply to normal populations without any related medical history or conditions. Refer to the healthcare practitioners for individual screening requirements.
根据马来西亚卫生部（MOH 2023）和美国预防服务工作组（USPSTF 2023）的当前指南，30岁或以下的女性可以每年进行一次子宫颈抹片检查，持续两年。如果检查结果正常，之后建议每三年进行一次检查。对于30至65岁之间的性活跃女性，建议每五年一次进行HPV基因检测及子宫颈膜片检查（结合），或者分开进行检测，即每三年一次进行子宫颈抹片检查和每五年一次进行HPV基因检测。65岁以上的女性则不建议进行筛检，除非之前没有常规筛检历史。然而，这些指南仅适用于没有相关病史或疾病的正常人群。请咨询医疗专业人士以了解个人筛检要求。
