Survival rates of cervical cancer patients in Sarawak: a single-centre referral study

BACKGROUND: Cervical cancer represents a significant health challenge in Malaysia, especially in the state of Sarawak which records some of the highest incidence rates across the country. This study evaluates the survival rates of cervical cancer patients in Sarawak, focusing on demographic characteristics, disease stage and survival outcomes to inform healthcare strategies. METHODS: A retrospective case notes review of disease stage, patterns of care and survival outcomes of patients diagnosed with cervical cancer at Sarawak General Hospital between January 2018 to December 2022 was conducted. Kaplan-Meier survival analysis and Cox Regression analysis were performed to assess survival outcomes and factors influencing survival. RESULTS: A total of 555 patients were included in this review. The majority of patients were diagnosed between the ages of 40 and 59, with a mean age of 53 years. Ibans comprised the largest subgroup by ethnicity. Only 11.2% of patients were diagnosed with Stage I disease. The majority of patients were diagnosed at advanced stages III and IV. The overall 5-year survival rate was 59.4%. Factors significantly affecting survival included FIGO cancer stage and ethnicity. CONCLUSIONS: Diagnosis at advanced stages of disease lead to poorer clinical outcomes in cervical cancer patients in Sarawak. This study highlights the critical need for enhanced screening and early diagnosis to improve survival rates amongst cervical cancer patients Sarawak. Efforts should focus on improving cervical health literacy, expanding access to healthcare services and improving the uptake of HPV vaccination and cervical screening particularly in rural communities

Human papillomavirus (HPV) genotype distribution in Malaysia: A systematic review

Background Human papillomavirus (HPV) is a key etiological factor in cervical cancer in both Malaysia and globally. It continues to pose a significant public health challenge. This systematic review aims to delineate the distribution of HPV genotypes across different demographics in Malaysia to inform targeted prevention strategies. Methods We conducted a systematic review following PRISMA guidelines, analyzing observational studies published from 2000 onward that reported HPV genotypes in cervicovaginal samples from Malaysian women. The review utilized PubMed, SCOPUS, The Cochrane Library, APA PsycNet, and Google Scholar for literature searches, focusing on studies that employed molecular methods for HPV genotyping. Two reviewers independently screened the articles, extracted data, and assessed study quality using the Newcastle-Ottawa Scale (NOS). A descriptive analysis was performed, and findings were synthesized by genotype, region, and ethnicity. Results The review included 22 studies from an initial pool of 2,547 articles, encompassing 44,251 women. These studies reported a HPV prevalence of up to 100% in confirmed cervical cancer cases and in general screenings from 4.5 to 47.7%. A total of 28 different HPV genotypes (high- and low-risk) were identified, with HPV16, HPV18, HPV58, HPV52, and HPV33 being the most prevalent high-risk genotypes. Genotype distributions showed significant variation across different states and ethnic groups within Malaysia, highlighting the diverse nature of HPV-related risks. Conclusions This review provides a detailed snapshot of the HPV genotype distribution in Malaysia, underscoring the necessity for tailored public health interventions that address the regional and ethnic diversity in HPV prevalence. The findings support the need for targeted vaccination programs and enhanced screening measures to effectively combat the high rates of HPV-related (99%) cervical cancer in Malaysia