Dr Aziz says that despite awareness campaigns highlighting the need for regular pap smear tests, the message is still not getting across, especially those who are at risk.

A survey by The National Population and Family Development Board, revealed that 90 per cent of women say they heard of pap smear test. It also showed that of that total interviewed, 55.2 per cent have gone for the test while 32.1 per cent do it regularly.

Those who do not take the test say that there is no need for the check-up as they are not ill and are either busy, shy or fear the pain. A small percentage cited a lack of information.

Dr Aziz, who is the past president of the Obstetrical and Gynaecological Society of Malaysia, says that compared to other types of cancers, women are reluctant to talk about cervical cancer because of the "stigma" it carries.

"People always associate cervical cancer with sexual behaviour as it is caused by a virus that is transmitted through sexual activities. Because of this, many women do not want to go for the test.

"This makes our effort of reducing the number of cervical cancer cases more difficult. Without the screening, it is impossible to detect and treat it early," he says at the launch of Cervarix, a vaccine against cervical cancer for women between 10 and 45 years old.

The vaccine contains antigens for the human papillomavirus (HPV) strain Types 16 and 18 that are responsible for up to 70 per cent of all cervical cancer cases.

It is estimated that up to 80 per cent of women will have HPV infection in their lifetime and up to 50 per cent of those infections will be potentially cancer-causing. The risk begins as soon as they are sexually active.

When a woman is infected with HPV, it usually takes from five to 10 years before it becomes cancerous.

Pap smear tests will detect abnormal and pre-cancerous cells on the cervix early on if done regularly.

In 1998, 7.9 per cent of all cancer admission in government hospitals in Malaysia were of cervical cancer and 81 per cent of the cases were at advanced stages.

It is reported that one out of 28 Chinese women are exposed to cervical cancer risks. For Indians, the ratio is one out of 34; while for Malays, it is one out of 89.

"Cervical cancer is a major health, psychological and social burden. But it can be prevented. It only takes little effort from women but they need to come forward. Take the test because early detection can save your life," says Dr Aziz.

This story was first published in The Straits Times on Apr 14, 2008.