Cervical cancer is no longer a disease that affects only older women. It often begins quietly. A missed screening, irregular bleeding waved off as stress, or a period that doesn’t feel quite right. For many Malaysian women, these early warning signs go unnoticed, until the disease has already progressed.
Once considered a cancer of later life, emerging data tells a very different story. Cervical cancer is now the fourth most common cancer among women worldwide and the third among Malaysian women, with more than half of all cases occurring in women aged 40 to 59. More alarmingly, gynaecologists and emergency physicians are seeing a growing number of younger patients, some as young as their late 20s, being diagnosed at advanced stages.
“Cervical cancer is absolutely preventable, yet many women are still coming in too late. Most of my younger patients with cervical cancer had never done a Pap smear before diagnosis. They didn’t think they were at risk,” says Dr Andi Anggeriana Binti Andi Asri, Consultant Obstetrician and Gynaecologist and Robotic Surgeon at Sunway Medical Centre, Sunway City.
Health experts say younger women are increasingly being diagnosed with cervical cancer due to delayed screening and low awareness of early risks. Women in their 20s and 30s often prioritise studies, careers, and family responsibilities over routine health checks, while others avoid screening due to discomfort or stigma surrounding gynaecological examinations.
Cervical cancer is primarily caused by the human papillomavirus (HPV), a common virus transmitted through skin-to-skin contact, including sexual activity. Although most HPV infections resolve naturally, high-risk strains like HPV 16 and 18 can cause silent cellular changes that may progress into cancer if left undetected.
“There is a widespread misconception that cervical cancer only affects older or married women,” said Dr Andi. “In reality, HPV causes more than 90% of cervical cancers can be contracted from the first sexual encounter, even with one partner.”
In Malaysia, more than 90% of cervical cancer cases are linked to HPV. However, Ministry of Health (MOH) data shows that six in 10 women have not undergone a Pap smear in the past three years, raising concerns about missed opportunities for early detection and prevention.
By the time some women come to the emergency room, symptoms have become severe. Dr Mohd Khalis Bin Abdul Rahim, Consultant Emergency Physician, Sunway Medical Centre, Sunway City says the signs are often dismissed until they can’t be ignored.
“We often see women coming in with abnormal vaginal bleeding after intercourse, at times other than normal periods, or post-menopause. They think it’s just a heavier cycle, but by then, the cancer may already be advanced,” he says.
Bleeding outside the normal cycle, persistent discharge with odour, pelvic pain, or bleeding after intercourse should all prompt a visit to the doctor. “If these symptoms persist across one or two cycles, don’t wait. Get checked,” he advises.
Period-tracking apps and smartwatches have become popular tools for monitoring menstrual cycles and general health, but both doctors caution that they should not be relied on for medical diagnosis. While these technologies may help flag changes such as irregular cycles or persistent fatigue, they are intended to support awareness, not replace professional medical screening.
“Apps can help identify patterns, but they can’t tell you what’s wrong. A pap smear or HPV test remains the gold standard for detecting cervical abnormalities early,” says Dr Andi.
Health experts stress that while digital health tools can empower women to better understand their bodies, regular screenings and timely consultations with healthcare professionals are still essential for early detection and effective treatment.
The HPV vaccine is one of the most effective ways to prevent cervical cancer. Malaysia’s school-based programme offers it free to 13-year-old girls, but uptake among older teens and adults remains inconsistent. “Even in your 20s or early 30s, the vaccine can still reduce your risk. It won’t cover all HPV strains, but it’s a powerful layer of protection,” says Dr Andi.
Early detection not only saves lives, but it can also help preserve fertility. In contrast, late-stage diagnosis often requires chemotherapy, radiation, or major surgeries that have long-term effects on physical and emotional health. “If we catch it early, we may not need to remove the uterus. Some women can even go on to conceive naturally,” Dr Andi explains.
Dr Andi and Dr Khalis say women should ask themselves three simple questions if they notice changes in their cycle: Is this bleeding outside my usual cycle? Has it happened more than once? And would I be worried if this were happening to my sister, daughter, or friend?
“If you say yes to any of these, don’t wait. Even if it’s nothing, you’ll have peace of mind,” says Dr Khalis. “If you’re uncomfortable with one doctor, see another. Your health is too important to ignore,” adds Dr Andi.
Cervical cancer is one of the few cancers that’s highly preventable. With regular screening, HPV vaccination, and early attention to symptoms, women have powerful tools to protect their health. “Don’t ignore your body. Most women with abnormal bleeding don’t have cancer but the only way to know for sure is to get checked. Cervical cancer doesn’t wait, and neither should you,” Dr Andi says.
