BULLETIN OF THE GENETICS SOCIETY OF MALAYSIA Homepage: http:// www.persatuangenetikmalaysia.com Jilid 10 No. 2 / ISSN 1394-5750 Dis. 2004 Bulletin PGM Dec. 2004 page 1 Cancer of the cervix is caused by micro-organisms called Human Papilloma Virus (HPV). This virus is only transmitted to women from their partners/spouses through sexual intercourse. In Malaysia, cancer of the cervix is the second most common cancer among females after breast cancer. The incidence is 21.5 per 100,000 population, with incidence among the Chinese being highest at 33.6 per 100,000 and among Malays the lowest being 12.6 per 100,000. For the past twenty years or so the Annual Reports of Ministry of Health recorded an average of 2500 new cases per year. Cancer of the cervix is preventable. The precursor cancer cells can be easily detected provided the women do regular screening tests called Pap Smear. In nearly all cases this cancer arises from the transformation zone of the cervix. This is the zone in the cervical mucosa in which the epithelium abruptly changes from hardy squamous epithelium of the ectocervix to the fragile columnar epithelium of the endocervix. Cervical cancer is the first solid tumour to be shown directly induced by virus. HPV is found in virtually all cervical carcinomas and their precursors. cancers of the lungs (1.24 million), breasts (1.05 million), colo-rectum (945,000) and stomach (876,000) (1). Collectively, the countries in Asia have the highest load of cancer of the cervix compared to countries in other continents. Socioeconomic factors play an important role in the pathogenesis of the cancer the cervix. Cancer of the cervix is ranked 3 rd of all cancers seen in Malaysia with the incidence of 21.5 per 100,000 populations (2). There are about 2500 new cases per year. Cervical Cancer - Understanding Its Molecular Genesis and Proposing the Use of Molecular Pap Smear in Malaysia. Professor Dr Nor Hayati Othman Deputy Dean (Research) & Professor of Pathology Universiti Sains Malaysia , 16150 Kubang Kerian , Kelantan , MALAYSIA Tel : 609 7664002 (office), 609 765 3712 , fax: 609 7656532 hayati@kb.usm.my Abstract Introduction In order to curb this cancer, we have to understand the pathogenesis of this disease. What makes the cervix, which normally looks smooth, shining, and moist with thin film of mucus coating the surface, becomes opaque and dull when abnormal? Nearly all cancer of the cervix arises from a region called the transformation zone. At this region, mucus secreting columnar cells abruptly change to squamous epithelium. This zone differs in location slightly according to the age of the women. Frequent sexual intercourse is perceived as a form of trauma to the fragile columnar epithelium thus an adaptive phenomenon called squamous metaplasia takes place whereby the columnar epithelium changes to another kind of epithelium which is stronger - the squamous epithelium. Slight modification is needed in the technique of Pap smear sampling in women of different ages in order to get adequate samples (3, 4). Continued on page 3 Cancers in general will remain the number one concern of the human population worldwide. There is an estimate of 10 million new cancers, with 6. 2 million deaths and 22.4 million people living with cancers in the year 2000. The most common cancers are Understanding the mechanism of the disease