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Cervical cancer is the third most common form of cancer that strikes Malaysian women. The National Cancer Registry in 2006 and 2007 reported that the age standardized incidence (ASR) of cervical cancer was 12.2 and 7.8 per 100,000 women, respectively. The cumulative risk of developing cervical cancer for a Malaysian woman is 0.9 for 74 years. Among all ethnic groups, the Chinese experienced the highest incidence rate in 2006, followed by Indians and Malays. The percentage cervical cancer detected at stage I and II was 55% (stage I: 21.0%, stage II: 34.0%, stage III: 26.0% and stage IV: 19.0%). Data from Ministry of Health Malaysia (2006) showed a 58.9% estimated coverage of pap smear screening conducted among those aged 30-49 years. Only a small percentage of women aged 50-59 and 50-65 years old were screened, 14% and 13.8% coverage, respectively. Incidence of cervical cancer was highest (71.6%) among those in the 60-65 age group (MOH, 2003). Currently, there is no organized population-based screening program available for the whole of Malaysia. A pilot project was initiated in 2006, to move from opportunistic cervical screening of women who attend antenatal and postnatal visits to a population based approach to be able to monitor the women through the screening pathway and encourage women at highest risk to be screened. The project was modelled on the screening program in Australia with some modifications to suit the Malaysian setting. Substantial challenges have been identified, particularly in relation to information systems for call and recall of women, as well as laboratory reporting and quality assurance. A cost-effective locally-specific approach to organized screening, that will provide the infrastructure for increasing participation in the cervical cancer screening program, is urgently required.

BACKGROUND: Archival Papanicolaou (Pap)-stained cervical cytology tests may be the only source of a clinical sample for the evaluation of previous human papillomavirus (HPV) infection. Pap tests are ideal because the majority of women in countries with comprehensive screening programs would have had several collected and stored. METHODS: In the current study, HPV detection and genotyping were compared in samples collected from a conventionally fixed Pap test with those collected using an endocervical brush and collected in PreservCyt (liquid-based) in 87 women undergoing management for a high-grade Pap test abnormality. Cytology slides were scanned to create high-resolution digital images before the removal of cells because the DNA extraction process resulted in the destruction of the cells from the original sample. RESULTS: All previously identified high-grade abnormalities on the Pap tests were detectable on the digital images. β-globin was detected in all extracted Pap tests, indicating the presence of recoverable, amplifiable DNA. A total of 62 (71.3%) and 59 (67.8%) tests were found to have high-risk (HR) HPV detected on PreservCyt and fixed Pap test slides, respectively, with >87% concordance for the detection of HR HPV genotypes. Complete HPV genotyping concordance was observed in 62% and was partial in 26% of sample pairs, with very good agreement for HPV types 16 and 18 (κ = 0.850 and 0.903, respectively). Only 1 Pap test slide was found to be positive whereas the PreservCyt had no detectable HPV DNA, demonstrating a low false-positive rate (1%). CONCLUSIONS: The results of the current study confirm that imaging and subsequent HPV detection and genotyping in archival cervical smears can offer accuracy in HPV detection that is comparable to endocervical brush-collected PreservCyt samples. Cancer (Cancer Cytopathol) 2010;. © 2010 American Cancer Society.

Objective To describe the epidemiology of infection with the human immunodeficiency virus type 1 (HIV-1) in Victoria from 1980 to 1991. Design Data on HIV-1 infection in Victoria, obtained through routine laboratory-based surveillance, were entered in a database. Missing information was sought by contacting the referring doctor where possible. Setting In Victoria, the acquired immunodeficiency syndrome (AIDS) is notifiable to Health Department Victoria by diagnosing doctors, and laboratories are required to notify new diagnoses of HIV-1 infection, without identifiers. All confirmatory testing for HIV-1 has taken place at the State HIV Reference Laboratory at Fairfield Hospital. Main outcome measures Diagnoses of HIV-1 infection, as confirmed at the State HIV Reference Laboratory by western blot immunoassay, and notifications of AIDS to Health Department Victoria. Results Over six years the annual number of diagnoses of HIV-1 infection in Victoria remained constant despite a substantial increase in the number of tests performed. To the end of 1991, 2679 people had been diagnosed with HIV-1 infection, 686 of whom had developed AIDS. Information on exposure was available for 2379 (88.8%). Homosexual and bisexual men made up 75.5% (85.0% of those for whom exposure had been ascertained); 3.4% were female or heterosexual male injecting drug users; and 3.7% were heterosexuals with no history of injecting drug use. The latter two groups contributed 2.0% in 1985 to the proportion of all new diagnoses for which exposure was known, and 14.3% in 1991; for recipients of contaminated blood or blood products before 1985 this proportion fell from 12.4% to 1.0%. The cumulative incidence of HIV-1 diagnoses was highest in the age group 25-29 years, and 20% of all HIV-1 infected people were under 25 at the time of diagnosis. In 1991, 81 of the 311 people who had been diagnosed with HIV-1 infection had had previous negative or indeterminate results of tests; half of these had acquired infection in the previous year. Conclusion Most HIV-1 infections in Victoria have been acquired through male homosexual contact, with a small but increasing proportion of diagnoses occurring in heterosexuals. Laboratory-based surveillance of voluntary testing, despite its limitations, has provided valuable information on the extent of the HIV-1 epidemic in Victoria. Surveillance of all HIV-1 test results and of seroconverters now supplements routine surveillance of HIV diagnoses and will ensure a more accurate picture of the epidemic in coming years.

The purpose of this project is to identify ovarian cancer susceptibility genes involved in stromal-epithelial cross talk. We have now genotyped 2138 samples for 1536 tagging, non-synonymous and miRNA binding site SNPs in 174 genes. Following Quality Control exclusions, the final dataset comprised 1839 samples (675 cases and 1164 controls) with genotype information for 1292 SNPs in 174 genes. We are using P(trend) values to select 25-30 SNPs for independent validation in ~2000 cases and ~4000 controls from other sites. Four of these SNPs will also be genotyped by the whole of the Ovarian Cancer Association Consortium (OCAC) (~4500 case and ~6500 controls). Currently our most significant finding is for a SNP in the podocalyxin-like (PODXL) gene for which the P(trend) = 0.0001, with a Positive Predictive Value of 33 %, and a Homozygote OR = 1.75 (95% CI 1.28-3.38).