In the year 1940

In the year 1940, the predominant cause of death of women in the childbearing age was cancer of the cervix.
Dr. George Nicholas Papanicolaou and Dr. Herbert F Traut collaborated together to explain how normal and abnormal cervical and vaginal cells could be identified through a microscope and how they can be classified. The straightforward procedure is now popular as Pap smear test which became the gold standard in the early diagnose of cervical cancer or cervical cancer screening. (Tan & Tatsumura, 2015)
Cervical cancer is one type of cancer that happens in the cells that located at the lower part of the uterus which links to the vagina. This type of cancer becoming one of the most recurrent worldwide malignant cancer in women and a significant common health problem. This cancer is typically asymptomatic in the early stage and also known as “silent” cancer. In Malaysia, Cervical cancer is the second most common malignancy in women which consists 12.9% of total female cancers. (Seng, L. M., Rosman, A. N., Khan, A., Haris, N. M., Mustapha, N. A. S., Husaini, N. S. M., & Zahari, N. F., 2018)
The etiology of the cervical cancer is genital human papilloma virus (HPV) infection. This infection is very common among women that is sexually active with multiple partners which lead to benign and malignant cancer of the cervix. (Koutsky, 1997) However, the early diagnosis and therapy of preneoplastic lesion stage progression to cervical cancer can be prevent.(Burd, 2003) The neoplasm cells can be easily diagnosed if the women regularly having Pap smear screening test. (Nor Hayati, 2002)
There are various programs that was established by Ministry of Health Malaysia involving public health programs that control and curb cervical cancer. Those programs including free screening of Cervical intraepithelial neoplasia (CIN) via Pap smear test, campaign and advertisement, as well as free Human Papilloma Virus (HPV) vaccination to student of the age 14. (Seng et al., 2018)
It is a prime concern for sexually active women who is more than 35 years old, have children, have been doing contraception for more than five years for family planning, and sexually transmitted diseases patients are recommended to undergo Pap smear test annually in the first two years and followed by once in three years.(Chee, Rashidah, Shamsuddin, & Intan, 2003)
Despite the fact that the Pap smear is well-known as one of the successful methods to diagnose the cervical cancer, the childbearing age women are still hesitating to undergo the test due to several barriers. They do not want to participate in Pap smear screening test because of lack of awareness, skepticism, the fear of being diagnosed with cervical cancer, abdominal discomfort after Pap smear, and painful feeling during the test. Indeed, the main barriers of this matter are insufficient knowledge about Pap test, awkwardness, and fear of cancer detection.(Ashtarian, Mirzabeigi, Mahmoodi, & Khezeli, 2017)