The Implementation of a Primary HPV Self-Testing Cervical Screening Program in Malaysia through Program ROSE-Lessons Learnt and Moving Forward
Open accessAbstract
Program ROSE (removing obstacles to cervical screening) is a primary HPV-based cervical screening program that incorporates self-sampling and digital technology, ensuring that women are linked to care. It was developed based on the principles of design thinking in the context of Malaysia. The program illustrates the importance of collaborative partnerships and addressing the multi-faceted barriers from policy changes, and infrastructure readiness to the implementation of a radically new cervical screening program in communities. The paradigm shift in cervical cancer requires a monumental and concerted effort in educating both the healthcare providers and the general public. In this short review, we highlight how Pilot Project ROSE incorporated evidence-based tools that rapidly scaled up to Program ROSE. These ideas and solutions can be adapted and adopted by other countries. Notwithstanding the impact of COVID-19, it is incumbent on countries to pave the road towards the elimination of cervical cancer with pre-existing footpaths.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
canSCREEN has been successfully used in projects in other low- and middle-income countries including Papua New Guinea, Malaysia, Kenya and Vanuatu.
“canSCREEN has been successfully used in projects in other low- and middle-income countries including Papua New Guinea, Malaysia, Kenya and Vanuatu.33 35”
From Protocol for a cervical screening implementation trial comparing two approaches for delivering HPV self-collection in low-resource settings in India: a type 3 hybrid cluster randomised controlled trial (SHE-CAN) (2025) · cites this paper as [35]
Section 4.3 says canSCREEN powered Program ROSE’s digital registry in Malaysia and helped staff identify participants overdue for follow-up. Section 5 reports the program’s screening reach and linkage to care. The paper does not report canSCREEN projects in Papua New Guinea, Kenya or Vanuatu, so it supports the Malaysia example but not the full country list. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Human papillomavirus and cervical cancer
Burd, E. M. (2003) · Clinical Microbiology Reviews · doi:10.1128/cmr.16.1.1-17.2003 · Cited by 2,420 · see citing works
Ronco, G., Dillner, J., Elfström, K. M., Tunesi, S., Snijders, P. J. F., Arbyn, M., Kitchener, H., Segnan, N., Gilham, C., Giorgi-Rossi, P., et al. (2014) · The Lancet · doi:10.1016/s0140-6736(13)62218-7 · Cited by 1,810 · see citing works
Brisson, M., Kim, J. J., Canfell, K., Drolet, M., Gingras, G., Burger, E. A., Martin, D., Simms, K. T., Bénard, É., Boily, M.-C., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30068-4 · Cited by 943 · cited 1× · see citing works
“Indeed, even two tests in a lifetime, provided these are spaced by at least 10 years, will have significant impact on cervical cancer incidence and mortality [29,30].”
BackgroundArbyn, M., Smith, S. B., Temin, S., Sultana, F., & Castle, P. (2018) · BMJ · doi:10.1136/bmj.k4823 · Cited by 851 · cited 1× · see citing works
“The rapid development of HPV testing platforms that are validated for population screening supplemented by the ease of obtaining a sample through self-testing has nothing been short of revolutionary [40,41].”
BackgroundMeijer, C. J. L. M., Berkhof, J., Castle, P. E., Hesselink, A. T., Franco, E. L., Ronco, G., Arbyn, M., Bosch, F. X., Cuzick, J., Dillner, J., et al. (2009) · International Journal of Cancer · doi:10.1002/ijc.24010 · Cited by 692 · see citing works
Canfell, K., Kim, J. J., Brisson, M., Keane, A., Simms, K. T., Caruana, M., Burger, E. A., Martin, D., Nguyen, D. T. N., Bénard, É., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30157-4 · Cited by 650 · see citing works
Benefits and Costs of Using HPV Testing to Screen for Cervical Cancer
Mandelblatt, J. S. (2002) · JAMA · doi:10.1001/jama.287.18.2372 · Cited by 302 · see citing works
Trends of cervical cancer mortality in the member states of the European Union
Arbyn, M., Raifu, A. O., Weiderpass, E., Bray, F., & Anttila, A. (2009) · European Journal of Cancer · doi:10.1016/j.ejca.2009.07.018 · Cited by 298 · see citing works
2020 list of human papillomavirus assays suitable for primary cervical cancer screening
Arbyn, M., Simon, M., Peeters, E., Xu, L., Meijer, C. J. L. M., Berkhof, J., Cuschieri, K., Bonde, J., Ostrbenk Vanlencak, A., Zhao, F.-H., et al. (2021) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2021.04.031 · Cited by 284 · see citing works
Ogilvie, G. S., van Niekerk, D., Krajden, M., Smith, L., Cook, D. A., Gondara, L., Ceballos, K. M., Quinlan, D., Lee, M. H., Martin, R. E., et al. (2018) · JAMA · doi:10.1001/jama.2018.7464 · Cited by 283 · see citing works
Towards the global elimination of cervical cancer
Canfell, K. (2019) · Papillomavirus Research · doi:10.1016/j.pvr.2019.100170 · Cited by 240 · see citing works
VALGENT: a protocol for clinical validation of human papillomavirus assays
Arbyn, M., Depuydt, C., Benoy, I., Bogers, J., Cuschieri, K., Schmitt, M., Pawlita, M., Geraets, D., Heard, I., Gheit, T., et al. (2016) · Journal of Clinical Virology · doi:10.1016/j.jcv.2015.09.014 · Cited by 157 · see citing works
Human papillomavirus vaccination uptake in low-and middle-income countries: a meta-analysis
Dorji, T., Nopsopon, T., Tamang, S. T., & Pongpirul, K. (2021) · EClinicalMedicine · doi:10.1016/j.eclinm.2021.100836 · Cited by 143 · see citing works
Removing global barriers to cervical cancer prevention and moving towards elimination
Alfaro, K. M., Maza, M., Cremer, M., MASCH, R. J., & Soler, M. (2021) · Nature reviews. Cancer · doi:10.1038/s41568-021-00396-4 · Cited by 80 · see citing works
Stanczuk, G. A., Baxter, G. J., Currie, H. D., LAWRENCE, J. R., Cuschieri, K. S., Wilson, A., & Arbyn, M. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-010660 · Cited by 80 · see citing works
Zhao, S., Huang, L., Basu, P. S., Domingo, E. J., Supakarapongkul, W., Ling, W. Y., Ocviyanti, D., Rezhake, R., Qiao, Y., Tay, E. H., et al. (2021) · Cancer Letters · doi:10.1016/j.canlet.2021.10.036 · Cited by 75 · see citing works
Impact of the Australian National Cervical Screening Program in women of different ages
Smith, M. A., & Canfell, K. (2016) · The Medical Journal of Australia · doi:10.5694/mja16.00289 · Cited by 65 · see citing works
Ma'som, M., Bhoo‐Pathy, N., Nasir, N. H., Bellinson, J., Subramaniam, S., Ma, Y., Yap, S. H., Goh, P., Gravitt, P. E., & Woo, Y. L. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-011022 · Cited by 61 · see citing works
Self-citationChallenges to cervical screening in a developing country: The case of Malaysia.
Othman, N. H., & Rebolj, M. (2009) · PubMed · Cited by 60 · see citing works
Khoo, S. P., Lim, W. T., Rajasuriar, R., Nasir, N. H., Gravitt, P. E., & Woo, Y. L. (2020) · Cancer Prevention Research · doi:10.1158/1940-6207.capr-20-0280 · Cited by 38 · see citing works
Self-citationRomero, C., de Albuquerque, R. D. C. R., Loureiro, R. B., Gollner, Â. M., de Freitas, M. G., Duque, G. P. D. N., & Viscondi, J. Y. K. (2022) · Clinics · doi:10.1016/j.clinsp.2022.100080 · Cited by 33 · see citing works
The impact of the COVID-19 pandemic on the national HPV immunization program in Malaysia
Rao, S. R., Kampan, N. C., Chew, K. T., & Shafiee, M. N. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.907720 · Cited by 18 · see citing works
Yong, C. J., Hong, L. L., Lee, K. Y., Krishnasamy, I., Nasir, N. H. B., Gravitt, P. E., Lee, Y.-E., & Woo, Y. L. (2018) · Journal of Global Oncology · doi:10.1200/jgo.18.86300 · Cited by 6 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 3
- [10]Quek D. The Malaysian Health Care System: A Review Proceedings of the Intensive Workshop on Health Systems in Transition Kuala Lumpur, Malaysia 29–30 April 2009
- [24]Parliament of Malaysia: House of Representatives Proceedings of the Parliamentary Business of the 3rd Session of Fourteenth Parliament 2020, 2nd Meeting Kuala Lumpur, Malaysia 13 July–27 August 2020
- [27]World Health Organization WHO Guideline for Screening and Treatment of Cervical Pre-Cancer Lesions for Cervical Cancer Prevention 2nd ed. WHO Geneva, Switzerland 2021 34314129
Cited by
Sorted by citations
Daponte, N., Valasoulis, G., Michail, G., Magaliou, I., Daponte, A.-I., Garas, A., Grivea, I., Bogdanos, D. P., & Daponte, A. (2023) · Cancers · doi:10.3390/cancers15061669 · Cited by 84 · see citing works
Self-sampling for HPV testing in cervical cancer screening: A scoping review
Colonetti, T., Uggioni, M. L. R., dos Santos, A. L. M., Uggioni, N. M., Elibio, L. U., Balbinot, E. L., Grande, A. J., & da Rosa, M. I. (2024) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2024.02.032 · Cited by 32 · see citing works
Wilailak, S., Kengsakul, M., & Kehoe, S. T. (2025) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.70276 · Cited by 31 · see citing works
Kundrod, K. A., Jerónimo, J., Vetter, B., Maza, M., Murenzi, G., Phoolcharoen, N., & Castle, P. E. (2023) · PLOS Global Public Health · doi:10.1371/journal.pgph.0001982 · Cited by 22 · see citing works
Gomes, M., Provaggi, E., Pembe, A. B., Olaitan, A., & Gentry‐Maharaj, A. (2025) · Diagnostics · doi:10.3390/diagnostics15091176 · Cited by 19 · see citing works
Brotherton, J. M. L., Vajdic, C. M., & Nightingale, C. E. (2025) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1080/14737167.2025.2451732 · Cited by 14 · see citing works
Anis-Syakira, J., Balqis-Ali, N. Z., Tang, K. F., Fun, W. H., Samad, S. A., Jahaya, R., Subakir, N. N., Ismail, R., Said, Z. M., & Sararaks, S. (2023) · BMC Public Health · doi:10.1186/s12889-023-17132-2 · Cited by 10 · see citing works
Ngu, S., Lau, L. S. K., Chan, C. Y., Ngan, H., Cheung, A., & Chan, K. K. (2024) · BMC Public Health · doi:10.1186/s12889-024-18551-5 · Cited by 8 · see citing works
COVID-19 as a catalyst for reimagining cervical cancer prevention
Luckett, R. L., Feldman, S., Woo, Y. L., Moscicki, A., Giuliano, A. R., de Sanjosé, S., Kaufmann, A. M., Leung, S. O. A., Garcia, F., Chan, K., et al. (2023) · eLife · doi:10.7554/elife.86266 · Cited by 8 · see citing works
Self-citationEnhancing equity in cervical screening – initiatives to increase screening participation
Costa, T., Bateson, D. J., & Woo, Y. L. (2024) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/gco.0000000000000979 · Cited by 8 · see citing works
Self-citationCervical Cancer Elimination in Australia and the Asia Pacific: Progress and Barriers
Yuill, S., Naidu, C., Smith, M., Bateson, D. J., Saville, M., Damutalau, B., & Canfell, K. (2026) · The Medical Journal of Australia · doi:10.5694/mja2.70164 · Cited by 5 · see citing works
Self-citationSurvival rates of cervical cancer patients in Sarawak: a single-centre referral study
Lim, M. S. H., Tan, S. S. N., Maharuddin, I. B. W., Voon, P. J., Rahim, N. K. B. A., Tiong, X. T., Chee, C. K. L., Ismail, A. M., & Augustin, Y. S. (2025) · BMC Cancer · doi:10.1186/s12885-025-14678-9 · Cited by 4 · see citing works
Rakhat, A., Marat, А., Sakhipova, G., Sakko, Y., & Aimagambetova, G. N. (2026) · Sci · doi:10.3390/sci8010005 · Cited by 4 · see citing works
Luckett, R. L., Ramogola‐Masire, D., Harris, D. A., Gompers, A. D., Gaborone, K., Mochoba, L., Ntshese, L., Mathoma, A., Kula, M., Shapiro, R., et al. (2024) · Frontiers in Global Women s Health · doi:10.3389/fgwh.2023.1300788 · Cited by 4 · see citing works
Design thinking in cancer care: A systematic literature review
Memon, M. M., Carroll, N., & Crowley, K. (2025) · Digital Health · doi:10.1177/20552076241313279 · Cited by 3 · see citing works
Ng, X. R., Quek, I. P., Pereira, M. J., Molina, J. A., Tan, K. E., Ngeow, J. Y. Y., & Wong, S. K. W. (2026) · The Annals of Family Medicine · doi:10.1370/afm.250683 · Cited by 3 · see citing works
Mohamad, N. A. N., & Omar, J. (2024) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.16031 · Cited by 3 · see citing works
Padolina, C. S., & Toral, J. A. B. (2024) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.16032 · Cited by 2 · see citing works
Balqis-Ali, N. Z., Anis-Syakira, J., Fun, W. H., Said, Z. M., Samad, S. A., Abidin, N. Z., Zulkepli, J. H., Ahmad, N., Abas, M. N. M., Yong, C. M., et al. (2024) · PLoS ONE · doi:10.1371/journal.pone.0307880 · Cited by 2 · see citing works
Oommen, A. M., Ashfaq, M., Tonsing, M. V., Cherian, A. G., Singarayar, P., Viswanathan, V., Muniswamy, V., Hawkes, D., Abraham, P., Pricilla, R. A., et al. (2025) · BMJ Open · doi:10.1136/bmjopen-2025-101599 · Cited by 1 · see citing works
Self-citationNg, X. R., Quek, I. P., Pereira, M. J., Molina, J. A. D. C., Ngeow, J. Y. Y., & Wong, S. K. W. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-095091 · Cited by 1 · see citing works
Gaspar, P. C., Machado, H. D. M., Bazzo, M. L., Scherer, A., Colusso, Á. L., Travassos, A. G., Arakaki-Sánchez, D., Baia-da-Silva, D. C., de Oliveira, E. C., Zago, I. R., et al. (2024) · Jornal Brasileiro de Doenças Sexualmente Transmissíveis · doi:10.5327/dst-2177-8264-2024361499 · Cited by 1 · see citing works
The profile of cervical dysplasia and cervical cancer of patients at MRCCC siloam Hospital Semanggi
Panjaitan, A. O., Susanto, J. D., Gultom, F. L., & Sirait, B. I. (2023) · World Journal of Biology Pharmacy and Health Sciences · doi:10.30574/wjbphs.2023.13.1.0263
Gearing up for implementation of self-sampled HPV-DNA screening test for cervical cancer in India
Kant, L. (2023) · Current Medicine Research and Practice · doi:10.4103/cmrp.cmrp_75_23
Self-testing for human papillomavirus as a screening method for identifying risk groups
Александровна, Г. Т., Levakov, S. A., & Мушкюрова, Д. Р. (2024) · Clinical Medicine (Russian Journal) · doi:10.30629/0023-2149-2024-102-5-6-415-421
Thapa, S., Davies, J. C., Crosbie, E. J., Payne, K., & Wright, S. J. (2025) · BMJ Open · doi:10.1136/bmjopen-2025-101800
Jailani, A.-S., Balqis-Ali, N. Z., Tang, K. F., Fun, W. H., Samad, S. A., Jahaya, R., Subakir, N. N., Ismail, R., Said, Z. M., & Sararaks, S. (2024) · Figshare · doi:10.6084/m9.figshare.26639635
Jailani, A.-S., Balqis-Ali, N. Z., Tang, K. F., Fun, W. H., Samad, S. A., Jahaya, R., Subakir, N. N., Ismail, R., Said, Z. M., & Sararaks, S. (2024) · Figshare · doi:10.6084/m9.figshare.24564236
Jailani, A.-S., Balqis-Ali, N. Z., Tang, K. F., Fun, W. H., Samad, S. A., Jahaya, R., Subakir, N. N., Ismail, R., Said, Z. M., & Sararaks, S. (2024) · Figshare · doi:10.6084/m9.figshare.26639632
Jailani, A.-S., Balqis-Ali, N. Z., Tang, K. F., Fun, W. H., Samad, S. A., Jahaya, R., Subakir, N. N., Ismail, R., Said, Z. M., & Sararaks, S. (2023) · Figshare · doi:10.6084/m9.figshare.24564192
Reasons and Barriers for Pap Smear Screening Among Women in Puncak Alam, Selangor
Isa, R., Ramli, N. A. A., Hairudin, M. A., Fauzi, R., & Isa, S. N. I. (2025) · Malaysian Journal of Medicine and Health Sciences · doi:10.47836/mjmhs.21.3.9
Minimum data set for implementing a registry for women infected with human papillomavirus
Eslamlo, S. F., Jebraeily, M., Ghasemnejad‐Berenji, H., Tabrizi, F. M., & Ayatollahi, H. (2025) · Journal of Health Administration · doi:10.66224/jha.28.3.13
Andreasen, E. K., Arum, A., Pedersen, H., Nielsen, T. D., Frandsen, P., Pedersen, B. T., Serizawa, R., & Bonde, J. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-112643
Harris, D. A., Toledo, R. G., Hacker, M. R., Wamakima, B. W., Sedabadi, L., Gaborone, K., Mochoba, L., Ntshese, L., Grover, S., Shapiro, R., et al. (2026) · AIDS · doi:10.1097/qad.0000000000004551
Balasubramani, L., Madhivanan, P., Anand, M., Gupta, M., Kumar, P. G., Shankar, A., & Krishnan, S. S. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1906243
Wongsuwan, H., Kittisiam, T., & Techapoonpon, K. (2026) · International Journal of Behavioral Medicine · doi:10.1007/s12529-026-10496-w
Volume 10, Supplementary 3 (2026)
Editorial Team IJAHS (2026) · INTERNATIONAL JOURNAL OF ALLIED HEALTH SCIENCES · doi:10.31436/ijahs.v10isupp3.1185
- Authors
- Woo, Y. L., Khoo, S. P., Gravitt, P., Hawkes, D., Rajasuriar, R., & Saville, M.
- Affiliations
- University of Malaya (MY)
- National Institutes of Health (US)
- Australian Centre for the Prevention of Cervical Cancer (AU)
- Corresponding author
- Woo, Yin Ling
- Venue
- Current Oncology
- Publisher
- MDPI AG
- Published
- 2022-10-02
- Volume
- 29
- Issue
- 10
- Pages
- 7379-7387
- ISSN
- 1198-0052 (ISSN-L)
- 1718-7729
- PMC
- PMC9600851
- OpenAlex
- W4303628943
- Cited by
- 35
- References
- 23
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 12 · 2023: 7
- FWCI
- 1.15
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Current Oncology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- HPV self-testing, cervical cancer screening, self-sampling, digital health technologies, design thinking, cervical cancer elimination, Malaysia
- MeSH terms
- Self-Testing, COVID-19, Uterine Cervical Neoplasms, Female, Humans, Malaysia, Pilot Projects, Papillomavirus Infections, Early Detection of Cancer
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
