Changing the Cervical Screening Paradigm in Malaysia: Program ROSE

4 October 2018 – Malaysia is a country with high human development, as defined by the UN Development Program, and it has low maternal mortality and under-5 mortality rates – key indicators of the strong state of its health system. Health care facilities are readily accessible to women, and campaigns have urged women to be screened for cervical cancer, yet uptake of screening is low. Cervical cancer is preventable and treatable if caught early, but an estimated 944 Malaysian women will die of it in 2018.

The founders of Program ROSE (launched as Project ROSE, Removing Obstacles in Cervical Screening) sought and found a way to improve screening rates and reduce the burden of cervical cancer in Malaysia. Led by Prof. Dr. Woo Yin Ling of the University of Malaya,Assoc. Prof. Marion Saville of VCS Limited, and the Malaysian Ministry of Health, Program ROSE addresses the particular barriers to cervical cancer screening in the Malaysian context.

The Program ROSE solution to those barriers is innovative in several ways:

  • It features self-sampling by women rather than sample collection by health care professionals.
  • Instead of the Pap diagnostic test for abnormal cervical cells—commonly used in high-income countries—it involves DNA testing for the virus that causes most cases of cervical cancer, human papillomavirus (HPV).
  • It uses a digital e-Health platform for high connectivity to participants and real-time reporting. Women receive their screening results via a message to their mobile phone within one day, usually within a couple of hours. The technology helps ensure follow-up to women with positive results, and supports collection of statistics to help target cervical cancer services.

According to the Program ROSE team, their work “is informing the roadmap for implementation and scale-up of a phased, feasible, cost-effective and sustainable national cervical cancer screening program” to complement what is considered a very successful HPV vaccination program in Malaysia.

“ROSE has been deployed in five major community clinics in Malaysia (each attending up to 1000 patients/day) and the response has been phenomenal,” stated Dr. Woo. “It’s highly acceptable to the patients” and health care professionals. In addition to its potential to reduce Malaysia’s cervical cancer burden, Dr. Woo also believes the Program ROSE solution could be adapted for other countries.

For more information on Program ROSE, visit their website:

Byline: Jennie Aylward