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Colorectal cancer: Most common cancer in men

KUALA LUMPUR: Colorectal cancer (CRC) is the most common of cancer types among men and the second most common among women in Malaysia at a prevalence of 13.2 per cent, as reported in the Malaysian National Cancer Registry Report (2007 – 2011).

Statistics showed that the incidence of the disease is highest among the Chinese, followed by Malays and Indians. The figures also revealed that the mortality rate for males was 1.42 times higher as compared to females.

The most common symptoms of the disease are altered bowel habit (41.7 per cent) followed by blood in stool (35.5 per cent), abdominal pain, (31.5 per cent), weight loss (31.0 per cent), anaemia (9.8 per cent) and intestinal obstruction (9.3 per cent).

These alarming figures were revealed by Health director-general Datuk Dr Noor Hisham Abdullah at the launch of the Clinical Practice Guidelines (CPG), which is the first of its kind handbook on the management of colorectal carcinoma at Hospital Selayang, today.

“Unfortunately, a majority of patients are at stage three and four (54.36 per cent), while only 8.4 per cent are diagnosed at stage one when they seek medical assistance.

He said some of the main causes in the rise of the disease was due to the unhealthy Malaysian lifestyle, in particular, the consumption of too much red meat and processed food, as well as the low intake of fibre.

“Genetics, consuming alcohol, smoking and lack of exercise are also contributing risk factors,” Dr Noor warned.

He pointed out that with the ever increasing number of new cases detected every year, the economic burden of CRC management is escalating especially if the patients are at the advanced stage.

“Hence, the introduction of screening programmes should be undertaken for early detection of the cancer which can ultimately reduce the economic burden of CRC, to the individual, family and country.

“Today, the estimated societal cost of CRC management in government hospitals in Malaysia using conventional chemotherapy ranges between RM13,622 and RM27,163 based on different stages, with an average of RM21,377 per patient. Early detection will not only save lives but also ease financial burden.

Among those present at the launch were colorectal specialist and chairman of the CPG steering committee Dr Nil Amri Mohamed Kamil and Hospital Selayang director Dr Sakinah Alwi.

“One of the objectives of the CPG is to assist family medicine specialists and other primary care providers in providing structured screening and referral programmes according to the symptoms and risk stratification.

“In addition, it is hoped that CPG will help to reduce the variation in clinical practice in management of patients namely diagnosis, staging, treatment and follow-up,” said Dr Nil.

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