KUALA LUMPUR, March 14 — Malaysia clocks around 3,000 new colorectal cancer cases every year.
About two-thirds of the cases are diagnosed at late stages, resulting in limited and more expensive treatment options.
University of Malaya Faculty of Medicine dean Professor Dr April Camilla Roslani said this trend has persisted for the last 20 years despite the government’s efforts to promote early detection through opportunistic screening programmes.
“Colorectal cancer is the most common cancer among males in Malaysia and the second most common cancer among females after breast cancer.
“This is a very worrying trend especially since Malaysia is becoming an ageing nation.
“And, it is also unfortunate because colorectal cancer is preventable at the pre-malignant stage and highly curable if caught in early stages,” said Dr April, a professor and senior consultant colorectal surgeon at the faculty’s surgery department.
She said those aged 50 and above are categorised as average risk group and must undergo colorectal cancer screening even if they have no obvious risk factors.
Most people, she said, are reluctant to undergo screening especially if they do not present any symptoms.
“The colon and rectum are like stretchable tubes. So, tumours can grow to a quite large size in there without causing symptoms.
“Most patients come to the doctor when they experience difficulty or bleeding during bowel movement.
“But, this indicates the cancer has already entered advanced stages,” she said.
Some people, she said, also avoid colonoscopy due to concerns about pain or that they may suffer bleeding or perforation although these risks are extremely low.
Yearly self-screening vital
Here’s where home bowel test kits play an important role, said Dr Chieng Jin Yu, an internal medicine, gastroenterology and hepatology consultant physician at Pantai Hospital Ampang.
“Self-screening using home bowel test kits is not an invasive procedure and therefore, has no risk of bleeding or perforation.
“So, those in the average risk group should do the test yearly, and if they test positive, they must undergo colonoscopy.
“Those with higher risk factors, like a strong family history with colorectal cancers, should directly undergo colonoscopy,” he said.
Echoing his views, Dr April stressed that those who clear the home bowel test must still repeat it yearly because it is an indirect test.
“The test only looks for microscopic amounts of blood that could have come from cancer, and does not identify cancer tissues.
“Meanwhile, those who clear the colonoscopy only have to repeat it every five to 10 years because that is how long it takes for the cancer to grow,” she said.
She said the home bowel test kits are available in primary care departments in public hospitals and governmental clinics as well as private medical labs.
The kits, Dr April says, come with an instruction sheet and the testing concept is somewhat similar to the Covid-19 self-test kits.
Younger ones with sedentary lifestyles at risk too
Citing local data, Dr April pointed out that about 10-15 per cent of colorectal cancer cases in Malaysia occur in individuals below the age of 50.
These cases, she said, are sporadic ones and are not linked to hereditary cancer syndromes.
Noting a similar trend in other parts of the world, Dr Chieng said countries like the United States have lowered the screening age for colorectal cancer from 50 to 45.
Dr Chieng advised those below 50 to reduce consumption of red meat and adopt a high-fibre diet which includes whole grains, beans and nuts to prevent constipation.
“And, avoid smoking and alcohol which increases your risk of developing cancers,” he said.
