Experts call for early screening to lower colorectal cancer incidence

An expert-led public forum highlighted colorectal health awareness and early screening of people aged 45 and above, as key steps to reduce the burden of colorectal cancer (CRC) in Malaysia.

CRC is the second most common cancer and the third leading cause of cancer-related deaths in Malaysia. About 70 percent of cases are diagnosed at stage III or IV where treatment is more complicated, and the outcome is poorer. [National Strategic Plan for Colorectal Cancer 2021-2025] Lack of public awareness, low screening participation rates, reliance on traditional medicine, misperceived risk, emotional barriers, and negative attitudes contribute to delayed case presentations. [BMC Cancer 2020;20(1):252; Asian J Surg 2017;40(6):481–489]

Above all, more than 90 percent of CRC cases in Malaysia occur in individuals aged 40 and above, underscoring the importance of early screening as a preventive measure. Early-stage CRC is frequently asymptomatic, thus remaining vigilant for any potential symptoms and early screening followed by treatment may improve outcomes and reduce its burden. Screening aims to detect CRC early for better treatment outcomes, prevent mortality, and even stop cancer development by identifying and removing precancerous growths or polyps. [Available at: http://www.myhealth.gov.my/en/colorectal-cancer/. Accessed on 21 July 2023.]

The forum, which was held recently at Sunway University and supported by EP Plus Group, featured a panel of distinguished healthcare experts and moderated by Professor Dr Raja Affendi Raja Ali, Dean of the School of Medical and Life Sciences at Sunway University. The forum covered various aspects of CRC including early screening protocols, identifying risk factors, exploring treatment options and proactive measures individuals can take to prevent its onset.

“Colorectal cancer offers immense potential for early detection. When we identify it at its nascent stage, the probability of successful treatment increases significantly. Screening, the cornerstone of this battle, is an effective approach that can detect precancerous polyps and early-stage cancers,” said Raja Affendi.

He added that the prevailing misconceptions that surround CRC, especially the discomfort associated with the screening procedures such as colonoscopy, should be discussed with patients. This is to improve the uptake of regular CRC screening among all people aged 45 and above while those with a family history of CRC and/or specific genetic disorders such as familial adenomatous polyposis (FAP), Peutz-Jeghers syndrome, or Lynch syndrome, should be considered for screening at a younger age based on their individual risk factors.

The forum was officiated by Dr Nor Saleha Ibrahim Tamin, Senior Principal Assistant Director at the Ministry of Health Malaysia, who said: “This disease knows no boundaries when it comes to age … we are observing a distressing pattern with a growing number of cases among younger individuals, which further compounds the economic burden of this disease in our country.”