Closing The Care Gap

Cancer is the leading cause of death around the world. In 2020, it was responsible for 10 million deaths, or about 1 in 6 deaths. In the same year, there were 29,530 cancer deaths, which contributed to 15.4% of medically certified deaths in Malaysia. If all deaths had been medically confirmed, the proportion of cancer-related mortality would be higher (1).

By 2040, the number of cancer cases in Malaysia is expected to double. The growing number of cancer cases will become a major health problem as it has a significant impact on the community and the country’s health care system (2).

In view of the disease burden of cancer, World Cancer Day is established to raise public awareness of cancer and to increase efforts to improve access to quality care, screening, early detection, treatment, and palliative care. The theme for 2023 is “Closing the Care Gap”, which is about identifying disparities in cancer care and taking action to make the required effort to overcome them. Urgent action is needed to increase cancer screening, detection, and diagnosis in the early stages to improve cancer patient’s chances of survival.

Certain cancer treatments (such as chemotherapy, radiation therapy, and surgery) or cancer itself can suppress or weaken the immune system. During the COVID-19 pandemic, cancer patients are at higher risk for COVID-19 infection with severe symptoms. The pandemic has also lowered the screening rates due to disrupted screening services which caused patients to present late for treatment. 

Delay diagnosis is associated with a poor prognosis. The five years survival rate for cancer in Malaysia is 65% compared with the US of 90.2% and Singapore’s 81%. Even though Malaysia is an upper-middle-income country with a good healthcare system, the cancer survival rates are still below the average of developed nations. This may be due to challenges such as poor cancer awareness and low screening rates, delays in cancer detection and diagnosis, and delays in obtaining medical care.

Breast cancer and cervical cancer are two of the main causes of death for cancer patients in Malaysia. However, the number of individuals who receive screenings is far short of expectations. Breast cancer screening ranged between 3.6% and 30.9% in the general population, and 80.3% among the medical personnel. A lack of understanding of the importance of regular cancer screening, and a lack of support from family members are among the causes of the low response to cancer screening (3).

In conjunction with World Cancer Day (on 4 February 2023), let’s unite to close the gap in cancer care through regular cancer screening.

This article was written by Dr Soh Yih Harng, DrPH candidate, and Professor Dr Moy Foong Ming, Centre for Epidemiology & Evidence-Based Practice, Department of Social Preventive Medicine, Faculty of Medicine, University Malaya.

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  1. Schliemann, D., Ismail, R., Donnelly, M. et al. Cancer symptom and risk factor awareness in Malaysia: findings from a nationwide cross-sectional study. BMC Public Health 20, 464 (2020).
  2. International Agency for Research on Cancer. Malaysia.
    Date accessed: Feb 2, 2023
  3. Aidalina M, Syed Mohamed ASJ. The uptake of Mammogram screening in Malaysia and its associated factors: A systematic review. Med J Malaysia. 2018 Aug;73(4):202-211. PMID: 30121682.

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