2023
Estimating excess mortalities due to the COVID-19 pandemic in Malaysia between January 2020 and September 2021. Jayaraj VJ, Chong DWQ, Wan KS, et al, Scientific Reports.
This study aimed to investigate levels of excess all-cause mortality and their geographic, age, and sex distribution between January 2020 – September 2021. Malaysia had a 5.5 to 23.7% reduction in all-cause mortality across 2020 contrast to 2021 which was 13 to 24%. All states and sexes reported excess trends consistent with the national trends. There was a reduction in mortality rate among people under 15 years and road accident mortalities which was higher during the first Movement Control Order. Overall, in 2020 had a lower all-caused mortality rate compared to 2021.
Proposal for improving access to palliative care by enhancing primary care services in an upper middle-income country. Segarmurthy MV, Lim RBL, Othman S et al, Ecancermedicalscience
This study aimed to determine the accessibility of palliative care services in Malaysia and explore the knowledge, challenges, and opportunities faced by primary care doctors providing palliative care alongside identifying if the minimum standard for palliative care services is clearly defined, available, and achieved in primary care facilities. The expected result is, this mapping study will provide data on the availability and accessibility of palliative care in Malaysia. It will also insights into the experiences and concerns of primary care physicians in providing this service. This study will provide real-world data on the availability of basic palliative care service components in primary care facilities.
Discriminatory Ability and Clinical Utility of the AJCC7 and AJCC8 Staging Systems for Breast Cancer in a Middle-Income Setting. Song C, Gils CH, Yip CH. et al, Diagnostics(Basel).
This study compared the prognostic accuracy of AJCC7 and AJCC8 staging systems in the middle-income setting with limited access to anti-HER2 therapy. A total of 4151 Malaysian women living with breast cancer were staged using the AJCC7 and AJCC8 systems. The study showed changes in the staging during the migration from AJCC7 to the AJCC8 system. 5% of the patients could not be staged using the AJCC8 system. The study also showed this system provided a good prediction of patients’ overall survival rate. The study concluded that AJCC7 is still simpler and more effective to be used in setting with limited resources however the AJCC8 system may offer benefits to patients in routine clinical practice.
Association between pre-existing cardiometabolic comorbidities and the pathological profiles of breast cancer at initial diagnosis: a cross-sectional study Subramaniam S, Kong YC, Yip CH, et al, Ecancermedicalscience.
This article aimed to examine the association between the presence of pre-existing comorbidities and tumor profile at the initial diagnosis of breast cancer. Through analysis of 2501 data of women newly diagnosed with breast cancer, we found that the presence of cardiometabolic conditions such as diabetes mellitus and Low levels of high-density lipoprotein were associated with larger tumors, involvement of a higher number of lymph nodes, distant metastasis, and human epidermal growth factor receptor 2 overexpression. Evidence from this study seems to support the presence of underlying biological mechanisms linking cardiometabolic comorbidities and pathological profiles of breast cancer among women who are newly diagnosed.
Out-of-pocket payments for complementary medicine following cancer and the effect on financial outcomes in middle-income countries in southeast Asia: a prospective cohort study Kong YC, Kimman M, Subramaniam S, et al, Lancet Global Health.
Complementary medicine, which refers to therapies that are not part of conventional medicine, is increasingly used by people with cancer. We determined the out-of-pocket spending patterns on complementary medicine and its association with adverse financial outcomes following cancer among 4754 households in Southeast Asia. We found that expenditures on complementary medicine were significantly associated with increased incidences of financial catastrophe and medical impoverishment. Equally important is the finding that economically disadvantaged households were disproportionately affected by out-of-pocket spending on complementary medicine following a cancer diagnosis, which in turn might put these patients at increased risk of refusing or discontinuing conventional cancer care. Integration of evidence-supported complementary therapies into mainstream cancer care, along with interventions to address the use of non-evidence-based treatments, might potentially alleviate any associated adverse financial impacts.
Development and Validation of a Dual-Language (English and Malay) Needs Assessment Tool for Breast Cancer (NeAT-BC). Kong YC, Danaee M, Kaur R, et al, Diagnostics (Basel).
Prior needs assessment tools for women with breast cancer were largely developed in high-income Western settings with advanced healthcare systems that also provide systematic supportive and survivorship care services. Nonetheless, many of the prior tools tended to focus on a specific domain of need or were developed for patients in a specific phase of their cancer journey. We developed a dual language (English-Malay) needs assessment tool that caters to patients living with breast cancer in multiethnic, middle-income settings. The tool has 48 questions encompassing 5 domains of need spanning a wide spectrum of issues faced along the cancer journey. It takes about 25 minutes to be completed, may be self-administered or interviewer-administered, and was deemed as easily understandable, acceptable, and non-intrusive. Importantly, a rigorous validation exercise that was guided by international standards proved that the tool is reliable and psychometrically sound. The tool may also have wider clinical and research utility in other multi-ethnic settings, as well as within the broader Southeast Asia region.
Translation and validation of the Malay version of the Oxford Happiness Questionnaire in a Malaysian setting. Sinnarajoo N, Kong YC, Rajah HDA, et al, SN Social Sciences, 2023.
Happiness is the degree to which an individual judges the quality of their life as a whole favorably. Given that culture may have a profound impact on the way emotions are displayed, perceived, and experienced, and that these emotional experiences may affect an individual’s level of happiness and the perception of happiness, it is conceivable that there may be differences between the Western settings and Asian settings. While the Western culture emphasizes the individual-oriented self, Asians value belonging to a collective society, and their ideal way of living by valuing the community’s needs has been shown to significantly influence the things that make them happy. The Oxford Happiness Questionnaire (OHQ) was developed as a tool to measure happiness. The aim of this study was to translate and validate a Malay version of the OHQ in Malaysia, which in turn is expected to lead to more happiness-related research in various fields in Malaysia.
2022
Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: a qualitative study Fnu N, Kuan WC, Kong YC et al., Ecancermedicalscience. 2022
This article aimed to explore the out-of-pocket costs, the resulting financial impact, and the coping strategies adopted by cancer survivors in Malaysia, a middle-income country with a government-led tax-funded public health sector, and a predominantly for-profit private health sector. From the study. fice major themes were found: 1) cancer therapies and imaging services, 2) supportive care, 3) complementary therapies, 4) non-medical costs, and 5) loss of household income. Unmet needs in coping with financial distress were higher among the women. The study suggests considering the unmet needs of cancer care which includes the non-health cost of cancer and also the loss of income.
Adolescents and young adults with cancer: Considerations from the Southeast Asian perspective. Dee EC, Eala MAB, Chua MLK, Bray F, Bhoo-Pathy N. Pediatr Blood Cancer. 2022
This article aimed to evaluate the preparedness of the health systems within LMICs in delivering cancer care during the pandemic. From the study, it was found that very few LMICs were ready for this situation with limited guidelines. Three strategies were also suggested in this article to secure cancer care in these countries. All LMICs should have better practices to face the pandemic situation which can avoid future problems for cancer patients.
Priorities for cancer research in low- and middle-income countries: a global perspective. Pramesh CS, Badwe RA, Bhoo-Pathy N et al. Nat Med. 2022
Major focus on cancer research is given n high-income countries, and the issues in the research field of LMICs need to be addressed. Five major issues were identified and addressed in this article. Focusing on these issues will provide a global impact on cancer control. Collaboration and commitment from governments, policymakers, funding agencies, healthcare organizations, researchers, and the public are needed to make this effort a success.
Supporting cancer survivors in LMICs. Kong YC, Eala MA, Bhoo-Pathy N. Lancet, 2022
Amidst the increasing survival rates in many low-middle income countries (LMICs), very little attention has been given to the provision of supportive care and survivorship care in these settings. Data on patient-centered outcomes serve as an important guide for policymakers in prioritizing clinical and supportive care interventions that matter most to cancer patients and their families
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00949-7/fulltext
Cancer-stricken households in the low- and middle-income countries (LMICs) bear a larger brunt of out-of-pocket costs. To address this, interventions are required at four levels. Firstly, at the patient-provider level, culturally sensitive discussions on financial concerns are crucial between the oncology team and patients. At the hospital level, there is a need to integrate financial navigators, counsellors and billing specialist into the multidisciplinary cancer care team. Meanwhile, health systems need to identify best practices for health financing based on their region. Finally, intersectoral cooperation between local and global stakeholders is paramount to improving accessibility to affordable cancer care in LMICs.
https://pubmed.ncbi.nlm.nih.gov/35713589/
Given the rising concern about cancer treatment-associated cardiotoxicities, we examined the time- and treatment-specific incidence of arrhythmia, heart failure, and ischemic heart disease following breast cancer. A register-based matched cohort study was conducted including 8015 women who were diagnosed with breast cancer from 2001 to 2008 in the Stockholm-Gotland region and followed up until 2017. It was demonstrated that compared to the general population, women with breast cancer had increased risks of heart failure, and arrhythmia, which persisted even beyond 10 years after diagnosis. The risk of ischemic heart disease following breast cancer nonetheless appeared to be only transiently elevated in the immediate year after diagnosis. While no increased risk of heart disease was identified following contemporary radiotherapy, receipt of trastuzumab, as well as administration of anthracyclines ± taxane-based regimens, was independently associated with an increased risk of heart failure. Aromatase inhibitors, but not tamoxifen, were associated with the risk of ischemic heart disease. Our findings highlight the urgent, and often unmet need for the establishment of coordinated partnerships between the oncology and cardiology specialties to improve cardiovascular outcomes following breast cancer.
https://pubmed.ncbi.nlm.nih.gov/35293856/
Clinical practice guidelines (CPGs) in cancer provide evidence-based guidance to oncologists on which patients should receive adjuvant treatments such as chemotherapy, radiotherapy, hormone therapy, or targeted therapy following surgery. While previous studies in high-income settings have demonstrated that women with breast cancer who were treated according to CPGs had better survival compared to their counterparts who were not treated according to CPGs, we are unsure if this may also apply to the low- and middle-income countries (LMICs). A key consideration here is that resource-stratified treatment guidelines developed for LMICs may detract from the standard of care in high-income countries. Through a recent study that we undertook in Malaysia, a middle-income country, we found that adherence to the Malaysian CPG for Management of Breast Cancer was fairly high in terms of administration of hormone therapy and radiotherapy. However, only 60% of breast cancer patients with indications for chemotherapy received it, and approximately 25% of patients with indications for targeted therapies were treated accordingly. Importantly, patients who were not treated according to CPGs had poorer survival compared to those treated according to CPGs. Our findings affirm that adherence to treatment guidelines that have been adapted for resource-limited settings may still provide effective guidance in improving breast cancer outcomes.
https://pubmed.ncbi.nlm.nih.gov/35245099/
The practice of using complementary medicine is widely embedded within the local communities in low- and middle-income countries. Likewise, complementary therapies are also highly sought by patients with cancer. Through analysis of data from a very large cohort study in Southeast Asia, we had recently demonstrated that the out-of-pocket costs of complementary medicine may account for a substantial proportion of the overall health expenditures made by cancer-stricken households living in the low- and middle-income countries, Importantly, our work provides empirical evidence suggesting that out-of-pocket spending on complementary medicine may be associated with significantly higher risks of catastrophic expenditures as well as medical impoverishment in the immediate year following cancer diagnoses, with patients from economically disadvantaged households bearing the greatest risk. These findings provide the much-needed evidence highlighting the significant risk of financial ruin to patients and their families from expenditures on complementary therapies for cancer. The data further support the subsidization of evidence-based complementary medicine as part of an integrated model of cancer care for countries moving towards universal health coverage.
https://pubmed.ncbi.nlm.nih.gov/35180423/
2021
The COVID-19 pandemic has had a huge impact on global health systems and economies. This study was aimed to qualitatively examine the documented impacts of the COVID-19 pandemic on cancer research. In 2020, the COVID-19 pandemic had extensive practical and economic effects on the field of cancer research, which were highly plural in nature. Overall, the review shows that the COVID-19 measures have 1) halted cancer research entirely, 2) limited cancer research activity, 3) forced adaptation of research procedures, 4) impacted cancer diagnosis, cases, and services, 5) affected the availability of resources, 6) disrupted the private sector, and 7) disrupted supply chains. It is therefore proposed that appraisal of cancer research strategies in a post-COVID era should acknowledge the potential for substantial limitations (such as on financial resources, limited access to patients for research, decreased patient access to cancer care, staffing issues, administrative delays, or supply chain issues), exacerbated cancer disparities, advances in digital health, and new areas of research related to the intersection of cancer and COVID-19. https://pubmed.ncbi.nlm.nih.gov/34966713/
In women undergoing mastectomy for breast cancer, breast reconstruction may positively impact body image, quality of life, and maintenance of social and marital relationships. This study compared clinical outcomes between women with breast cancer who underwent immediate breast reconstruction after mastectomy and their counterparts who received mastectomy alone, in a public tertiary hospital from 2011 to 2015. Data showed that out of 790 eligible women who underwent mastectomy for breast cancer, less than 10% received immediate breast reconstruction. This was mainly due to existing socioeconomic inequalities in the patient population. Of note, younger patients, those of Chinese descent, those who received tertiary education, those diagnosed more recently or with invasive breast cancer were more likely to undergo immediate breast reconstruction post-mastectomy. Results of the study showed that immediate breast reconstruction was linked to short-term surgical complications (up to 6 months); Possibly because a majority of women undergoing immediate breast reconstruction in this study had received tissue-based reconstruction, rather than implant-based reconstructions. However, having immediate breast reconstruction was not associated with any delays in starting chemotherapy, or with a higher risk of breast cancer recurrence, or death. This study while allaying concerns with respect to the safety of immediate breast reconstruction following mastectomy also highlights the evident inequalities in gaining access to such services in the Malaysian public healthcare system. These in turn point towards the need for wider availability and access to oncoplasty services in Malaysian hospitals https://www.surgjournal.com/article/S0039-6060(21)00768-6/pdf
The COVID-19 pandemic has been a major challenge for our healthcare system, including cancer care services. This proposal seeks to develop a guideline that will ensure the maintenance of quality cancer care in Malaysia. Perspectives of various stakeholders such as cancer patients, healthcare providers, and policymakers will be incorporated to identify the key facilitators and barriers to cancer care during the COVID-19 pandemic. Three rounds of Delphi survey with a panel of experts will be conducted to develop a consensus on the best practices to ensure cancer care continuity. Overall, this proposal outlines the need for collaboration with multiple cancer stakeholders to develop an emergency preparedness plan for cancer care, which is not only feasible in the context of the current pandemic, but also one that is adaptable to future crises. https://www.sciencedirect.com/science/article/pii/S221353832100031X#!
This cohort study assessed the association between pre-existing cardiovascular disease, and its modifiable (hypertension, dyslipidemia, diabetes, obesity, smoking) and non-modifiable (family history) risk factors, with cancer treatment decision-making in multi-ethnic breast cancer patients. The study revealed a high burden of cardiovascular risk factors at initial cancer diagnosis, even among the younger Malaysian women. Furthermore, the Indians and Malays were more likely to present with pre-existing cardiovascular disease and its risk factors. The presence of baseline cardiovascular disease was associated with a lower rate of adjuvant treatment administration. Worryingly, the majority of the patients with breast cancer in this study were predicted to have high or very high risks of developing cardiotoxicities in the future owing to a high presence of pre-existing cardiovascular risk factors and administration of anthracyclines, a class of anticancer drugs. This study highlights the urgent need for partnerships between both the cardiology and oncology specialties, as well as the important role of primary care physicians in promoting cardiovascular health, and reducing the risk of cardiotoxicity in people living with cancer in Malaysia. https://ecancer.org/en/journal/article/1293-baseline-cardiovascular-comorbidities-and-the-influence-on-cancer-treatment-decision-making-in-women-with-breast-cancer
Cancer and COVID-19 vaccines: a complex global picture Yusuf A et al . Lancet Oncology. 2021
A high-level analysis was conducted by the COVID-19 and Cancer Taskforce to get a global perspective on vaccine access to countries with contrasting economic settings and their responses in rolling out vaccines to citizens with cancer. Although a growing number of COVID-19 vaccines are being manufactured and approved for widespread administration, vaccine inequity is apparent as higher-income countries have dominated access to vaccine supplies, despite the WHOs initiative to enable global equitable access to vaccines under the COVAX initiative. Variance in vaccination strategies is also seen among countries, with varying vaccine deployment rates that depend on other factors like the efficiency of government-led national programs. Our results also show that there has been very little planning for the systematic collection of data from patients with cancer receiving COVID-19 vaccines, with the exception of the VOICE study in the Netherland. The study shows that there is very little understanding about the effects of different COVID-19 vaccines in various types of cancer and hence the Taskforce advocates for countries to conduct prospective studies of this kind to monitor responses of vaccines in patients with solid organ and hematologic malignancies. https://pubmed.ncbi.nlm.nih.gov/33930324/
Out-of-Pocket Costs of Complementary Medicine Following Cancer and the Financial Impact in a Setting With Universal Health Coverage: Findings From a Prospective Cohort Study Bhoo-Pathy N et al. JCO Oncology Practice. June 2021
Data from the ASEAN CosT In Oncology (ACTION) study was utilized to determine household spending patterns on complementary medicine following a cancer diagnosis, and its association with incident financial catastrophe (out-of-pocket costs related to cancer ≥ 30% of annual household income) and economic hardship (inability to pay for essential household items or services). One-third of patients reported spending on complementary medicine, which accounted for 20% of their total out-of-pocket costs and 35% of their health costs respectively. The risk of financial catastrophe was significantly higher for households that reported out-of-pocket spending on complementary medicine, especially among those from low-income households. Nonetheless, spending on complementary medicine was not associated with economic hardship in the immediate year after a cancer diagnosis. Integration of subsidized evidence-based complementary medicine into mainstream cancer care may reduce the financial burden associated with its use. Concurrent efforts to reduce the use of non-evidence-based complementary therapies are also needed.https://pubmed.ncbi.nlm.nih.gov/34077232/
Beliefs, Facilitating Factors, and Barriers in Using Personal Dosimeter among Medical Radiation Workers in a Middle-Income Asian Setting Mohd Ridzwan S et al. Ann Work Expo Health. May 2021
This research aims to study the reasons behind the lack of personal dosimeter use among medical radiation workers in Asian settings. Outcomes of the study shows that majority of workers concede the benefits of using the device, although there are factors that affect their usage, ranging from the expensive penalty with its loss, delayed supply of dosimeters in hospitals and defects in devices that get disconnected from the monitoring system. Some workers also do not regularly use dosimeters because of the low perceived risk of dangerous exposures to radiation. Overall, the study was deemed successful in exploring workers beliefs in support of the ‘Theory of planned behavior’ regarding the use of personal dosimeters and may help in devising possible measures to underline the significance of good practices in personal radiation monitoring. https://pubmed.ncbi.nlm.nih.gov/34037205/
Continuation of Screening Endoscopy for Colorectal Cancer in Older Adults Bhoo-Pathy N, Bujang NN, Ng CW . JAMA oncology, July 2021.
Early detection of colorectal cancer and removal of lesions at early stages is associated with low mortality rates and high survivability for patients. Notwithstanding, screening of colorectal cancer has an age limit of 75 years, followed by individualized decision-making for people older than 75 years, as recommended in the US Preventive Services Task Force (USPSTF) guidelines. A recently published paper by Ma et al challenges this age limit when examining the association between lower endoscopy (colonoscopy and sigmoidoscopy) and the risk of colorectal cancer, as well as its mortality in older adults, reporting significantly low incidence of colorectal cancer and colorectal cancer–related mortality. Viewing these results through a different lens, it was noted that although Ma et al had provided the best available evidence of the association of lower colonoscopy to the mortality of older patients, the study had not considered the frailty of the patients. The procedure of colonoscopy has been associated with complications, including perforation, gastrointestinal bleeding, and cardiopulmonary complications, and the inability to tolerate oral bowel-cleansing agents puts patients at risk of hypovolemia, kidney failure, and electrolyte disturbances. From an economic standpoint, lower colonoscopy is also a considerably expensive procedure and may not be accessible to those from low- and middle-income countries. In short, we affirm the age limit for colorectal cancer screening and believe that the recommendations of the USPSTF seem most appropriate for older patients. It is opined that the fecal immunochemical test (FIT) may be a more appropriate primary screening strategy for the continuation of screening in individuals older than 75 years, although its effectiveness to reduce cancer mortality remains unproven and needs to be studied further. https://pubmed.ncbi.nlm.nih.gov/34014277/
Is pre-operative axillary ultrasound alone sufficient to determine need for axillary dissection in early breast cancer patients. Jamaris S et al. Medicine (Baltimore) May 2021
In early breast cancer detection and diagnosis, the pre-operative status of axillary lymph node (ALN) is assessed by preoperative ultrasound, followed by ultrasound-guided needle biopsy (UNB) for confirmation. After the assessments, patients with positive nodal status would undergo axillary lymph node dissection (ALND), whereas those with negative nodal status would have a sentinel lymph node biopsy. The study aims to determine whether axillary ultrasounds readings alone are able to detect pathologically positive nodal statuses to identify the need for axial dissections. Results show that the overall sensitivity, specificity, and accuracy of pre-operative axillary ultrasounds in detecting diseased nodes were 45.5%, 80.7%, and 60.3% respectively. Features like round shape, loss of fatty hilum, and mass-like appearances, usually seen in ALN positive conditions, had the highest positive predictive values (PPVs) of 87%, 83%, and 81.6% respectively. In contrast, cortical thickness of > 3mm, another symptom of positive ALNs, only showed low PPV at 69.1%. To sum it up, histopathology reports indicate that axillary ultrasound readings show higher PPVs for lymph nodes with round shapes, loss of fatty hilum, and with mass-like appearances, whereas showing low PPVs for those with cortical thickness > 3 mm. These features must be carefully considered before ruling out the need for UNBs. https://pubmed.ncbi.nlm.nih.gov/34106588/
Breaking News of Cancer Diagnosis: A Qualitative Study on the Experiences and Emotional Needs of Patients With Cancer in a Multiethnic Asian Setting. Wong LP et al. JCO Oncol Practice. April 2021
The breaking of news of a cancer diagnosis requires personalized communication so as to reduce the emotional distress of patients and their families. By doing so, patients and their families’ may cope better with the news and have a positive attitude towards cancer therapy and their road to recovery. Our recent research findings among Malaysian cancer patients showed that young individuals, as well as those who have young children, were among those who were deeply affected by their cancer diagnosis. While patients with a family history of cancer appeared to react calmly when receiving a cancer diagnosis, they reported being less hopeful and less eager to seek cancer therapies due to ‘sad experiences’ with their close family members who died of cancer. Our research also showed that although most patients wanted emotional support from their families when receiving the news of cancer diagnosis, some preferred to be alone, and this brought challenges in breaking the news to their loved ones. Overall, the focus group discussions that we had conducted with cancer patients in Malaysia highlighted the need for physicians to be sensitive and empathetic during the diagnosis period, and when needed supplemented with professional psychological support and written informational support. https://pubmed.ncbi.nlm.nih.gov/32986532/
Insights on emotional distress following cancer, sources of support and the unmet needs in a setting with limited supportive care services for people living with cancer. Rajah HDA et al . Support Care Cancer. October 2021
This study reveals the distress and unmet needs of cancer survivors in a resource-limited setting where cancer survivorship support and services are still scarce. The study suggests pragmatic changes to improve the emotional well-being of cancer patients. Thematic analyses were conducted through focus group discussions with patients from different ethnic and socioeconomic backgrounds. Based on the responses, emotional distress experienced by patients can be categorized into two: direct and indirect stressors. Direct stressors include physical and cognitive effects of cancer surgery and treatment apart from the fear of recurrence while indirect stressors include familial worries, financial distresses, work commitments, and lack of practical support at home. Women more commonly have also raised distress from their altered physical appearances and lack of family support, indicating that both sexes have disproportionate emotional needs. Emotional support comes from informal sources like family and religion, whereas formal emotional support for cancer patients is currently lacking. is from professional counselors. Needs like coping with the fear of recurrence, financial distresses, and workplace discrimination were also addressed. The study highlights the importance of post-treatment assistance and support and hopes to see an improvement in the delivery of supportive cancer care. https://pubmed.ncbi.nlm.nih.gov/33742239/
Silver linings: a qualitative study of desirable changes to cancer care during the COVID-19 pandemic. Lombe D et al. Ecancermedicalscience. March 2021
The Covid-19 pandemic emerged to be a major public health emergency that has changed the norms we live in. In order to uphold premium cancer care for patients, healthcare officials have been forced to accelerate the innovation of public health interventions. Results collected from interviews with members of the International COVID-19 and Cancer Taskforce show ten major themes of positive changes that have emerged from these interventions. The themes included value in cancer care, digital communication, convenience, inclusivity and cooperation, decentralization of cancer care, acceleration of policy change, human interactions, hygiene practices, health awareness and promotion, and systems improvement. Some notable obstacles and hindrances in implementing major changes and upscale are the resources, disparities, and dissimilarities in legal frameworks of various countries. https://pubmed.ncbi.nlm.nih.gov/33889211/
Factors Associated with Colorectal Cancer Screening Via Immunochemical Fecal Occult Blood Test in an Average-Risk Population from a Multiethnic, Middle-Income Setting. Bujang NN et al. JCO Glob Oncology. Feb 2021
Factors associated with colorectal cancer screening via Immunochemical Fecal Blood test (iFOBT) were studied to identify ways to reach out to a multiethnic public in middle-income settings. The results showed that 60% of the participants involved were willing to be screened, however, only a small fraction of 7.5% agreed to undergo the procedure. Increased willingness for screening was seen among individuals who had good knowledge of the risk factors of bowel cancer, perceived susceptibility to cancer, and those with a doctor’s recommendation. On the other hand, older individuals and those with negative perceptions towards the procedure were associated with a lower willingness to be screened. A multivariable analysis proved that doctor’s recommendation seemed to be a dominant pushing factor for average-risk individuals to undergo iFOBT testing, whereas the main factor of a hindrance for the procedure was the negative perception towards the test. Overall, this cross-sectional study was successful in gauging the screening behavior of Malaysians and to understanding the receptivity and acceptance for the screening test among the public.https://pubmed.ncbi.nlm.nih.gov/33625866/
Prevalence and sociodemographic correlates of anogenital Human Papillomavirus (HPV) carriage in a cross-sectional, multi-ethnic, community-based Asian male population. Khoo SP et al. PLoS One. Jan 2021
Though it’s not common knowledge, anogenital HPV infection is common among men in Malaysia and is increasingly becoming a public health issue. According to a cross-sectional study recruiting 503 healthy males, results from 14 high risks and 2 low-risk HPV DNA detection and genotyping with genital and anal samples showed that the anogenital HPV6/11 prevalence was 3.2% whereas high-risk for HPV prevalence was 27.1%. Detection of genital HPV prevalence for HPV6/11 was 2.9% while high-risk for HPV was 18.8%. HPV6/11 prevalence in the anal canal was 1.6% whereas high-risk HPV was 12.7%. The most prevalent genotype detected in the anogenital area was HPV 18. A significant independent association between genital and anal HPV infections among these groups of men was also seen. To sum it up, the data shown in this study showed evidence on how crucial it is to address the burden of HPV-associated diseases as a public health issue in order to spread awareness about the importance of healthier sexual practices, for the safety of both men and women. https://pubmed.ncbi.nlm.nih.gov/33471825/
2020
Cancer and COVID-19: economic impact on households in Southeast Asia. Kong YC, Sakti VV, Sullivan R, Bhoo-Pathy. Ecancermedicalscience, November 2020
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/33281926/
Working after cancer: in-depth perspectives from a setting with limited employment protection policies. Kong YC, Rauf N, Subramaniam S, Bustamam RS, Wong LP, Ho GF, Zaharah H, Mellor M, Yip CH, Bhoo-Pathy N. J cancer surviv. October 2020
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/33094415/
Treatment abandonment in children with cancer: Does a sex difference exist? A systematic review and meta-analysis of evidence from low- and middle-income countries. A, Balane C, Shanthosh J, Jun M, Bhoo-Pathy N, Gadsden T, Canfell K, Jan S. Int J cancer. September 2020
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/32875569/
Association between night-shift work, sleep quality and health-related quality of life: a cross-sectional study among manufacturing workers in a middle-income setting. Lim YC, Hoe VCW, Darus A, Bhoo-Pathy N. BMJ open. September 2020
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/32895261/
Cancer research in the 57 Organisation of Islamic Cooperation (OIC) countries, 2008-17. Lewison G, Hussain SF, Guo P, Harding R, Mukherji D, Sittah GA, Aggarwal A, Fouad F, Bhoo-Pathy N, Shamieh O, Torode J, Kutluk T, Sullivan R. Ecancermedicalscience. Aug 2020
PubMed: https://pubmed.ncbi.nlm.nih.gov/33014136/
Correction to: Impact of migraine on workplace productivity and monetary loss: a study of employees in banking sector in Malaysia. Wong LP, Alias H, Bhoo-Pathy N, Chung I, Chong YC, Kalra S, Bahkt Sultan Shah ZU. J Headache Pain. Aug 2020
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/32811428/
Impact of migraine on workplace productivity and monetary loss: a study of employees in banking sector in Malaysia. Wong LP, Alias H, Bhoo-Pathy N, Chung I, Chong YC, Kalra S, Shah ZUBS. J Headache Pain. June 202
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/32513174/
Understanding the Financial Needs Following Diagnosis of Breast Cancer in a Setting with Universal Health Coverage. Kong YC, Wong LP, Ng CW, Taib NA, Bhoo-Pathy NT, Yusof MM, Aziz AF, Yehgambaram P, Ishak WZW, Yip CH, Bhoo-Pathy N. Oncologist. June 2020
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/31922332/
Intake of Common Alcoholic and Non-Alcoholic Beverages and Breast Cancer Risk among Japanese Women: Findings from the Japan Collaborative Cohort Study. S, Okabayashi S, Kawamura T, Mori M, Bhoo-Pathy N, Aishah Taib N, Ukawa S, Tamakoshi A. Asian Pac J Cancer Prev. June 2020
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/32592367/
Outcome and presentation of heart failure in breast cancer patients: findings from a Swedish register-based study. Papakonstantinou A, Gernaat SAM, Altena R, Brand JS, Alfredsson J, Bhoo-Pathy N, Herrmann J, Linde C, Dahlstrom U, Bergh J, Hubbert L. Eur Heart J Qual Care Clinical Outcomes. April 2020
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/31328233/
The association between methods of biopsy and survival following breast cancer: A hospital registry based cohort study Kong YC, Bhoo-Pathy N, O’Rorke M, Subramaniam S, Bhoo-Pathy NT, See MH, Jamaris S, Teoh KH, Bustam AZ, Looi LM, Taib NA, Yip CH. Medicine (Baltimore). Feb 2020
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/32028433/
2019
Perceptions on radioprotective garment usage and underlying reasons for non-adherence among medical radiation workers from public hospitals in a middle-income Asian setting: A qualitative exploration. Mohd Ridzwan SF, Bhoo-Pathy N, Isahak M, Wee LH. Heliyon. September 2019
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/31687573/
Financial Toxicity After Cancer in a Setting With Universal Health Coverage: A Call for Urgent Action Bhoo-Pathy N, Ng CW, Lim GC, Tamin NSI, Sullivan R, Bhoo-Pathy NT, Abdullah MM, Kimman M, Subramaniam S, Saad M, Taib NA, Chang KM, Goh PP, Yip CH . J Oncol Pract. June 2019
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/31112479/
2018
Association between night-shift work, sleep quality and metabolic syndrome. Lim YC, Hoe VCW, Darus A, Bhoo-Pathy N. Occup Environ Med. October 2018
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/30032104/
Health-related quality of life and psychological distress among cancer survivors in a middle-income country. Subramaniam S, Kong YC, Chinna K, Kimman M, Ho YZ, Saat N, Malik RA, Taib NA, Abdullah MM, Lim GC, Tamin NI, Woo YL, Chang KM, Goh PP, Yip CH, Bhoo-Pathy N. Physchooncology. September 2018
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/29856903/
Long-term exposure to insulin and volumetric mammographic density: observational and genetic associations in the Karma study. Borgquist S, Rosendahl AH, Czene K, Bhoo-Pathy N, Dorkhan M, Hall P, Brand JS. Breast Cancer Res. Aug 2018
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/30092829/
Prevalence and sociodemographic correlates of cervicovaginal human papillomavirus (HPV) carriage in a cross-sectional, multiethnic, community-based female Asian population. Khoo SP, Bhoo-Pathy N, Yap SH, Anwar Shafii MK, Hairizan Nasir N, Belinson J, Subramaniam S, Goh PP, Zeng M, Tan HD, Gravitt P, Woo YL. Sex Transmitted Infect. June 2018
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/29180538/
MyBCC Study Group. Use of Complementary and Alternative Medicine Among Newly Diagnosed Breast Cancer Patients in Malaysia: An Early Report From the MyBCC Study. Mohd Taib NA, Dahlui M, Bhoo-Pathy N, Al-Sadat N, Abdul Majid H, Hussain S. Integr Cancer Ther. June 2018
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/29218996/
2017
Missed Opportunities for Loco-Regional Treatment of Elderly Women with Breast Cancer. Bhoo-Pathy N, Balakrishnan N, See MH, Taib NA, Yip CH. World J Surg. Dec 2016
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/27456497/
Impact of Time Since Last Childbirth on Survival of Women with Premenopausal and Postmenopausal Breast Cancers. Balakrishnan N, Teo SH, Sinnadurai S, Bhoo Pathy NT, See MH, Taib NA, Yip CH, Bhoo Pathy N. World J Surg. Nov 2017
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/28653143/
Impact of adjuvant chemotherapy on survival of women with T1N0M0, hormone receptor negative breast cancer. Bhoo-Pathy NT, Inaida S, Tanaka S, Taib NA, Yip CH, Saad M, Kawakami K, Bhoo-Pathy N. Cancer Epidemiol. June 2017
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/28371729/
Advanced Stage at Presentation Remains a Major Factor Contributing to Breast Cancer Survival Disparity between Public and Private Hospitals in a Middle-Income Country. Kong YC, Bhoo-Pathy N, Subramaniam S, Bhoo-Pathy N, Taib NA, Jamaris S, Kaur K, See MH, Ho GF, Yip CH. Int J Environ Res Public Health. April 2017
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/28420149/
Policy and priorities for national cancer control planning in low- and middle-income countries: Lessons from the Association of Southeast Asian Nations (ASEAN) Costs in Oncology prospective cohort study. ACTION Study Group. Eur J cancer. March 2017
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/28335885/
Time-dependent risk and predictors of venous thromboembolism in breast cancer patients: A population-based cohort study. Brand JS, Hedayati E, Bhoo-Pathy N, Bergh J, Hall P, Humphreys K, Ludvigsson JF, Czene K. Cancer. Feb 2017
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/27727456/
2016
Outcome after neoadjuvant chemotherapy in Asian breast cancer patients. Lim LY, Miao H, Lim JS, Lee SC, Bhoo-Pathy N, Yip CH, Taib NA, Chan P, Tan EY, Lim SH, Lim GH, Woo E, Tan YS, Lee JA, Wong M, Tan PH, Ong KW, Wong FY, Yap YS, Hartman M. Cancer Med. Dec 2016
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/28000426/
Ten-year survival in women with primary stage IV breast cancer. Breast Cancer Res Treat. Eng LG, Dawood S, Sopik V, Haaland B, Tan PS, Bhoo-Pathy N, Warner E, Iqbal J, Narod SA, Dent R. Breast Cancer Res Treat. Nov 2016
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/27628191/
Validation of the CancerMath prognostic tool for breast cancer in Southeast Asia. Miao H, Hartman M, Verkooijen HM, Taib NA, Wong HS, Subramaniam S, Yip CH, Tan EY, Chan P, Lee SC, Bhoo-Pathy N. BMC Cancer, October 2016
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/27769212/
Sweet-beverage consumption and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). Navarrete-Muñoz EM, Wark PA, Romaguera D, Bhoo-Pathy N, Michaud D, Molina-Montes E, Tjønneland A, Olsen A, Overvad K, Boutron-Ruault MC, Clavel-Chapelon F, Fagherazzi G, Katzke VA, Kühn T, Steffen A, Trichopoulou A, Klinaki E, Papatesta EM, Masala G, Krogh V, Tumino R, Naccarati A, Mattiello A, Peeters PH, Rylander C, Parr CL, Skeie G, Weiderpass E, Quirós JR, Duell EJ, Dorronsoro M, Huerta JM, Ardanaz E, Wareham N, Khaw KT, Travis RC, Key T, Stepien M, Freisling H, Riboli E, Bueno-de-Mesquita HB. Am J Clinical Nutr. September 2016
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/27510540/
Attitudes and factors affecting acceptability of self-administered cervicovaginal sampling for human papillomavirus (HPV) genotyping as an alternative to Pap testing among multiethnic Malaysian women. Ma’som M, Bhoo-Pathy N, Nasir NH, Bellinson J, Subramaniam S, Ma Y, Yap SH, Goh PP, Gravitt P, Woo YL. BMJ Open. Aug 2016
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/27491667/