Too Soon To Say Malaysia’s Cancer Strategy Failed, Activist Says

By Vinodh Pillai | 31 January 2020

The National Strategic Plan for Cancer Control Programme was only in effect from 2016, while a new cancer report reported incidence from as early as 2012.

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KUALA LUMPUR, Jan 31 — The 11 per cent increase of new cancer cases in Malaysia does not necessarily mean that the government’s cancer control strategy failed, an activist said.

National Cancer Society of Malaysia medical director Dr M. Murallitharan said the newly released Malaysia National Cancer Registry Report (MNCRR) 2012-2016 does not capture the full picture of efforts to control the chronic illness in the country.

This, the cancer advocate told CodeBlue, is largely due to the fact that the National Strategic Plan for Cancer Control Programme (NSPCCP) 2016-2020 only came into effect from 2016 onwards.

“So, really, there’s no way to know whether the Ministry (of Health) has been doing things well with the new strategic plan, which is enforced now. And this data doesn’t reflect that.

“I think that’s an important thing for everyone to realise as well.”

Dr Murallitharan added that MOH is doing a lot more work now for cancer, citing the Peka B40 health screening programme and the mySalam government health protection scheme that aim to plug gaps in access for cancer patients.

Peka B40 provides free medical check-ups for the low-income at participating private clinics, whereas mySalam, which is under the Finance Ministry, gives the bottom 40 per cent RM8,000 cash when they get diagnosed with a critical illness from January 1, 2019.

The MNCRR 2012-2016, the second of two reports to identify cancer trends and cases in Malaysia from 2007 to 2016, is not reflective of this either, he pointed out.

It is also too early to say if the latest figures on cancer cases reflect the Pakatan Harapan (PH) government’s strategies, nor that of the previous Barisan Nasional (BN) administration, Dr Murallitharan added.

But the public health specialist said MOH is one ministry that has been achieving progress with regards to cancer control, regardless who is in power.

Malaysia recorded an 11.3 per cent increase in new cancer cases from 103,507 in 2007-2011 to 115,238 in the 2012-2016 period, with more people being diagnosed late with cancer, from 58.7 per cent from 2007 to 2011, to 63.7 per cent in 2012 to 2016.

The Galen Centre for Health and Social Policy said Putrajaya’s previous cancer control strategy, which ended in 2015, was inadequate, and that efforts were “generally insufficient” to ensure early detection of the disease, provide timely diagnosis, and successfully ensure good linkage with treatment.

Klang MP and cancer activist Charles Santiago, on the other hand, said the increase in cancer incidence was “horrifying”, as he called on the PH administration to increase its resolve to fight cancer. The government lawmaker warned that the numbers might be even higher than what were reported.

Dr Murallitharan said while the MNCRR 2012-2016 has recorded higher new cancer incidence, this may not necessarily be because of a sudden surge in cancer. Data can tell two different stories, he said.

“It could just be that a lot more people are now coming into the official kind of treatment system and that, actually, is a good thing because it actually shows that the Ministry of Health, like all these other branches of government, civil society, all of us are actually succeeding and getting a lot more people detected, and coming into the system.”

The way the Malaysian cancer registry works is that patients with cancer are included into the system only when they see a doctor, he explained.

Nevertheless, Dr Murallitharan said that cancer stakeholders can do better, citing the rise of about five percentage points in cancers detected in Stage 3 and Stage 4 as a clear “signal”.

But “we will only know how good we have been at picking this up or downstaging the amount of cancers when the data comes out for 2020”, he said, referring to the outcomes of the NSPCCP 2012-2016.

“For the time being, we’re taking it cautiously,” he said. “A little bit of optimism as well, if I could say, because I think it’s a sign that a lot more people are getting aware (and) getting detected.”

Cancer is the second leading cause of death in the world and in Malaysia, as of 2018. It contributes to 9.6 million deaths worldwide and 16,000 deaths in Malaysia.

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