KUALA LUMPUR, June 22 — The Ministry of Health (MOH) has mandated doctors to notify it of cancer cases, amid outdated data on the chronic disease that advocates say is under-reported in Malaysia.
Cancer registry data in Malaysia is more than five years’ old; the Malaysia National Cancer Registry Report 2012-2016 was released only in January this year. The previous cancer registry was also over a four-year period from 2007 to 2011.
Non-communicable diseases (NCDs) like cancer are generally not notifiable diseases. Illnesses that require notification to health authorities are predominantly infectious diseases, as covered by the Prevention and Control of Infectious Diseases Act 1988 that lists sicknesses like dengue fever, measles, and HIV infection, among others.
Health director-general Dr Noor Hisham Abdullah said in a circular that registered medical officers and assistant medical officers across public and private health facilities, who are involved in diagnosing and treating cancer, must report all cancer cases to MOH.
He said although cancer data at the national level has been collected since January 2007, data collection was previously done manually. However, MOH has since set up a Malaysian Health Data Warehouse (MyHDW) that provides an online data collection platform.
“Therefore, the switch from manual cancer data collection to an online method is important and in line with the government’s vision to provide effective and efficient services,” said Dr Noor Hisham in his April 27 circular this year as sighted by CodeBlue, adding that the circular was in force from the date of the letter.
Cancer cases that require notification to the National Cancer Registry, MOH — via the M2b Module in the Sistem Maklumat Rawatan Pelanggan (SMRP) at all public and private health facilities nationwide — are:
- Primary cancer cases that have already been diagnosed at all government and private health facilities;
- New primary cancer cases with a diagnosis verified by a registered medical officer;
- Primary cancer cases among citizens and non-citizens;
- Unknown primary cancer; and
- Cancer cases with more than one primary cancer diagnosis (multiple primary). Notification must be sent for each primary cancer diagnosis.
“Primary cancer” refers to cancer cases involving the place in the body (organ or tissue) where the cancer first started. Each primary cancer case needs only to be notified once.
Cancer cases that do not need to be notified are benign tumours, recurrent cancer, and secondary or metastatic cancer, where the cancer has spread to another part of the body from the place it first started.
“The notification of cancer is meant for the collection of data on cancer cases in Malaysia for use in the analysis and publication of cancer statistics in Malaysia,” said the Cancer Unit from MOH’s Disease Control Division in an April 21 appendix attached to the Health DG’s circular.
“To get true cancer statistics in this country, information on all cancer cases must be obtained. Therefore, it is important for all government and private health facilities that diagnose and treat cancer cases to report such cancer cases.”
Registered medical officers involved in the management of cancer cases at MOH health facilities are required to report all cancer cases treated in their respective facility, while private medical centres and those run by public universities and the Ministry of Defence are similarly asked to do the same.
Public or private health facilities that are not involved directly in the confirmation of a cancer diagnosis, but are involved in cancer treatment, are also encouraged to notify MOH if they have complete diagnosis information (for cancer cases that have never been notified).
Malaysia recorded an 11.3 percentage point 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 in the 2007-2011 period, to 63.7 per cent in the 2012-2016 period. The top three cancer cases in Malaysia from 2012 to 2016 were breast, colorectal, and lung cancers.
The Malaysia National Cancer Registry Report also reported a total of 82,601 cancer deaths from 2012 to 2016, marking a hike of 28.5 percentage points from the 64,275 recorded cases from 2007 to 2011.