KUALA LUMPUR, August 27 — The Selangor state government’s Selangor Saring programme shows that most Malaysians are generally unhealthy, worsened by their unwillingness to undergo follow-up visits after health screenings.
Based on data provided by the state government to CodeBlue, the majority of Selangor Saring participants every year, from 2022 to 2025, had abnormal blood tests. Cancer was detected in under 8 per cent of participants annually from 2022 to 2024.
Follow-up rates among patients with abnormal results from Selangor Saring screenings were also very poor, generally ranging between 4 per cent and 39 per cent from various examinations (blood, urine, colorectal, cervix, and prostate) since 2022.
The only stark exception was a 96 per cent follow-up for patients with abnormal results from colorectal screenings in 2022, but this nose-dived to 15 per cent in 2023 and 27 per cent in 2024.
“We remain hopeful that the number of follow-ups will increase moving forward, as this is vital to the health and well-being of Selangor’s citizens. At Selgate Healthcare, we are proud to continue supporting the Selangor state’s preventive care initiative — a commendable and comprehensive outreach programme that aligns with our mission to care for the community,” Selgate Healthcare chief strategy officer Tengku Iesta Tengku Alaudin told CodeBlue.
This year, 1,804 people have undergone screenings under Selangor Saring so far. The current phase of the state-subsidised health screening programme targets B40 individuals, especially those aged 40 and above.
It focuses on Selangor residents with a family history of chronic diseases, such as diabetes, hypertension, and cancer. Priority is also given to those without regular access to health screenings.
About 42 per cent of 1,804 participants in the current phase of Selangor Saring are young adults aged 31 to 45, followed by 32 per cent aged 46 to 64. About six in 10 Selangor Saring participants in the current phase are female. Some 74 per cent of the 1,804 participants are ethnic Malay.
Since 2022, Selangor Saring has screened nearly 32,000 people, from 15,522 in 2022, dropping to 4,940 in 2023, and then going back up to 9,361 last year. This year so far, 3,109 people have been screened.
Selangor Saring offers a slew of exams: physical exam (height, weight, blood pressure, waist circumference recorded), blood test to check glucose levels and a full blood count, urine test, iFOBT test to screen for colorectal cancer, cervical swab to screen for cervical cancer, prostate exam, mammogram, eye exam, dental check-up, and ear exam. Physiotherapy is also offered.
A Selangor resident can register for Selangor Saring using the Selangkah app.
People Must Take Responsibility For Their Health, Experts Praise Selangor Saring
Galen Centre for Health and Social Policy chief executive Azrul Mohd Khalib said the poor follow-up rates in Selangor Saring indicated the need for people to take responsibility for their own health.
“Government-subsidised health screening programmes are not just meant for you to know about your health problems, but for you to do something about it so that you can prevent your condition from deteriorating,” Azrul told CodeBlue.
“Health care will be more costly, either for patients themselves or the public health care system, at one’s later stage of disease.”
While the general public and policymakers often talk about health worker shortages (i.e. supply of health care) that are straining the public health service, there is less attention on individual behaviour driving demand for health care.
Then Ministry of Health (MOH) deputy secretary-general (finance) Norazman Ayob said last November that the public health care system is nearing its “end” of capacity because there are too many sick Malaysians with non-communicable diseases (NCDs).
Dr Megat Mohamad Amirul Amzar Megat Hashim, a family medicine specialist at the Department of Primary Care Medicine at Universiti Malaya Medical Centre (UMMC), observed an increase in younger generations being diagnosed with NCDs.
“Yes, we’re seeing more young adults with NCDs today, largely due to sedentary lifestyles, poor dietary habits (high-calorie, low-nutrient, processed foods), and increasing stress levels,” he told CodeBlue.
The new National Health and Morbidity Survey 2024: Nutrition study revealed the extent of very bad eating habits among Malaysian teens and adults: eating late at night; too much sugar, salt, and fat; barely any milk; and insufficient fruits and veggies and most food groups except grains.
Dr Amirul praised Selangor Saring as a “commendable” initiative that supports the federal MOH in the early detection of NCDs that pose a major burden on the health care system.
“With limited resources, the MOH is largely focused on treatment, making early detection a challenge. Expanding the number of screening points improves access.”
Echoing similar sentiments, National Cancer Society of Malaysia (NCSM) deputy medical director Dr Vignesvari Subramaniam commended Selangor Saring.
“NCSM views the programme as a commendable initiative that aligns with NCSM’s mission to promote early detection and prevention of NCDs and cancers. Selangor Saring is a very good initiative which should be replicated to the entire of Malaysia, and not just in Selangor,” she told CodeBlue.
“NCSM has actively supported similar programmes, such as providing free breast and cervical cancer screenings for underprivileged women in collaboration with the Rotary Club of Ara Damansara.”
Experts Tout Continuity Of Care
However, medical experts also called for a continued care pathway to ensure the success of Selangor Saring.
“It’s crucial to ensure a closed-loop system. Individuals who screen positive must receive proper counselling and be referred for appropriate follow-up and treatment,” Dr Amirul said.
“The key is a well-defined referral pathway and a centralised, integrated data system. Shared access between state and federal levels (especially MOH) ensures coordinated care and better nationwide disease surveillance.”
Dr Vignesvari suggested that Selangor Saring link up with civil society organisations (CSOs) that also promote health and cancer awareness and screenings to maximise impact, besides improving public-private partnerships (PPP).
“There needs to be a succinct follow-up and referral pathway for patients who are under Selangor Saring. The end goal is to downstage the cancer upon diagnosis, to reduce socioeconomic burden on the patient, their family members and down the pipeline, the Ministry of Health.”
Dr Vignesvari urged young adults to undergo cancer screenings, including those in their 30s with significant risk factors.
“Some people may be especially panicked about cancer, but people should still go for further diagnostic testing to confirm the diagnosis so that they can get on treatment as soon as possible,” she said.
Dr Amirul stressed that health screening programmes ultimately hinge on the quality of disease management, saying: “Continuity of care is essential in managing chronic diseases; doctor-hopping will compromise treatment outcomes.”
