WORLD CANCER DAY 2025 

Cancer is a major problem for society, public health, and the economy of a country. It is responsible for almost one in six deaths (16.8%) and one in four deaths (22.8%) from non-communicable diseases (NCDs) worldwide. The disease causes three out of ten premature deaths globally from NCDs (30.3% among those aged 30–69 years) and is one of the three leading causes of death in this age group in 177 out of 183 countries. In addition to being a major obstacle to improving life expectancy, cancer is also associated with significant social and macroeconomic costs. These barriers vary by cancer type, geography, and gender. According to the Department of Statistics Malaysia (DOSM) 2023 report, cancer is the fourth leading cause of death in Malaysia, increasing from 10.5 percent in 2021 to 12.6 percent in 2022. The Malaysian Oncology Society recorded an increase of more than 50 percent in the number of patients and death rates from cancer from 2012 to 2022.

Essentially, cancer progression is due to the continuous and uncontrolled growth of cancer cells. Normal cells are regulated by a variety of signals and pathways that control cell behaviour. In contrast, cancer cells grow and divide uncontrollably, invade normal tissues and organs, and eventually spread throughout the body. The general loss of growth control exhibited by cancer cells is due to disruptions in the cell's regulatory system.

Cancer can result from the abnormal growth of any of the different types of cells in the body. These characteristics of cancer cells mean that there are more than a hundred different types of cancer. Each type of cancer will have significant differences in its behaviour and response to treatment.

The most important issue in cancer pathology is the distinction between benign (non-harmful) and malignant (dangerous) tumours. Benign tumours, such as common skin warts, remain confined to their original location, without invading surrounding normal tissue or spreading to distant parts of the body. Malignant tumours, however, are capable of invading surrounding normal tissue and spreading throughout the body through the circulatory or lymphatic systems (metastasis).

In developed countries, mortality rates from stroke and coronary heart disease are decreasing, while cancer is the only major disease that shortens life expectancy. Due to population growth and aging, a significant downward trend in the major high-risk cancers has not yet been observed, and the burden of this disease is increasing rapidly in some countries. This reflects that changes in the prevalence and distribution of cancer are influenced by changes in the social and economic development of a region.

In Malaysia, various efforts have been emphasized in the National Cancer Control Program to address this health crisis, which focuses on prevention, early detection, improved treatment, and palliative care. A preventive approach is one of the cost-effective measures and can be introduced at the individual level. According to the World Health Organization (WHO), between 30 to 50% of cancers are currently preventable by avoiding risk factors and implementing existing evidence-based prevention strategies.

To ensure that prevention approaches are successful, risk factors that potentially contribute to cancer incidence need to be identified. The causes of cancer can be multifactorial. Several risk factors can be avoided by changing lifestyle and reducing exposures, for example tobacco use, alcohol intake, excess weight, and lack of physical activity have been reported as major risk factors for cancer worldwide. These factors are also common risk factors for other NCDs.

There has been a significant increase in the number of new cancer cases diagnosed in Malaysia, particularly breast, colorectal, and lung cancers, between 2012 and 2016. The reported cancer incidence rates for the period 2012–2016 were 86 cases per 100,000 men and 102 cases per 100,000 women, representing an 11% increase compared to the 2007–2011 report. This may be due to low cancer awareness, lack of screening, delay in seeking medical attention, delay in detection and diagnosis, and inadequate access to high-quality cancer treatment. Despite the increase in cancer incidence, there are only over 150 oncologists in Malaysia, which is about 50% of the need to meet the country's oncology services.

Malaysia is one of the growing clinical trial sites, because of various government efforts such as the establishment of Clinical Research Malaysia (CRM) and the Phase 1 Realization Project (P1RP), an initiative to promote early drug development in Malaysia. In 2021, a total of 215 clinical trials were initiated at MOH facilities, with oncology trials accounting for approximately 15.3% of the total.

Close collaboration between academic research centres and cancer service providers, efficient networking with regional and industry partners, as well as strong commitment and continued investment from the Malaysian government are essential to building a sustainable and conducive ecosystem for oncology research in the country. Building a strong clinical research ecosystem depends on understanding cancer biology and the application of experimental therapies with the goal of providing high-quality cancer treatment to patients.

Dr. Sandra Maniam

Senior Lecturer

Department of Human Anatomy

Faculty of Medicine and Health Sciences

Universiti Putra Malaysia

Date of Input: 03/02/2025 | Updated: 03/02/2025 | nadia_rahman