Rising cancer incidence in Malaysia: Addressing the growing burden through a multisectoral approachAugust 1, 2024
Recent global cancer statistics reveal a troubling rise in cancer incidence, with 51,650 new cases reported in Malaysia in 2022. Among these, 24,892 cases were reported in males and 26,758 in females. Alarmingly, cancer has emerged as one of the top 10 causes of death in Malaysia, with lung cancer accounting for 2.1% of deaths and breast cancer 1.5%.
In the context of the Western Pacific region, Malaysia contributes 0.76% to the region's cancer cases and approximately 0.25% to the global cancer burden. Even more concerning is the rising number of cancer-related deaths among children and adolescents in the country. The growing cancer burden in Malaysia Dr Rabindra Abeyasinghe (pix), Head of the World Health Organization (WHO) country office for Malaysia, Brunei, and Singapore, highlights the multifaceted factors contributing to Malaysia's growing cancer burden. Speaking at the National Cancer Congress Malaysia on contextualizing cancer within the Sustainable Development Goals (SDGs), Dr Rabindra noted, "The numbers are big. There's multiple factors that contribute to that; one of which is that we are rapidly aging." Malaysia, like many countries, is undergoing rapid economic advancement, which has led to better diagnostic capabilities. However, urbanization and structural changes have also contributed to the rising cancer rates. It is not only the aging population at risk, but also children, a trend that threatens the future potential of the country. By 2050, the number of cancer cases is expected to double, exacerbated by a growing population with a basic reproduction rate of 1.7. This increase in cancer incidence will have significant economic implications for the country, making it imperative to address the cancer burden through comprehensive strategies. Health as an investment, not an expense Health should be viewed as an investment, not an expense. The societal and economic benefits of a healthy population far outweigh the costs associated with healthcare. Investing in health, particularly in cancer prevention, diagnosis, and treatment, is crucial for the development and economic potential of a nation. The cancer continuum and sustainable development goals Traditionally, efforts to combat cancer have been aligned with SDG 3, which focuses on health and well-being. The cancer continuum encompasses disease prevention, early detection, treatment, rehabilitation, and palliative care. While the health needs of cancer patients are addressed within this framework, other critical factors impacting cancer risk and patient management are often overlooked. These non-health factors, which include social, economic, and environmental determinants, are integrated into the broader spectrum of the SDGs across five key domains. Dr Rabindra emphasized the importance of addressing these factors in tandem with health interventions to reduce the cancer burden. Integrating cancer management within the five UN domains The Sustainable Development Goals are organized into five key domains: People, Planet, Prosperity, Peace, and Partnership. To effectively combat cancer, efforts must transcend the health sector and involve collaborative actions across all these domains. People: Financial and social security (SDG 1, 2) A significant portion of cancer-related health services and treatments in Malaysia are still paid for out-of-pocket, reducing families' disposable income for other essential health-related behaviors, such as accessing healthy food options and engaging in physical activities. Strengthening financial and social security for all citizens is crucial to improve cancer outcomes. Planet: Food and water security (SDG 6, 14, 15) Ensuring access to clean water and fresh, nutritious food is essential in reducing cancer risk. Contaminated water and processed foods, high in carcinogenic substances, contribute to the rising incidence of cancer. Sustainable practices in food and water security can reduce reliance on processed foods and lower the overall treatment costs associated with cancer. Prosperity: Financial equity and sustainable development (SDG 8, 9, 10, 11) Economic disparities significantly impact access to healthcare and cancer treatment. Financial equity, better job accessibility, and improved working conditions can reduce the financial burden on cancer patients. Moreover, sustainable energy and development practices can lower the environmental impact, thereby reducing the health risks associated with climate change. Peace: Reducing vulnerabilities (SDG 10, 11) Vulnerable populations, such as the elderly and people with disabilities, often face barriers in accessing cancer care. Improving access to health services and community support can enhance treatment outcomes and survivorship among these groups. Partnership: Biodiversity preservation and environmental management (SDG 12, 13, 14, 15) Preserving biodiversity and managing environmental health are critical in reducing the risk of cancer. Responsible production practices can minimize exposure to carcinogenic chemicals, while biodiversity preservation can mitigate the health effects of climate change. The role of literacy and female empowerment in cancer prevention Education and literacy play a pivotal role in cancer prevention. Increasing awareness of cancer symptoms and promoting healthy behaviors are essential in reducing cancer risk. However, knowledge alone is not enough. Behavioral insights are needed to encourage people to make lasting changes, such as quitting smoking or avoiding harmful substances like e-cigarettes. Female empowerment is also a crucial factor in cancer prevention and management. Women, who often make decisions about family nutrition and lifestyle, can significantly influence the health outcomes of their families. Empowering women through education and financial independence can lead to generational changes in health behaviors, reducing the prevalence of cancers, particularly breast and gynecological cancers. Strengthening governance for sustainable development To effectively address the cancer burden, strong governance is needed to ensure the implementation and follow-through of policies across sectors. National governments, in collaboration with the UN and other stakeholders, must work together to integrate health outcomes into all policies, from environmental management to economic development. Advancing the sustainable development goals and achieving the 2030 agenda for sustainable development remains the best approach for countries like Malaysia to address the inequities caused by social determinants of health. By improving health outcomes and reducing the national health burden, these efforts can lead to a healthier, more prosperous future. The rising cancer burden in Malaysia is a wake-up call for all stakeholders to take decisive action. It is essential to move beyond the traditional health sector approach and embrace a multisectoral strategy that addresses the complex interplay of social, economic, and environmental factors contributing to cancer. By investing in health, strengthening governance, and promoting sustainable development, Malaysia can reduce the cancer burden and improve the quality of life for its citizens. The fight against cancer requires collective effort and a commitment to creating a healthier, more equitable society. |
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