IN Malaysia, about 65 per cent of cancer cases are detected at stages three and four, according to the National Cancer Registry Report 2017-2021, including cases of colorectal, lung and breast cancer.
Late detection leads to more challenges in treatment and reduced survivability.
A mix of psychological and cultural factors contribute to this pattern, as well as whether people in any given population have easy access to screening and diagnostic procedures.
If something feels worrisome and doesn't go away in a week or two, seek medical help. That is the standard advice from doctors, says medical oncologist and cancer initiative coordinator for Medecins Sans Frontieres (Doctors Without Borders) Dr Ivo Juliao.
However, in many cases, it can be difficult for people to accept that something is wrong, even when they are experiencing unusual symptoms, he adds.
If they have always been healthy, this acceptance becomes even more difficult to come by.
Symptoms such as unexplained weight loss, blood in the faeces, sores or ulcers that don't seem to heal properly, unexplained lumps, changes in one's neurological state or repeated infections are signs that something could be wrong, he explains.
"If you are feeling unwell for unspecific reasons for a long period of time, and there's no explanation for what is happening, it's a sign that something is getting worse and not getting resolved."
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GET EDUCATED
Health literacy plays a crucial role in early detection, he adds. When people are able to recognise certain signs or symptoms as warranting further investigation, they are more likely to seek screening or at least visit a doctor with their concerns.
Misconceptions about cancer and its causes can also hinder early detection.
For example, many people still assume that cancer is a disease of the elderly or that someone with a generally healthy lifestyle will not get cancer.
Why would I get lung cancer if I have never smoked or cervical cancer if I have only had one sexual partner? These are misconceptions which can be harmful.
Dr Juliao says fundamental misunderstandings about cancer serve as obstacles to screening and early detection.
While one's risk for cancer is greatly lowered through a healthy, active lifestyle, it does not guarantee being risk-free.
Non-smokers do get lung cancer and many women with no family history of the disease have been diagnosed with breast cancer.
Colon cancer, meanwhile, is increasingly being diagnosed in young, seemingly healthy young people around the world, so paying attention to signs that seem "off" and taking necessary action to address them is crucial.
"We now have to consider not only how cancer behaves, but also how it has changed over time and how it manifests itself differently across generations."
It's a given fact that diets high in processed foods and transgenic fat and low in fibre, coupled with rising obesity rates are contributing factors.
"We now have a generation that will be more prone to a set of diseases that weren't there 50 years ago."
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MAKING SCREENING ACCESSIBLE
One way to address late detection is for countries to look into cancer screening procedures which are fast, efficient and can reach a large segment of the population.
This would mean more people get tested and certain cancers are able to be picked up and treated much earlier.
For bowel cancer, for example, the gold standard in screening is a colonoscopy but it's an expensive procedure which uses a lot of medical resources and cannot be organised on a large scale.
In contrast, faecal occult blood test kits are a simple home-based screening method to detect hidden blood in the stool which may be an early sign of colorectal cancer.
It means we can make screening accessible to a larger pool of people and based on the results, those who show an elevated risk can be sent for further, more detailed tests.
According to data from the National Cancer Institute, colon cancer is now the second most common cancer among Malaysians, with cases increasing by 53.9 per cent from 15,515 between 2012 and 2016.
Ultimately, to combat late detection, our approach to cancer management has to change, says Dr Juliao.
We need to put into place strategies which are current and relevant as this would eventually lead to better outcomes in the long term.
meera@nst.com.my
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