Disease Control Division, Ministry of Health Malaysia, Wilayah Persekutuan Putrajaya, Malaysia.
Hospital Sultanah Bahiyah, Department of Internal Medicine, Kedah, Malaysia.
Med J Malaysia. 2020 May;75(3):235-239.
Colorectal cancer (CRC) is the second most common cancer in Malaysia with 65% detected at stage III and IV. Despite the increasing incidence of cancers including CRC, Malaysia has yet to implement populationbased screening for cancers. The objective of this paper is to review the strategic planning and implementation of the CRC screening program in Malaysia.
A desk review was conducted from August to October in 2018, to examine, review and describe the historical perspective, strategic planning and implementation of the current CRC screening program in Malaysia.
The main policy documents related to CRC screening are the National Strategic Plan for Cancer Control Programme 2016-2020, the Clinical Practice Guideline for Management of Colorectal Carcinoma 2017, and the Implementation Guideline for CRC Screening in Malaysia 2014. Several papers have been published on the epidemiology of CRC in Malaysia. Between 2014 and 2018, 127,957 men and women were screened using immunochemical Faecal Occult Blood Test (iFOBT); 9.3% had positive iFOBT results and were referred for colonoscopy. For those who underwent colonoscopy, CRC detection rate was 4.1% and 13.9% for pre-malignant conditions. Barriers were identified along the continuum of screening process, including patient, provider, and system factors.
Although population-level organised screening programmes are preferable to opportunistic screening, the CRC programme in Malaysia was tailored to meet the needs of the population based on available existing resources. A well-mapped budget for the entire screening programme continuum, a strong partnership between stakeholders and an opportunistic screening strategy is crucial to address the rising incidence of CRC.
结直肠癌（CRC）是马来西亚第二常见的癌症，65%的病例在 III 期和 IV 期被发现。尽管包括 CRC 在内的癌症发病率不断上升，但马来西亚尚未开展基于人群的癌症筛查。本文旨在回顾马来西亚 CRC 筛查计划的战略规划和实施情况。
2018 年 8 月至 10 月进行了一次桌面审查，以检查、审查和描述马来西亚 CRC 筛查计划的历史背景、战略规划和实施情况。
与 CRC 筛查相关的主要政策文件包括《2016-2020 年国家癌症控制计划战略计划》、《结直肠癌管理临床实践指南》（2017 年）和《马来西亚结直肠癌筛查实施指南》（2014 年）。已有几篇关于马来西亚 CRC 流行病学的论文发表。2014 年至 2018 年间，共有 127957 名男性和女性接受了免疫化学粪便潜血试验（iFOBT）筛查；9.3%的人 iFOBT 结果呈阳性，并被转介进行结肠镜检查。在接受结肠镜检查的人群中，CRC 检出率为 4.1%，癌前病变检出率为 13.9%。在筛查过程的连续体中发现了各种障碍，包括患者、提供者和系统因素。
尽管人群水平的有组织筛查计划优于机会性筛查，但马来西亚的 CRC 计划是根据现有资源的情况，针对人群的需求量身定制的。为整个筛查计划连续体制定一个详细的预算、利益相关者之间建立强有力的合作伙伴关系以及采取机会性筛查策略，对于解决 CRC 发病率上升的问题至关重要。
