title: Colorectal cancer in Malaysia: Its burden and implications for a multiethnic country.
abstract: BACKGROUND
  This study aims to provide an analytical overview of the changing burden of colorectal cancer and highlight the implementable control measures that can help reduce the future burden of colorectal cancer in Malaysia.
  
  
  METHODS
  We performed a MEDLINE search via OVID with the ​Medical Subject Headings (MeSH) terms "Colorectal Neoplasms"[Mesh] and "Malaysia"[Mesh], and PubMed with the key words "colorectal cancer" and "Malaysia" from 1990 to 2015 for studies reporting any clinical, societal, and economical findings associated with colorectal cancer in Malaysia. Incidence and mortality data were retrieved from population-based cancer registries/databases.
  
  
  RESULTS
  In Malaysia, colorectal cancer is the second most common cancer in males and the third most common cancer in females. The economic burden of colorectal cancer is substantial and is likely to increase over time in Malaysia owing to the current trend in colorectal cancer incidence. In Malaysia, most patients with colorectal cancer have been diagnosed at a late stage, with the 5-year relative survival by stage being lower than that in developed Asian countries. Public awareness of the rising incidence of colorectal cancer and the participation rates for colorectal cancer screening are low.
  
  
  CONCLUSIONS
  The efficiency of different screening approaches must be assessed, and an organized national screening program should be developed in a phased manner. It is essential to maintain a balanced investment in awareness programs targeting general population and primary care providers, focused on increasing the knowledge on symptoms and risk factors of colorectal cancer, awareness on benefits of screening, and promotion of healthy life styles to prevent this important disease.
authors: School of Pharmacy/School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia.
authors: Sajesh K
authors: SK
authors: Veettil
authors: Clinical School, Department of Surgery, International Medical University, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia. Electronic address: keanghee_lim@imu.edu.my.
authors: Kean Ghee
authors: KG
authors: Lim
authors: School of Pharmacy, Monash University, Bandar Sunway, Selangor, Malaysia; Centre of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; School of Population Health, University of Queensland, Brisbane, Australia; School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA.
authors: Nathorn
authors: N
authors: Chaiyakunapruk
authors: Department of Family Medicine, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Malaysia.
authors: Siew Mooi
authors: SM
authors: Ching
authors: Gastroenterology Service, Ministry of Health, Malaysia; Department of Internal Medicine, Hospital Sultanah Bahiyah, Kedah, Malaysia.
authors: Muhammad Radzi
authors: MR
authors: Abu Hassan
mesh_terms: D000328:Adult; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000601:surgery; D003906:Developing Countries; D055088:Early Detection of Cancer; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D018570:Risk Assessment; D012959:Socioeconomic Factors; D016019:Survival Analysis
keywords: Malaysia; burden; cancer prevention; colorectal neoplasms; review; screening