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Malaysia And Breast Cancer

Breast cancer is the most common cancer among Malaysian women from all ethnicities and it is also the most common cause of cancer death among

women in Malaysia. The disease accounts for 30.4% of newly diagnosed cancer cases in Malaysian women. The incidence continues to rise as confirmed by the latest report of the Malaysian National Cancer Registry (Lim, Halimah, & Lim, 2003). Breast cancer incidence for 2002 is 4,337, compared to 3,825 for the year 2000. The actual number of women infected by the disease could be higher than the official figures as many women fail to seek treatment for various reasons.

In many developed nations the disease is prevalent among older women, but in Malaysia, the first and latest survey reveals that 52.3 percent of the cases of breast cancer involve women below 50 years of age. Over one third of the cases are in the pre-menopausal group. The disease strikes at the time when most working women are still raising children and establishing themselves in a career. In addition, the type of cancers that are found in this age group are often more difficult to treat.

Although, official rates of breast cancer mortality are not known, the number of deaths reported by a study released in the year 2001 is cause for alarm. According to the report, in the year 2000 deaths from the disease totaled 1,707; that is, close to 45 % of the cases result in death. The actual figure may be higher, owing to the underreporting of cases and the difficulties in obtaining accurate statistics from some geographically remote places. Unconfirmed reports suggest that although Malay women have the lowest incidence rates of breast cancer among the three major ethnic groups (incidence is reportedly highest among the Chinese, followed by the Indian), they have the highest mortality rates.

The Malaysian Medical Association asserts that women who were less likely to undergo breast examination are at a higher risk of late detection of breast cancer. This scenario is reportedly more prevalent among women who have low or no formal education, come from rural areas, live in agricultural communities, and are from low-income families (Lim, 2003). Furthermore, unofficial reports also suggest that many of the women who have been diagnosed with breast cancer often fail to seek treatment or discontinue their treatment.At present, there is scant research being carried out to understand these phenomena in Malaysia. Moreover, there is no institutional set up that concentrates upon utilizing such knowledge, even if it is available. Such a set up is crucial in the development and dissemination of culturally, ethically and linguistically appropriate breast cancer educational materials to effectively change those behaviors and beliefs that impede accurate understanding about the disease and the treatment of the disease.

Excerpts from National Cancer Registry (2003)

a. The most common cancer among women
b. The most common cancer among females in all ethnic groups
c. The most common cancer among females from age 20 years
d. 4337 new cases diagnosed in 2002.
e. 52.3% of the new cases in 2002 were in women below 50 years old
f. Overall crude rate (CR) –number of cases first notified for a given population – 45.1 per 100,000
g. Age-standardize incidence (ASR) – for meaningful comparison
of 2 population that differ in their age structure – 52.8
h. A women in Malaysia had a 1 in 19 chance of getting the diseases (1:14 for Chinese, 1:15 for Indian, and 1 in 24 for Malay)

From a study in two breast clinic in Kuala Lumpur Taken from : Yip, C.H., & Abdullah, N.H. (2003) Spectrum of breast cancer in Malaysian Women: Overview. World Journal of Surgery 27, 921-923

a. Peak age group range 40-49 years
b. The mean tumor size at presentation 5.4 cm
c. 50-60% of the newly diagnose cases are at stage 3 and 4
d. The tumor were much larger in Malay ethnic group patients
e. The advance stage of breast cancer is observed to be the highest among the Malay ethnic group
f. Percentage of advance cases is thought to be higher in rural hospitals
g. There are 16 breast clinic for 23 mil. population ( way below recommendation of 1:16 mil)
h. Nation-wide breast screening program is yet to be established
i. Situation in East Malaysia is not yet known
j. Delays in seeking treatment and defaults in further treatment are commonly observed.

Submitted by:

Ahmad Munawwar Rahmat

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