OBJECTIVESThis is the first study that estimates the incidence and mortality rate for colorectal cancer (CRC) patients in Malaysia by sex and ethnicity.METHODSThe 4,501 patients were selected from National Cancer Patient Registry-Colorectal Cancer data. Patient survival status was cross-checked with the National Registration Department. The age-standardised rate (ASR) was calculated as the proportion of CRC cases (incidence) and deaths (mortality) from 2008 to 2013, weighted by the age structure of the population, as determined by the Department of Statistics Malaysia and the World Health Organization world standard population distribution.RESULTSThe overall incidence rate for CRC was 21.32 cases per 100,000. Those of Chinese ethnicity had the highest CRC incidence (27.35), followed by the Malay (18.95), and Indian (17.55) ethnicities. The ASR incidence rate of CRC was 1.33 times higher among males than females (24.16 and 18.14 per 100,000, respectively). The 2011 (44.7%) CRC deaths were recorded. The overall ASR of mortality was 9.79 cases, with 11.85 among the Chinese, followed by 9.56 among the Malays and 7.08 among the Indians. The ASR of mortality was 1.42 times higher among males (11.46) than females (8.05).CONCLUSIONSCRC incidence and mortality is higher in males than females. Individuals of Chinese ethnicity have the highest incidence of CRC, followed by the Malay and Indian ethnicities. The same trends were observed for the age-standardised mortality rate.

OBJECTIVES:The goal of this study was to assess the relationship between intestinal obstruction and the prognosis of colorectal carcinoma.METHODS:Data pertaining to 4,501 colorectal carcinoma patients were extracted from the national colorectal registry and analysed. Survival analysis was performed using the Kaplan-Meier method. The log-rank test was used to compare the survival rate between patients with intestinal obstruction and those without intestinal obstruction. The p-values<0.05 were considered to indicate statistical significance. Simple Cox proportional hazards regression analysis was used to estimate the crude hazard ratio of mortality from colorectal cancer.RESULTS:Intestinal obstruction was reported in more than 13% of patients. The 3-year survival rate after treatment was 48.3% (95% confidence interval [CI], 43.9 to 52.8) for patients with intestinal obstruction (n=593) and 54.9% (95% CI, 53.1 to 56.6) for patients without intestinal obstruction (n=3,908). The 5-year survival rate for patients with intestinal obstruction was 37.3% (95% CI, 31.9 to 42.8), which was lower than that of patients without intestinal obstruction (45.6%; 95% CI, 43.5 to 47.7). After adjusting the hazard ratio for other prognostic variables, intestinal obstruction had a statistically significant negative correlation with the survival rate of colorectal cancer patients, with an adjusted hazard ratio of 1.22 (p=0.008).CONCLUSIONS:The presence of intestinal obstruction is associated with a lower survival rate among colorectal cancer patients.

In addition to the quality of examination, the effectiveness of colonoscopy depends on the screening uptake. In a trial involving eight Spanish regions, the participation rate for colonoscopy was lower than for iFOBT (24.6% vs 34.2%), which hampered the

Introduction: Colorectal cancer (CRC) is the third most common cancer globally. This study aimed to determine the incidence, mortality, and survival rates of CRC in northern Malaysia over the last decade. Materials and Methods: This was a registry-based, cross-sectional study. All the CRC patients seeking treatment from any of the 21 hospitals located in northern Malaysia between 2008 and 2017 were included in this study. Both the incidence and mortality rates were expressed as the number of cases per 100,000. The time series analysis was performed to assess the changes in the age-standardized incidence and mortality rates (ASIR and ASMR) of CRC, while the Cox regression analysis was used to detect the differences in the mortality risk between subgroups of CRC patients. Results: Of the 5746 CRC patients identified, approximately 40% were diagnosed only at Stages III and IV of the disease. Although the ASIR of CRC was stable and narrowly ranged from 17.03 to 20.01 per 100,000 (P = 0.775), the ASMR of CRC significantly reduced from 12.73 per 100,000 in 2008 to 2.99 per 100,000 in 2017 (P < 0.001). Besides increasing with age and the severity of the disease, the mortality risk was significantly higher in men (adjusted hazard ratio [HR]: 1.18; 95% confidence interval [CI]: 1.02, 1.17) and the Malay ethnic group (adjusted HR: 1.33; 95% CI, 1.08, 1.64). Conclusion: While efforts had been made to promote the timely treatment of CRC, it is encouraging to note a downtrend in its mortality rate. However, there is still a need to upscale the CRC screening going forward.