95% of lung cancer cases detected late

PETALING JAYA: Almost 95% of lung cancer cases are detected late although it is one of the top three cancers to affect Malaysians, says National Cancer Society Malaysia (NCSM) managing director Dr Murallitharan Munisamy.

“In men, this is the second highest cancer after colorectal. This is keeping in mind that more than 50% of males smoke.

“However, lung cancer has risen in women who are non-smokers,” he said when contacted.

Dr Murallitharan said researchers found links between lung cancer and second-hand or even third-hand smoke.

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Third-hand smoke refers to persistent residue generated from aged second-hand smoke that adheres to indoor dust and surfaces and re-emits into the air.

He said women who are non-smokers were also at increased risk and they should not ignore the symptoms.

“Women smokers, especially vapers, are also on the rise alarmingly, and this may worsen the trend of lung cancer among women,” he said.

On the challenges of screening, he said, it was not effective and cost-efficient to screen the whole population.

He said screening was done not only by X-ray but also CT scans, adding that one must also be mindful of the exposure to radiation on a yearly basis.

“However, the most at-risk who should be screened are smokers, and they just don’t come for screening.

“They always shy away from screening and feel that they will not get cancer.

“Some 90% of lung cancer patients remain smokers. So more focused awareness to those at risk is the way forward,” said Dr Murallitharan, adding that getting smokers to quit smoking or getting them screened remain an ongoing challenge.

The World Health Organisation (WHO) forecast that the prevalence of lung cancer in Malaysia could double by 2040.

According to its estimation for past and future trends in terms of total cases per year, lung cancer cases increased from 4,403 in 2012 to 4,686 in 2018.

The number is expected to increase to 9,679 by 2040.

Meanwhile, WHO’s Global Cancer Observatory noted that lung cancer accounted for the third highest new cancer cases reported in 2020 with 5,139 cases or 10.6% of the 48,639 diagnoses in the year under review.

It also accounted for the highest number of new diagnoses in males with 3,925 cases (17% of all 23,052 cases involved males of all ages).

It also ranked as the second highest when it came to mortality rates with over 4,000 fatalities.

According to the “Lung Cancer in Malaysia” paper, published in the Journal of Thoracic Oncology in 2020, one in 55 Malaysian males had the lifetime risk of contracting the disease, while the probability for females was one in 135.7.

“The age-standardised incidence rate of lung cancer increases rapidly from age 45 and is highest in the 60- to 74-year-old age group,” the paper noted.

“Nearly 90% of lung cancer patients in Malaysia are diagnosed with stage III or IV disease.”

The paper revealed that the prevalence of smoking was high in Malaysia with nearly 50% of all adult males being smokers, and more than 90% of male lung cancer patients had a significant smoking history.

It added that nearly all young female lung cancer patients in Malaysia were non-smokers.