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GLOBAL CONCERN OF CANCER - The Second Leading Cause Of Death


Global Concern Of Cancer - The Second Leading Cause Of Death


CANCER is the second leading cause of death globally and is estimated to account for 9.6 million death in 2018. It is considered as a major burden of disease worldwide. Reportedly around the world every year, there are around tens of millions of people are diagnosed with cancer, and more than half of the patients eventually die from it.

In many countries, cancer is ranked the second most common cause of death following cardiovascular diseases.

It is also noted that cancer is a leading cause of death for children and adolescents around the world and approximately 300,000 children aged 0 to 19 years old are diagnosed with cancer each year.

In conjunction with World Cancer Day 2018, WHO released a news on the 4th February 2018, stated that nearly every family in the world is touched by cancer, which is now responsible for almost one in six deaths globally.


Cancer arises from the transformation of normal cells into tumour cells in a multistage process that generally progresses from a pre-cancerous lesion to a malignant tumour. The changes are the result of the interaction between a person's genetic factors and 3 categories of external agents which include:

   ♦  physical carcinogens, such as ultraviolet and ionizing radiation;

   ♦  chemical carcinogens, such as asbestos, components of tobacco smoke, aflatoxin (a food contaminant), and arsenic (a drinking water contaminant); and

   ♦  biological carcinogens, such as infections from certain viruses, bacteria, or parasites.

Cancer is caused by changes (mutations) to the DNA within cells. The DNA inside a cell is packaged into a large number of individual genes, each of which contains a set of instructions telling the cell what functions to perform, as well as how to grow and divide. Errors in the instructions can cause the cell to stop its normal function and may allow a cell to become cancerous.

Cancer risk factors can be divided into the following groups:

   1. biological or internal factors, such as age, gender, inherited genetic defects and skin type

   2. environmental exposure, for instance to radon and UV radiation, and fine particulate matter

   3. occupational risk factors, including carcinogens such as many chemicals, radioactive materials and asbestos

   4. lifestyle-related factors.

Lifestyle-related factors that cause cancer include:

   ♦  tobacco

   ♦  alcohol

   ♦  UV radiation in sunlight

   ♦  some food-related factors, such as nitrites and poly aromatic hydrocarbons generated by barbecuing food).

Cancer causing factors related to work and living environments include:

   ♦  asbestos fibres

   ♦  tar and pitch

   ♦  polynuclear hydrocarbons (e.g. benzopyrene)

   ♦  Some metal compounds

   ♦  Some plastic chemicals (e.g. Vinyl chloride)

Bacteria and viruses can cause cancer:

   ♦  Helicobacter pylori (H. pylori, which causes gastritis)

   ♦  HBV, HCV (hepatitis viruses that cause hepatitis)

   ♦  HPV (human papilloma virus, papilloma virus, which causes changes eg. Cervical cells)

   ♦  EBV (Epstein-Barr virus, the herpes virus that causes inflammation of the throat lymphoid)

Radiation can cause cancer:

   ♦  ionising radiation (e.g. X-ray radiation, soil radon)

   ♦  non-ionised radiation (the sun’s ultraviolet radiation)

Some drugs may increase the risk of cancer:

   ♦  certain antineoplastic agents

   ♦  certain hormones

   ♦  medicines that cause immune deficiency


The most common cancers around the world are listed down as below:

   ♦  Lung (2.09 million cases)

   ♦  Breast (2.09 million cases)

   ♦  Colorectal (1.80 million cases)

   ♦  Prostate (1.28 million cases)

   ♦  Skin cancer (non-melanoma) (1.04 million cases)

   ♦  Stomach (1.03 million cases)

The most common causes of cancer death are cancers of:

   ♦  Lung (1.76 million deaths)

   ♦  Colorectal (862 000 deaths)

   ♦  Stomach (783 000 deaths)

   ♦  Liver (782 000 deaths)

   ♦  Breast (627 000 deaths)


Signs and symptoms caused by cancer will vary depending on what part of the body is affected. There are few signs and symptoms associated with, but not specific to, cancer which include:

   ♦  Fatigue

   ♦  Lump or area of thickening that can be felt under the skin

   ♦  Weight changes, including unintended loss or gain

   ♦  Skin changes, such as yellowing, darkening or redness of the skin, sores that won't heal, or changes to existing moles

   ♦  Skin changes, such as yellowing, darkening or redness of the skin, soresthat won't heal, or changes to existing moles

   ♦  Changes in bowel or bladder habits

   ♦  Persistent cough or trouble breathing

   ♦  Difficulty swallowing

   ♦  Hoarseness

   ♦  Persistent indigestion or discomfort after eating

   ♦  Persistent, unexplained muscle or joint pain

   ♦  Persistent, unexplained fevers or night sweats

   ♦  Unexplained bleeding or bruising


There's no certain way to prevent cancer. Cancer mortality can be reduced if the cancers are detected and treated early. There are two components of early detection which are:

Step 1: Early diagnosis

Cancer is more likely to respond to effective treatment and result in a greater probability of surviving, less morbidity, and less expensive treatment, given it is identified earlier. Significant improvements can be made in the lives of cancer patients.

Early diagnosis consists of 3 steps that must be integrated and provided in a timely manner which are awareness and accessing care, clinical evaluation, diagnosis and staging, and access to treatment. If the early diagnosed is skipped, patients normally will be diagnosed as late stages and this makes curative treatment may no longer be an option.

Step 2: Screening

Screening is aimed to identify individuals with abnormalities suggestive of a specific cancer or pre-cancer who have not developed any symptoms and then refer for diagnosis and treatment.

Screening programme will be effective for select cancer types when appropriate tests are used, implemented effectively, linked to other steps in the screening process and when quality is assured. Examples of screening methods are:

   ♦  visual inspection with acetic acid (VIA) for cervical cancer in lowincome settings;

   ♦  HPV testing for cervical cancer;

   ♦  PAP cytology test for cervical cancer in middle- and high-income settings; and

   ♦  mammography screening for breast cancer in settings with strong or relatively strong health systems.



Stop smoking

   ✔  Avoid tobacco in all its forms including exposure to secondhand smoke.

   ✔  If you smoke, quit. If you don't smoke, don't start. Smoking is linked to several types of cancer — not just lung cancer. Stopping now will reduce your risk of cancer in the future.

Eat Properly (healthy diet)

   ✔  Choose a diet rich in fruits and vegetables. Select whole grains and lean proteins.

   ✔  Reduce your consumption of saturated fat and red meat, which appears to increase the risk of colon and prostate cancers.

   ✔  Limit your intake of charbroiled foods (especially meat), and avoid deep-fried foods. Increase your consumption of fruits, vegetables, and whole grains.

   ✔  Avoid sugary drinks, and limit consumption of high-calorie foods, especially those low in fiber and rich in fat or added sugar.

Get vaccinated - Ask your doctor about immunizations
   ✔  Immunizations may help prevent those viruses, including hepatitis B, which increases the risk of liver cancer, and human papillomavirus (HPV), which increases the risk of cervical cancer and other cancers.

   ✔  Ask your doctor whether immunization against these viruses is appropriate for you.

Protect yourself from the sun

   ✔  Avoid excessive sun exposure, stay in the shade, cover exposed areas.

Maintain a healthy weight and be physically active

   ✔  Maintaining a healthy weight might lower the risk of various types of cancer, including cancer of the breast, lung, colon and kidney.

   ✔  Work to achieve and maintain a healthy weight through a combination of a healthy diet and regular exercise.

Get regular medical care

   ✔  Regular self-exams and schedulescreening exams for various types of cancers such as cancer of the skin, colon, cervix and breast.

   ✔  Talk to your doctor about what types of cancer screening exams are best for you based on your risk factors.


1. Targeted Therapy

A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells with less harm to normal cells.

2. Hormone Therapy

Treatment that adds, blocks, or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels.

3. Immunotherapy

A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection, and other diseases.

4. Surgery with Chemotherapy

Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, or infusion, or on the skin, depending on the type and stage of the cancer being treated.

These are several complications of cancer and its treatment which are:


Cancer has been found to be the fourth most common cause of death in Malaysia, the Health Ministry has said in its latest report called the Malaysian Study on Cancer Survival (MySCan).

It was revealed that cancer is responsible for 12.6% of all deaths in government hospital — but the rate was more than doubled in private hospitals, at 26.7%.

In addition, there are approximately 37,000 newly-diagnosed cases of cancer every year, and the number is estimated to rise to more than 55,000 cases by 2030.

According to the National Cancer Registry 2002 report:

   ♦  There were over 26,000 new cancer cases diagnosed in Peninsular Malaysia.

   ♦  Unlike Singapore, Malaysian women have a higher incidence of cancer (55 per cent versus 45 per cent) than men.

   ♦  One in 5.5 Malaysians are expected to get cancer in their lifetime (1 in 4 for Chinese, 1 in 5 for Indians and 1 in 7 for Malays).

Common cancers in Malaysia:

   ♦  Malaysian males: Lung cancer and nasopharyngeal or nose cancer.

   ♦  Malaysian females: Breast cancer and followed by cervical cancer.

   ♦  Both sexes: Colorectal cancer is seen increased.


Fact 1: About 16% of people die from cancer

In 2015, 8.8 million people died from cancer – nearly 1 in 6 global deaths. Cancer is the second leading cause of death globally, and is responsible for an estimated 9.6 million deaths in 2018.

Fact 2: Cancer affects everyone

About 70% of all deaths from cancer occur in low- and middle-income countries. Around one third of deaths from cancer are due to the 5 leading behavioral and dietary risks: high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, and alcohol use.

Fact 3: Top 5 types of cancer killing men

Worldwide, in 2018, the 5 most common types of cancer that kill men are (in order of frequency): lung, liver, stomach, colorectal and prostate cancers.

Fact 4: Top 5 types of cancer killing women

Worldwide, in 2018, the 5 most common types of cancer that kill women are (in the order of frequency): breast, lung, colorectal, cervical and stomach cancers.

Fact 5: Not using tobacco can help prevent cancer

Between 30-50% of cancers are preventable. Tobacco use is the single largest preventable cause of cancer in the world, and is responsible for approximately 22% of all cancer-related deaths.

Fact 6: Vaccination against cancer-causing infections

In 2012, cancer-causing infections were responsible for up to 25% of newly diagnosed cancer cases in low- and middle-income countries. Human papillomavirus (HPV) causes cervical cancer, and hepatitis B virus (HBV) causes liver cancer. Vaccination against these two viruses could prevent 1.1 million cancer cases each year.

Fact 7: Access to cancer treatment in low-income countries is low

Late-stage presentation and inaccessible diagnosis and treatment are common. In 2017, less than 30% of low-income countries reported treatment services were generally available, compared to more than 90% of highincome countries.

Fact 8: Cancer creates significant burden on global economy

The economic impact of cancer is significant and is increasing. The total annual economic cost of cancer in 2010 was estimated at approximately US$ 1.16 trillion.

Fact 9: Palliative care

Worldwide, only about 14% of people who need palliative care currently receive it.

Fact 10: Lack of data disables cancer policies

Only 1 in 5 low- and middle-income countries have the necessary data to drive cancer policy.


By 2030, the global burden is expected to grow to 21.7 million new cancer cases and 13 million cancer deaths. With significant improvement in treatment and prevention of cardiovascular diseases, cancer has or will soon become the number one killer in many parts of the world. As elderly people are most susceptible to cancer and population aging continues in many countries, cancer will remain a major health problem around the globe. Therefore, everyone must take part in order to prevent the number getting increase by starting to live healthily.


Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global Cancer Statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, in press. Retrieved from Media centre fact sheets [Internet] Geneva, Switzerland: World Health Organization; [updated 2005 June; cited 2007 April 2]. Retrieved from Press release: FAO/WHO: Amount of poor-quality presticides sold in developing countries alarmingly high [Internet] Geneva, Switzerland: World Health Organization; [updated 2001 February 1; cited 2007 April 2]. Retrieved from

Jennette Leung, Project Specialist, Global Health & Healthcare Industries, World Economic Forum Geneva

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