22.8pc increase in cancer case over five years

Izah Azahari

Brunei Darussalam has seen a 22.8-per-cent increase in the number of cancer patients over five years from 2015-2019, compared to 2010-2014.

Minister of Health Dato Seri Setia Dr Haji Mohd Isham bin Haji Jaafar revealed this in a message released in conjunction with World Cancer Day 2021, themed ‘I Am and I Will’.

“According to statistics obtained from the Brunei Darussalam Cancer Register, the Sultanate recorded 704 people (compared to 644 in 2018) citizens and permanent residents of Brunei Darussalam diagnosed with cancer in 2019. In the same year, the total number of cancer deaths was 347 deaths, which is 22.6 per cent of all deaths,” the minister said.

In 2019, among the highest types of cancer among men were colorectal (74 cases), prostate (30) and lungs (25), while among women, the highest incidence of cancer were breast (105 cases) followed by colorectal (57) and uterus (45). The risk for a man to suffer cancer is at 27 per cent or one in four men, while for women it is 29 per cent or one in three women.

According to the World Health Organization (WHO), it is estimated that globally, one in five people will suffer from cancer for the rest of their lives, and that one in eight men and one in 11 women will die from cancer. This means that over 50 million people worldwide have been cancer stricken in the last five years.

Citing the latest statistics from the Global Cancer Observatory (Globocan) 2020, the minister said that for the first time, breast cancer among women has had the highest diagnosis, surpassing lung cancer. However, lung cancer remains the leading cause of death among all cancers.

“Every February 4, the world celebrates World Cancer Day with the aim of enhancing public awareness on the disease. This year is the third and final year World Cancer Day follows the theme ‘I Am and I Will’.”

The theme aims to remind the public of each individual’s commitment to act together in the present, which in turn will positively impact the future.

Minister of Health Dato Seri Setia Dr Haji Mohd Isham bin Haji Jaafar

At the same time, it intends to help countries achieve the Sustainable Development Goals to reduce premature deaths caused by cancer and non-communicable diseases by one third by 2030.

“Cancer development is due to complex factors, including genetic and environmental. The effects of these factors varies from one individual to another. There is evidence stated in the World Cancer Report 2020 showing that genetic factors contribute to five to 10 per cent of cancer development, while environmental factors have a higher risk – in the range of 80 to 90 per cent,” the minister said.

This shows that the risk for each individual can be reduced if factors can be addressed – such as stopping tobacco use, consuming adequate vegetables and fruits, conducting physical activities, having a normal body mass index (BMI) and not consuming alcohol.

In working towards a cancer-free future, the minister said the Brunei government, through the Ministry of Health, has taken measures to control cancer risk factors, among them being the implementation of the Brunei Darussalam Multisectoral Action Plan for Prevention and Control of Non-communicable Diseases (BruMAP-NCD). This is a national action plan covering various sectors to prevent and control non-communicable diseases. As cancer is the leading cause of death in the country, an important component of the action plan is on the prevention and control of cancer. The Multisectoral Taskforce on Health (MSTFH) comprising agencies and ministries has worked and contributed towards the implementation of this action plan.

The minister said that one of the approaches that can be taken is to adopt a healthier lifestyle and undergo regular health screenings to detect early signs of cancer.

Tobacco use is still one of the leading causes of cancer worldwide. The World Cancer Report 2020 estimates that each year, 2.4 million cancer patient deaths are related to tobacco use.

According to the national STEPS NCD 2016 survey, in Brunei, 20 per cent or one in five adults are smokers, of which 36 per cent or one in three are adult men.

A Global Youth Tobacco Survey in schools conducted in 2019 among adolescents aged 13-15 found that 9.2 per cent or one in 10 adolescents are smokers or use tobacco products, and 52 per cent of teens have reported being exposed to secondhand smoke.

“A majority of countries, Brunei included, has shown encouraging progress in tobacco control. However, it is still far from sufficient because there are still many challenges that need to be faced in reducing tobacco use. Among the challenges that need to be taken into account is in controlling the entry of tobacco into this country, because the use of cigarettes among adults and youth remains despite there being no legal tobacco sellers registered in Brunei Darussalam,” the minister said.

Apart from raising public awareness on the dangers of smoking and secondhand smoke, the MoH also provides smoking cessation clinics at all health centres in each district for those hoping to kick the habit.

The WHO launched the Global Strategy to Accelerate the Elimination of Cervical Cancer in November 2020. Brunei fully supports this and has pledged its full commitment (through the MoH) in the effort to eradicate cervical cancer by 2030.

Among the targets are 90 per cent of female adolescents receive full Human Papillomavirus (HPV) vaccination by age 15; 70 per cent of women are screened using high-performance tests at ages 35 and 45; and 90 per cent of women who suffer from cervical disease receive treatment.

“Brunei Darussalam has achieved the target of vaccination and treatment, but there is still room to improve the target of 70 per cent of women eligible for screening for cervical cancer. Therefore, I would like to call on women to also register for cervical cancer screening at the nearest Maternal and Child Health Clinic,” the minister said.

“Early detection of cancer is a very important component in the control of cancer, which allows us to diagnose and remove tumours while they are still in the early stages and improve the survival or longevity of patients.”

The public is strongly encouraged to use the screening facilities and participate in the initial detection programmes provided by the Brunei government. National screening programmes for breast, cervical and colorectal cancer are offered at all health centres and clinics at Maternal and Child Health Clinics nationwide, including at the Early Detection and Cancer Prevention Services (EDCP), Pantai Jerudong Specialist Centre (PJSC).