Colorectal Cancer in Brunei Darussalam: An Overview and Rationale for National Screening Programme.

Mei Ann Lim,Sok King Ong,Vui Heng Chong,Ya Chee Lim

doi:10.31557/apjcp.2019.20.12.3571

Abstract

Colorectal cancer (CRC) is the third most common cancer worldwide after lung and breast cancers, and ranks second in terms of cancer mortality globally. Brunei Darussalam reports high incidence of CRC in the Southeast Asian region and has no formal national screening programme for CRC. Screening for CRC in Brunei Darussalam is offered in an opportunistic fashion for individuals with average or above average risks for CRC, that is, the individual has a positive family history of CRC or neoplasms and is more than 50 years old. Opportunistic screening is widely practiced but this is not standardised. The Ministry of Health in Brunei Darussalam is currently in the process of implementing a CRC screening programme as part of a larger national health screening based on the increasing incidence of non-communicable diseases (NCDs). This review article assesses the situation of CRC in Brunei Darussalam from the 1980s to present day, including incidence of CRC in different age groups, ethnicities and genders; relevant non-modifiable and modifiable risk factors of CRC in Brunei Darussalam setting; and common CRC screening techniques used in Brunei Darussalam as well as other Asia-Pacific countries. The review also discusses the merits of a national CRC screening programme. With the increasing incidence of CRC worldwide and in Brunei Darussalam, national screening for CRC in Brunei Darussalam is an important strategy to lower morbidity and mortality rates. A review of the progress and outcome of the national screening programme will be available a few years after rollout.

Highlights

Colorectal cancer (CRC) is the third most common cancer worldwide after lung and breast cancers, and ranks second in terms of cancer mortality (Bray et al, 2018)
The Ministry of Health in Brunei Darussalam is currently in the process of implementing a CRC screening programme as part of a larger national health screening based on the increasing incidence of non-communicable diseases (NCDs)
This review article assesses the situation of CRC in Brunei Darussalam from the 1980s to present day, including incidence of CRC in different age groups, ethnicities and genders; relevant non-modifiable and modifiable risk factors of CRC in Brunei Darussalam setting; and common CRC screening techniques used in Brunei Darussalam as well as other Asia-Pacific countries

Summary

Introduction

Colorectal cancer (CRC) is the third most common cancer worldwide after lung and breast cancers, and ranks second in terms of cancer mortality (Bray et al, 2018). Non-Modifiable Risk Factors The main non-modifiable risk factors for CRC are increasing age, genetic predispositions (positive family history of CRC and other related cancers cluster), previous history of polyps, and IBDs (Crohn’s disease and Ulcerative Colitis) (Cunningham et al, 2010; WCRF/ AICR, 2018). With regards to dietary patterns, the consumption of processed meat (meat preserved by smoking, curing, salting or adding chemical preservatives) and the intake of alcoholic beverages (intakes above 30 grams per day, equivalent to approximately two or more alcoholic drinks per day) as strong convincing risk factors of CRC (WCRF/AICR, 2018) is consistent with the findings reported by the IARC monograph series (Cogliano et al, 2011), which established that the consumption of processed meat and alcohol are group 1 carcinogens in CRC cases. Vitamin D deficiency is generally not considered an issue, except in the older or younger population with limited sunlight exposure

Incidence of Cancer Among Citizens and Permanent Residents of Brunei

Diabetes Mellitus

Findings

Number of Deaths