Browsing by Author "Huan-Keat Chan"
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- PublicationA 5-year evaluation of using stool-based test for opportunistic colorectal cancer screening in primary health institutions across Malaysia(Elsevier Ltd., 2020)
;Nor Saleha Ibrahim Tamin ;Khursiah Ahmad Razalli ;Siti Norain Sallahuddin ;Huan-Keat ChanMuhammad Radzi Abu HassanIntroduction: The immunochemical fecal occult blood test (iFOBT) has been widely used for opportunistic colorectal cancer (CRC) screening in average-risk individuals seeking care from public health clinics in Malaysia. This study provides a 5-year outcome evaluation of such a practice. Methods: The findings for a few outcome indicators, ranging from the iFOBT uptake to the CRC and polyp detection rates, were generated from the data contributed by 583 public health clinics between 2014 and 2018. The trends in their changes were also evaluated. Results: The iFOBT uptake constantly increased over the years (p < 0.001), totaling 2.29 % (n = 127,957) as at 2018. Nearly 10 % (n = 11,872) of the individuals screened had a positive test result. Of those who underwent colonoscopy (n = 6,491), 4.04 % (n = 262) and 13.93 % (n = 904) were found to have CRC and polyps, respectively. Conclusion: An uptrend in the CRC screening uptake was witnessed following the introduction of the iFOBT in public health clinics. - PublicationA Malaysian retrospective study of acupuncture-assisted anesthesia in breast lump excision(2020)
;Ju-Ying Ang ;Kavita Bhojwani ;Huan-Keat ChanAi-Chen ChanIntroduction: The objective of this retrospective study was to evaluate the effectiveness and safety of acupuncture assisted anesthesia (AAA) in breast lump excision. Methods: The medical records of all patients who underwent breast lump excision under AAA in combination with electrical stimulation at traditional acupuncture points in 2016 were examined. All of them (n ¼ 17) received electro stimulation (2–4 Hz) using single needles inserted at bilateral LI4 and PC6. They also underwent insertion of four acupuncture needles at the lump site, which were electrically stimulated at 30 Hz frequency. Results: All surgical procedures were successful with minimal use of analgesics and local anesthetic. The median pain score reported was 1/10 (interquartile range (IQR) ¼ 2/10) at the first hour, and slightly increased to 2/10 (IQR ¼ 2/10) between 24 and 48 h of the surgery. No major postoperative adverse events were documented, except for drowsiness in one case. Conclusion: AAA was found to be generally safe and effective for anaesthesia and analgesia in breast lump excision. However, a large-scale randomized controlled study is required to verify the findings. - PublicationHepatitis C virus (HCV) infection in Malaysia: findings from a nationwide cross-sectional study(2023)
;Eida Nurhadzira Muhammad ;Mohd Hatta Abdul Mutalip ;Zhuo-Lin Chong ;Huan-Keat Chan ;Fazidah Yuswan ;Noor Ani AhmadMuhammad Radzi Abu HassanBackground: The prevalence of hepatitis C virus (HCV) infection in Malaysia has been estimated at 2.5% of the adult population. Our objective, satisfying one of the directives of the WHO Framework for Global Action on Viral Hepatitis, was to forecast the HCV disease burden in Malaysia using modelling methods. Methods: An age-structured multi-state Markov model was developed to simulate the natural history of HCV infection. We tested three historical incidence scenarios that would give rise to the estimated prevalence in 2009, and calculated the incidence of cirrhosis, end-stage liver disease, and death, and disability-adjusted life-years (DALYs) under each scenario, to the year 2039. In the baseline scenario, current antiviral treatment levels were extended from 2014 to the end of the simulation period. To estimate the disease burden averted under current sustained virological response rates and treatment levels, the baseline scenario was compared to a counterfactual scenario in which no past or future treatment is assumed. Results: In the baseline scenario, the projected disease burden for the year 2039 is 94,900 DALYs/year (95% credible interval (CrI): 77,100 to 124,500), with 2,002 (95% CrI: 1340 to 3040) and 540 (95% CrI: 251 to 1,030) individuals predicted to develop decompensated cirrhosis and hepatocellular carcinoma, respectively, in that year. Although current treatment practice is estimated to avert a cumulative total of 2,200 deaths from DC or HCC, a cumulative total of 63,900 HCV-related deaths is projected by 2039. Conclusions: The HCV-related disease burden is already high and is forecast to rise steeply over the coming decades under current levels of antiviral treatment. Increased governmental resources to improve HCV screening and treatment rates and to reduce transmission are essential to address the high projected HCV disease burden in Malaysia. - PublicationIncidence, Clinico-demographic Profiles and Survival Rates of Colorectal Cancer in Northern Malaysia: Comparing Patients Above and Below 50 Years of Age(Asian Pacific Organization for Center Prevention, 2020)
;Nik Razima Wan Ibrahim ;Huan-Keat Chan ;Shahrul Aiman Soelar ;Ahmad Najib Azmi ;Rosaida Mohd SaidMuhammad Radzi Abu HassanBackground: While the world witnesses an increasing trend of young-onset colorectal cancer (CRC), the information regarding the impact of age on CRC is limited in Malaysia. This study aimed to compare the incidence, clinic-demographic profiles and survival rates of CRC between patients above and under 50 years of age in northern Malaysia. Methods: This was a registry-based, cross-sectional study. All the CRC cases reported by 18 hospitals to the National Cancer Patient Registry - Colorectal Cancer (NCPR-CC) between January 2007 and December 2017 were included in the analysis. The patients were categorized by age into the above-50 and under-50 groups. The changes in the age-standardized incidence and mortality rates of both the age groups were determined using the time-series analysis, and the impact of age on the mortality risk was assessed using the Cox regression analysis. Results: Of the 6,172 CRC patients enrolled in the NCPR-CC, 893 (14.5%) were in the under-50 group. As compared with their older counterparts, the patients in the under-50 group were more likely to be female, be of Malay ethnicity, be non-smokers, have a family history of CRC, and present late for treatment. The age-standardized incidence and mortality rates of CRC in the under-50 group remained stable over the years, while a decreasing trend was clearly seen in the mortality rates of CRC in the above-50 group (p=0.003). Nevertheless, the two age groups also did not differ in the mortality risk (adjusted hazards ratio: 1.10; 95% CI: 0.90, 1.36). Conclusion: Young-onset CRC constituted a considerable proportion of CRC cases in Malaysia. However, in contrast with the findings of most studies, it demonstrated neither an uptrend in age-standardized incidence rates nor a higher mortality risk. Our findings suggest the need to upscale and lower the recommended age for CRC screening in Malaysia. - PublicationSpatial clustering of colorectal cancer in Malaysia(2023)
;Sharifah Saffinas Syed Soffian ;Azmawati Mohammed Nawi ;Rozita Hod ;Khairul Nizam Abdul Maulud ;Ahmad Tarmizi Mohd Azmi ;Mohd Hazrin Hasim Hashim ;Huan-Keat ChanMuhammad Radzi Abu HassanThe rising trend of Colorectal Cancer (CRC) incidence has become a global concern. Spatial determinants may play an important role as suggested by registered geographical variations of CRC incidence. The current study was designed to identify the spatial distribution pattern of CRC at the neighbourhood level in Malaysia by geocoding the addresses of CRC cases registered by the National Cancer Registry between 2010 and 2016. Cluster analysis was performed to examine the spatial dependence of CRC cases as well as group differences with regard to socio demographic characteristics. Identified clusters were categorized into urban and rural areas based on the population background. Most of the 18,405 individuals included in the study were male (56%) and people aged between 60 and 69 years (30.3%). Among patients with available information on their CRC stage, 71.3% presented for care late (at stages III or IV of the disease). The Malaysian states shown to have CRC clusters were Kedah, Penang, Perak, Selangor, Kuala Lumpur, Melaka, Johor, Kelantan and Sarawak. Spatial autocorrelation detected significant clustering (Moran’s I = 0.244, p < 0.01, Z-score >2.58). The CRC clusters in Penang, Selangor, Kuala Lumpur, Melaka, Johor and Sarawak occurred in urbanized areas, while those in Kedah, Perak and Kelantan were in rural areas. Factors associated with urban CRC clusters as shown by Odds Ratio (OR) included late-stage presentation (1.27, CI 1.15-1.41); post-mortem diagnosis (0.82, CI 0.76-0.89); and adenocarcinoma type of the cancer (0.81, CI 0.67- 0.98). We conclude that the presence of several clusters in urban ized and rural areas implies the impact of ecological determinants at the neighbourhood level. These findings can be used to guide the policymakers in resource allocation and cancer control.