A trace of blood in the stool, a mild stomach ache, and a persistent urge to pass motion. Most Malaysians would dismiss these as haemorrhoids or a simple stomach upset.
Main image: Dr. Jothinathan Muniandy urged general practitioners to normalise conversations about bowel health as primary care doctors are the first line of defence.
But these seemingly harmless symptoms are often the first warnings of colorectal cancer, Malaysia’s most common cancer among men and the second most common among women, warned Dr. Jothinathan Muniandy, a consultant general and colorectal surgeon at Oriental Melaka Straits Medical Centre.
According to the Malaysia National Cancer Registry Report 2017–2021, about 70 percent of colorectal cancer cases are only diagnosed when the disease has already reached stage three or four. “By then, treatment becomes tougher and survival drops sharply. This is a disease that can be prevented or cured if caught early,” stressed Dr. Jothinathan.
The data paint a worrying picture. Colorectal cancer now makes up nearly 10 percent of all cancer cases worldwide, and in Malaysia, its incidence is highest among the Chinese population, followed by Malays and Indians. Traditionally seen in older adults, cases are now increasingly appearing among younger Malaysians in their 20s to 50s, a trend that the expert describes as “deeply concerning and a sign of lifestyle and dietary shifts.”
Screening, he said, is the single most powerful tool in changing these outcomes. The immunochemical Faecal Occult Blood Test (iFOBT) and M2-PK stool tests are simple, affordable, and available at most clinics.
“These non-invasive tests can detect hidden blood or enzyme markers long before symptoms arise. For those who test positive, a colonoscopy, the gold standard, allows doctors to both diagnose and remove any suspicious growths during the same session.”
While screening for average risk individuals is recommended from age 50, both the Ministry of Health Malaysia and the American Cancer Society have revised guidelines suggesting it begin as early as 45 years old, particularly due to rising cases in younger age groups. For those with family history, Dr Jothinathan advises starting at 40 years old, or ten years before the age their relative was diagnosed.
Despite widespread availability, uptake remains low, below 20 percent among eligible adults. Many Malaysians still avoid screening due to fear, stigma, or embarrassment. “People worry it will be painful, or they simply don’t want to talk about that part of their body. But the truth is, most of these tests are quick, painless, and can save your life,” he added.
According to the National Strategic Plan for Colorectal Cancer (2021–2025), early detection dramatically improves survival; about 75.8 percent of patients diagnosed at stage one live beyond five years, compared to just 17.3 percent for those at stage four. Yet, awareness remains the biggest barrier.
Government clinics and NGOs such as the National Cancer Society Malaysia and Colorectal Cancer Survivorship Society Malaysia (CORUM) currently offer free screening, but participation is voluntary. Dr. Jothinathan believes that integrating routine screening reminders into national health systems, similar to programmes in Japan, Singapore, and the UK would significantly boost early detection rates.
Beyond cancer prevention, he stressed that colon health is central to overall well-being. A balanced diet high in fibre, fruits, and whole grains, along with regular exercise, adequate sleep, and stress management, all contribute to a healthy gut and body.
“Your gut affects everything from your digestion to your mood and energy levels. A healthy colon truly reflects a healthy life,” the expert explained.
He also urged general practitioners to normalise conversations about bowel health as primary care doctors are the first line of defence.
The message is simple but urgent: listen to your body, get screened early, and don’t wait for symptoms. Colorectal cancer is preventable, treatable, and curable, but only if caught in time.
Dr. Jothinathan Muniandy
Consultant General and Colorectal Surgeon
Oriental Melaka Straits Medical Centre
