Medical Journal of Malaysia最新文献

{"title":"The barriers to colorectal cancer screening tests among adults attending Seremban health clinic in Negeri Sembilan, Malaysia.","authors":"H H Sein, S M Tay, P S Chong, M C Y Lee, R K Naliena, M N I F Sonakshi, F Z Zainal, S Elhariri, M M Theingi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal cancer (CRC) is the second most common cancer in Malaysia, with most cases diagnosed at late stages, leading to poor survival. Stool-based screening methods, like the immunological faecal occult blood test (iFOBT), can reduce CRC mortality, but national uptake remains below 3%. This study explores barriers to CRC screening and their association with sociodemographic factors among adults aged 50 and above attending Seremban Health Clinic.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted in March 2025 at Seremban Health Clinic, Negeri Sembilan, involving 400 adults aged 50 and above. Participants were selected through purposive sampling and completed a self-administered questionnaire adapted from the Scottish Bowel Screening Programme. Data analysis was performed using IBM SPSS version 28.0, with statistical methods including multiple linear regression.</p><p><strong>Results: </strong>The most frequently reported barriers included low self-efficacy, unfamiliarity with screening procedures, emotional concerns, and negative perceptions of screening. Age, gender, education level, employment status, and previous experience on cancer screening were found to have significant associations with barriers to cancer screening. Respondent's belief in early detection, a sense of health responsibility, and encouragement from healthcare providers and family were identified as facilitators to cancer screening. Prior screening experience was linked to fewer barriers.</p><p><strong>Conclusion: </strong>Findings indicate the need for targeted interventions to improve awareness, confidence, and attitudes toward screening.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 5","pages":"714-721"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential utility of cell-free deoxyribonucleic acid for detection of early-stage resectable non-small cell lung cancer.","authors":"A Sachithanandan, P K Tan, H Mahendra-Raj, B Vivek, H H Hoh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cell-free DNA (cfDNA) has emerged as a promising non-invasive biomarker for cancer detection, including non-small cell lung cancer (NSCLC). While these approaches have demonstrated high diagnostic accuracy in controlled settings, their performance in real-world clinical populations remains uncertain. This study aimed to evaluate the diagnostic performance of a plasma cfDNA assay for early-stage NSCLC detection and to explore its association with clinicopathological parameters.</p><p><strong>Materials and methods: </strong>This was a single-center, crosssectional study involving 61 patients with radiologically suspected lung lesions, of whom 52 were confirmed NSCLC. Plasma samples were analyzed using a shallow genomewide sequencing-based cfDNA assay incorporating fragmentomic and copy number features. cfDNA results were compared against histopathological diagnosis to determine sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Associations between cfDNA detection and clinical variables were evaluated using appropriate statistical tests.</p><p><strong>Results: </strong>The cfDNA assay demonstrated a sensitivity of 75% and a PPV of 84.8% with a specificity of 22.2% and NPV of 13.3%. cfDNA detection rates increased with advancing disease stage, although a relatively high sensitivity was observed even in stage I disease (79.4%). No statistically significant associations were found between cfDNA positivity and conventional markers of tumour burden, including tumour size, serum carcinoembryonic antigen, and SUVmax.</p><p><strong>Conclusion: </strong>The cfDNA assay evaluated in this study demonstrated limited clinical utility as a standalone screening tool due to its low specificity and NPV in a realworld early-stage NSCLC population. Future efforts should focus on improving assay specificity through the incorporation of multi-omic tumour-specific biomarkers and validation that includes early-stage lung cancer cases and benign pulmonary conditions.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 5","pages":"685-691"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of complex older patients with acute ischaemic stroke and atrial fibrillation: A comparison study with and without the use of oral anticoagulants for secondary stroke prevention.","authors":"S H Chee, K M Tan, S L Ooi, L Y Ting","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Direct oral anticoagulants (DOACs) have become the mainstay of stroke prevention in patients with atrial fibrillation (AF). Decision to anticoagulate frail and post-stroke patients with AF may be challenging and complex. This study aimed to compare the outcomes of complex older patients with acute ischaemic stroke and AF who were treated with and without oral anticoagulants for secondary stroke prevention.</p><p><strong>Materials and methods: </strong>This is a retrospective observational study of all older persons (≥65 years) admitted to the geriatric medicine ward in our university hospital with acute ischaemic stroke and AF from January 2016 - December 2021. The inclusion criteria in our study were patients discharged alive from hospital post-ischaemic stroke with AF. Exclusion criteria were those who died as inpatient, those undergoing end-of-life care or with very severe frailty which are contraindication to anticoagulation. Comparison was done between patients who were anticoagulated and patients who were eligible for anticoagulation but were not anticoagulated for various reasons.</p><p><strong>Results: </strong>There were 539 patients with ischaemic stroke, of whom 110 (21%) had AF. Among them, 29 patients were excluded due to death during hospitalization (19), end-of-life (4), and very severe frailty (6). While 65 (80%, mean age 84.1 ± SD 6.3) were discharged on anticoagulation, 16 (20%, mean age 88.3 ± SD 4.3, p=0.388) were discharged without anticoagulation. The median clinical frailty score was six in both groups. Among the anticoagulated, 59 (91%) were commenced on DOACs and six (9%) were on warfarin. The main reasons recorded for not commencing anticoagulants in eligible patients were patient/family did not agree to start (8), high bleeding risk (7), and poor social support (1). Mortality was significantly higher in the non-anticoagulated group (n=10, 63%) compared to the anticoagulated group (n=22, 32%) (p=0.036).</p><p><strong>Conclusion: </strong>Although frail older persons are perceived to have a poorer benefit/risk ratio when anticoagulated, our study demonstrated lower mortality in post-stroke anticoagulated complex older AF patients compared to those who were not anticoagulated. However, given the small numbers of participants in our study, further studies are required to determine characteristics of patients who may have better outcomes or lower risk of adverse events on anticoagulants. These findings also underscore the pressing need for a standardized, frailty-prescribing and monitoring protocol to maximise benefit and minimise risks of adverse outcomes.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 5","pages":"627-633"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translating communication partner training evidence for multilingual aphasia rehabilitation in Malaysia: A structured narrative review.","authors":"J Shaari, M A A Aziz, F H Hassan, N Yusoff, K Khalid, M F Ali, N B I Zulkifli, N S M Zawawi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Aphasia affects everyday communication, social participation, and caregiver wellbeing. Communication partner training (CPT) is a participationoriented intervention that equips familiar partners with strategies to support communication in daily interactions. However, most CPT evidence is drawn from monolingual contexts, limiting applicability to multilingual settings such as Malaysia. This structured narrative review synthesised evidence on CPT effectiveness, implementation determinants, delivery modalities including telepractice and hybrid care, and multilingual aphasia rehabilitation, with the aim of translating these findings to the Malaysian rehabilitation context.</p><p><strong>Materials and methods: </strong>A structured narrative review was conducted to synthesis the evidence thematically. Evidence was purposively selected to capture CPT effectiveness, caregiver and participation outcomes, implementation determinants, telepractice delivery, multilingual aphasia, and Malaysian service contexts. Findings were synthesised thematically.</p><p><strong>Results: </strong>CPT consistently improves partner communication behaviours and dyadic conversation outcomes, particularly with trained partners. In contrast, caregiver wellbeing and communication participation outcomes are measured less consistently. Implementation evidence identifies barriers related to time, resources, and service organisation, alongside facilitators such as structured training materials, coaching, and organisational support. Telepractice is a feasible CPT delivery mode, with hybrid approaches offering improved access and flexibility. Multilingual evidence indicates variable cross-language generalisation, highlighting the importance of context-sensitive and flexible CPT designs.</p><p><strong>Conclusion: </strong>CPT has strong evidence as a participationfocused intervention for improving trained partner behaviours and dyadic communication outcomes in aphasia. Its application to multilingual rehabilitation contexts, including Malaysia, requires careful adaptation to family language use, caregiver readiness, delivery feasibility, and service resources. Integrating implementation strategies, telepractice, and multilingual considerations is essential for translation into routine care. A modular, caregiver-centred CPT framework may provide a practical foundation for future co-design, piloting, and evaluation in Malaysian rehabilitation services.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 5","pages":"769-777"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"8-Hydroxy-2'-Deoxiguanosine (8-OHdG) as a reliable biomarker for rheumatoid arthritis.","authors":"W Wasan Al-Bassam, B D H Al Khayali, S T Hamad, W Noor Ali, A Haider Hassan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Rheumatoid arthritis (RA) is a chronic, autoimmune, destructive inflammatory synovitis that ultimately affects metabolic function, the vascular system, and systemic bone. Many researchers have demonstrated that free radicals induce oxidative stress and are involved in several disease conditions. It was observed that a physiological equilibrium between oxidants and antioxidants is being disrupted by oxidative stress. Free radicals are molecules, ions, or atoms with unpaired electrons. These elements tend to be stabilized. For stabilization, they attack other molecules to get electrons. In the cells, this behavior can cause mutations or even cellular death. This study aimed to evaluate the oxidative stress marker 8-Hydroxy-2-Deoxiguanosine (8-OHdG) as a biomarker for Iraqi RA patients.</p><p><strong>Materials and methods: </strong>The estimation of the plasma level of this marker was achieved in human RA patients using ELISA. The current study included 132 adult individuals who were diagnosed as RA patients with joint complications, while the remaining 66 were healthy and served as controls. Blood plasma levels of 8-OHdG were estimated using a commercial ELISA kit. The resultant solution was washed after being incubated, and then a conjugate enzyme was added; finally, the results were read using an ELISA reader at 450nm.</p><p><strong>Results: </strong>A significant increase in plasma concentration of 8- OHdG was detected in the disease group. The most significant increase in this biomarker (p = 0.001) appeared in RA patients in comparison with the healthy subjects. The significant increase of inflammatory and oxidative biomarkers highlighted in this study might point to a relationship between these biomarkers and the pathogenesis and progression of rheumatoid arthritis in adult subjects.</p><p><strong>Conclusion: </strong>This study suggests the role of 8-OHdG as an early diagnostic marker of RA. Because 8-OHdG is a strong indicator of oxidative stress-related DNA damage, this result may have significant clinical implications.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 5","pages":"634-638"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical negligence adjudication in Malaysia: A retrospective analysis of law cases in 2025.","authors":"H Zainal Abidin, H Y H Razali","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Medical negligence litigation in Malaysia is rising, making judicial decisions vital for defining contemporary duties of care and clinical governance. This study presents a retrospective document-based analysis of medicolegal cases adjudicated in 2025 to systematically identify and categorise the core clinical and systemic issues driving liability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A retrospective document search was conducted on reported Malaysian medical negligence judgments published between January 1 and December 31, 2025, across the LexisNexis and Current Law Journal databases. From 51 initial records, 22 non-relevant disputes were excluded, yielding 29 clinically relevant medicolegal cases for analysis. A descriptive, quantitative and demographic profiling of the dataset was conducted to map the structural landscape of the litigation. To systematically analyse the evolving standards of medical accountability and clinical governance in Malaysia, a retrospective, document-based thematic analysis using a structured threestage qualitative coding framework was conducted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Litigation was heavily concentrated in the High Court (22 cases), clustered in urban centres, and dominated by public hospitals (15 cases). Surgical domains were the most frequently litigated: Orthopaedics (10 cases), Obstetrics & Gynaecology (8 cases), and Other Surgical Specialities (6 cases). The qualitative analysis synthesised five dominant areas of judicial scrutiny: 1) Negligence in Timely Intervention and Diagnosis, 2) Breach of Informed Consent and Patient Autonomy, 3) Medical Records and Documentation Evidence, 4) Systemic Liability, and 5) Legal and Procedural Issues. Liability was consistently driven by critical delays in time-sensitive interventions, such as emergency Caesarean sections resulting in severe birth injuries and delayed vascular treatment leading to limb loss. Diagnostic failures, including the inability to order essential radiological investigations or misdiagnosing acute conditions like Deep Vein Thrombosis and fatal septic shock, were also key findings. Furthermore, the judiciary showed a consistent judicial emphasis on protecting patient autonomy, penalising doctors for insufficient disclosure of material risks and failure to advise on alternative treatments. Judicial severity was notably demonstrated against healthcare professionals operating beyond their credentialed boundaries, confirming that practice must strictly adhere to regulatory standards. A significant trend identified is the increased focus on corporate accountability, with hospitals being held corporately liable under the principle of non-delegable duty for systemic failures. Inadequate referral systems and a lack of qualified standby personnel led to hospital liability even where individual treating doctors were absolved of direct clinical negligence. Additionally, the integrity of medical records proved piv","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 5","pages":"722-734"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of pursed lips breathing using a pinwheel on oxygenation status in children with pneumonia.","authors":"I Reni, R P Andayani","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Pneumonia is one of the causes of child death in the world. One of the non-pharmacological therapies given to overcome the impact of pneumonia in children is Pursed Lips Breathing (PLB) exercises. PLB is given to help overcome the ineffectiveness of airway clearance in patients with pneumonia by increasing the development of the alveoli in each lung lobe so that it can induce a normal breathing pattern and the child becomes more relaxed. The purpose of this study was to determine the effectiveness of PLB using pinwheel game on oxygenation status in children with pneumonia.</p><p><strong>Materials and methods: </strong>This study is a quantitative study using a quasi-experimental design using a pretest and posttest approach with control group design. This study consisted of two groups, namely the intervention group given PLB blowing a pinwheel with a penguin game, while the control group was given LPS. The study was conducted at Reksodiwiryo Army Hospital Padang with 15 respondents in the intervention group and 15 in the control group. Data analysis was carried out using a pooled t-test and paired ttest.</p><p><strong>Results: </strong>The effectiveness of PLB using a pinwheel on oxygenation status in children with pneumonia found in this study can be used as evidence-based practice in treating children with pneumonia.</p><p><strong>Conclusion: </strong>PLB can be used as an independent nursing intervention that can be implemented in hospitals.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 5","pages":"644-647"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic kidney disease in type 2 diabetes: Identifying key risk factors from Johor national diabetes registry study.","authors":"M H A Khebir, T R Razak, N Ismail, M I Abdul Hafidz, N Ismail, M R Isa","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) is a common and important complication among patients with, contributing to substantial morbidity and adverse clinical outcomes. This study aimed to determine the factors associated with CKD among patients with T2DM in Johor, Malaysia.</p><p><strong>Materials and methods: </strong>This was a registry-based crosssectional study using secondary data from the Malaysian National Diabetes Registry (NDR). The study included patients with T2DM captured in the Johor NDR during the 2020-2021 audit cycle. CKD status was determined by calculating the estimated glomerular filtration rate (eGFR) using the CKD Epidemiology Collaboration (CKD-EPI) formula based on serum creatinine and relevant patient variables extracted from the registry. Patients were operationally classified as having CKD if the available registry-derived eGFR was <60 mL/min/1.73 m². Sociodemographic, clinical, biochemical, diabetes-related complication, and medication-related variables were analysed. Univariate analysis was performed using Chisquare test or Fisher's exact test, and variables with p<0.05 were entered into multivariable logistic regression to identify factors independently associated with CKD among patients with T2DM.</p><p><strong>Results: </strong>A total of 10,117 patients with T2DM were included, of whom 2,387 (23.6%) had CKD. Factors independently associated with CKD were age ≥60 years (aOR: 2.97, 95% CI: 2.60, 3.38), hypertension (aOR: 1.37, 95% CI: 1.10, 1.70), diabetes duration >10 years (aOR: 1.84, 95% CI: 1.58, 2.14), abnormal triglyceride (aOR: 1.59, 95% CI: 1.42, 1.79), abnormal high-density lipoprotein (HDL) (aOR: 1.26, 95% CI: 1.13, 1.40), diabetic retinopathy (aOR: 1.22, 95% CI: 1.06, 1.40), cerebrovascular disease (aOR: 1.40, 95% CI: 1.06, 1.85), and diabetic foot ulcer (aOR: 2.40, 95% CI: 1.68, 3.41). Medication-related associations were observed but should be interpreted cautiously because of potential confounding by indication and reverse causation.</p><p><strong>Conclusion: </strong>CKD affected nearly one-quarter of patients with T2DM in this Johor registry-based study. Older age, hypertension, longer diabetes duration, lipid abnormalities, diabetic retinopathy, cerebrovascular disease, and diabetic foot ulcer were independently associated with CKD. These findings provide useful real-world evidence to support earlier risk identification and future development of a locally derived CKD risk prediction model among Malaysian patients with T2DM.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 5","pages":"648-660"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review on barriers to the use of contraceptive services and other family planning services among married couples in South Asia.","authors":"S S Husain, M Pavlova, W Groot, M T Zaigham, Z Ahmad","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>There is a dearth of research in terms of systematic review to explore the barriers to contraceptives faced by married couples in South Asia. This systematic review explores the evidence on issues faced by married couples in South Asia regarding the use of contraceptives and other family planning services.</p><p><strong>Materials and methods: </strong>A systematic literature review was conducted using PubMed, EBSCO, and Web of Science databases. Articles published in English between 2011 and 2025 were included. Inclusion criteria were: South Asian married couples, forms of contraception, barriers to using contraception and other family planning services. A directed qualitative content analysis approach was employed, using Andersen's Behavioral Model to classify findings into predisposing, enabling, and need-based factors. Risk Of Bias assessment was done using CASP tool.</p><p><strong>Results: </strong>Out of 301 records identified, 65 studies were finally included following screening and full-text assessment. Among these, 62% identified cultural and gender-related barriers, 54% highlighted religious influences (especially in Pakistan and Afghanistan), and 48% noted misinformation and knowledge gaps. Additional themes included service inaccessibility, provider bias, and poor outreach, particularly in Nepal and rural India.</p><p><strong>Conclusion: </strong>In South Asian countries, there are major barriers to the use of contraception and other family planning services, mostly due to the overall lack of knowledge, religious factors and allowing myths and misinformation to discourage the use of contraceptives.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 5","pages":"750-758"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and patterns of management of metastatic/recurrent cervical carcinoma in Malaysia: A single institutional observational cohort study.","authors":"S M Yacob, R A Malik","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical cancer is the fourth most common malignancy in women. Approximately 15% of the patients have metastatic disease. The Malaysian National Cancer Registry (MNCR) 2017-2021 reported that over the five-year period, there were 2654 new cases. 47.1% of the patients presented with late stages (stages 3 and 4), slightly higher compared to 41% in the MNCR 2012-2016 report. There were no standard approaches to the management of metastatic/recurrent cervical cancer. Therefore, this study aimed to determine the survival outcomes of patients with metastatic/recurrent cervical cancer and to evaluate the clinicopathological factors based on demographic and tumour characteristics that may affect survival outcomes. Besides that, we would like to outline the management patterns in this cohort of patients.</p><p><strong>Materials and methods: </strong>This was a retrospective observational cohort study looking at the 35 patients diagnosed with metastatic/recurrent cervical cancer at the Department of Clinical Oncology, Universiti Malaya Medical Centre (UMMC) over the five-year period from 1st of January 2016 until 31st of December 2020. Data were obtained from the electronic medical record. The Kruskal-Wallis H and Mann-Whitney U non-parametric tests, Spearman correlation, and Kaplan-Meier survival analysis were conducted to analyse the survival outcomes and clinicopathological factors that may affect the survival outcomes in the form of progression-free survival (PFS) and overall survival (OS). Descriptive analysis was used to describe the prevalence of metastatic/recurrent cervical cancer and the patterns of management.</p><p><strong>Results: </strong>Out of the total 94 cervical cancer patients registered at the Department of Clinical Oncology, UMMC, 37.2% had metastatic/recurrent disease. Survival analysis demonstrated that median PFS and OS for metastatic/recurrent cervical cancer were six and 12 months, respectively, which were consistent with the global populations. Nonparametric multivariate tests and survival analysis showed that the presence of metastatic disease at less common sites had worse survival. Most of the patients received active oncological treatments, i.e., chemotherapy, radiotherapy or combinations of both.</p><p><strong>Conclusion: </strong>This study showed that a significant portion of the patients were diagnosed at a late stage, with poor survival outcomes, indicating the necessity for enhanced initiatives in the screening and education programmes to increase awareness of early diagnosis and detection, hence improving survival outcomes of cervical cancer patients.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 5","pages":"669-676"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}