NATIONAL

STRATEGIC PLAN FOR

CANCER CONTROL
PROGRAMME
2021-2025

M I N I S T RY O F H E A LT H M A L AY S IA
Published by
Non-Communicable Disease Section (NCD)
Disease Control Division
Ministry of Health Malaysia
Level 2, Block E3, Complex E
Federal Government Administration Centre
62590 WP Putrajaya
MALAYSIA

Year of publication: 2021

Suggested citation
Ministry of Health Malaysia (2021). National Strategic Plan for Cancer Control
Programme 2021-2025.

Copyright © Ministry of Health Malaysia

All rights reserved. This book may not be reproduced, in whole or in part, in any
form or means, electronic or mechanical, including photocopying, recording, or by
any information storage a retrieval system now known or hereafter invented, without
written permission from the publisher.

This document is available at the MOH Website:

http://www.moh.gov.my
 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

Table of Contents

ACKNOWLEDGEMENT.............................................................................................i
FOREWORD............................................................................................................ii
EXECUTIVE SUMMARY.........................................................................................iii
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025
..................................................................................................................... 1
1 INTRODUCTION................................................................................................1
1.1 Cancer Situation Worldwide........................................................................1
1.2 Cancer Situation in Malaysia.......................................................................1
2 ACHIEVEMENT OF PREVIOUS STRATEGIC PLAN (NSPCCP 2016-2020)...........6
3 SWOT ANALYSIS.............................................................................................10
4 POLICY STATEMENT, VISION AND MISSION..................................................11
4.1 Policy Statement........................................................................................11
4.2 Vision........................................................................................................11
4.3 Mission.....................................................................................................11
5 OBJECTIVE....................................................................................................12
6 SPECIFIC OBJECTIVES..................................................................................12
7 OVERALL TARGETS........................................................................................12
8 FOCUS AREAS OF THE STRATEGIC PLAN......................................................13
9 PRIORITIES....................................................................................................13
10 PLAN OF ACTION.........................................................................................14
10.1 Prevention and Health Promotion...........................................................14
10.1.1 Background........................................................................................14
10.1.2 Plan of Action Matrix...........................................................................14
10.2 Screening and Early Diagnosis...............................................................15
10.2.1 Background........................................................................................15
10.2.2 Plan of Action Matrix...........................................................................17
10.3 Diagnosis...............................................................................................17
10.3.1 Background........................................................................................17
10.3.2 Plan of Action Matrix...........................................................................20
10.4 Treatment..............................................................................................21
10.4.1 Background........................................................................................21
10.4.2 Plan of Action Matrix...........................................................................25
10.5 Survivorship...........................................................................................25
10.5.1 Background........................................................................................25
10.5.2 Plan of Action Matrix...........................................................................27
 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

10.6 Palliative Care...................................................................................27

10.6.1 Background...................................................................................27
10.6.2 Plan of action matrix......................................................................27
10.7 Traditional and Complementary Medicine.........................................28
10.7.1 Background...................................................................................28
10.7.2 Plan of Action Matrix......................................................................28
10.8 Research and Development...............................................................28
10.8.1 Background...................................................................................28
10.8.2 Plan of Action Matrix......................................................................30
10.9 Monitoring and Surveillance..............................................................31
10.9.1 Background...................................................................................31
10.9.2 Plan of Action Matrix......................................................................31
10.10 Human Capacity Building and Development.....................................31
10.10.1 Background................................................................................31
10.10.2 Plan of Action Matrix...................................................................31
11 PATIENT NAVIGATION............................................................................32
12 ACTION WITH OTHER NON-GOVERNMENT STAKEHOLDERS................33
13 CONCLUSION.........................................................................................34
REFERENCES.................................................................................................35
APPENDICES..................................................................................................36
ABBREVIATIONS..........................................................................................153
EDITORS AND CONTRIBUTORS.................................................................. 159
 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

ACKNOWLEDGEMENT

The Non-Communicable Disease Section, Disease Control Division, Ministry of Health

Malaysia would like to express its gratitude to all individuals and organisations who
have directly or indirectly contributed to the development of the National Strategic
Plan for Cancer Control Programme 2021-2025.

Special thanks especially to the following:

1. Tan Sri Dato’ Seri Dr Noor Hisham Abdullah

Director General of Health Malaysia

2. Datuk Dr Chong Chee Kheong

Deputy Director General of Health (Public Health)

3. Dato’ Dr Norhizan bin Ismail

Deputy Director General of Health (Medical)

4. Datuk Dr Hishamshah bin Mohd Ibrahim

Deputy Director General of Health
(Research and Technical Support)

5. Datuk Dr Norhayati binti Rusli

Director, Disease Control Division

6. Dr Khebir bin Verasahib

Director, Family Health Development Division

7. Dr Ahmad Razid bin Salleh

Director, Medical Development Division

8. Suraiya binti Syed Mohamed

Director, Health Education Division

9. Dr Goh Cheng Soon

Director, Traditional and Complementary Medicine Division

10 Dr Noormi binti Othman

Principal Director, Oral Health Programme

11. Dr Mohd Anis bin Haron@Harun

Director, National Cancer Institute

12. Directors of relevant research institutes

National Institute of Health, Ministry of Health

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

FOREWORD
Cancer is one of the most important non-communicable diseases
(NCDs) worldwide, and the incidence is expected to continue rising.
The expected increase in incidence is mainly due to the rapidly
ageing population and unhealthy lifestyles.

The World Health Organization (WHO) in its Globocan report 2018,

estimated that the global burden of cancer was 18.1 million new
cases, 9.5 million cancer deaths and 43.8 million people living with
cancer. It is estimated that 30 to 50% of cancers can be prevented
through healthy lifestyles, eradication of risk factors such as
tobacco use and vaccination. Whilst systematic screening and access to treatment
can lead to effective treatment of a significant proportion of cancers in high-income
countries, late presentation and limited access to treatment lead to the high percentage
(around 70%) of deaths due to cancer in low- and middle-income countries.

In Malaysia, malignant neoplasm persists as one of the five principal causes of national
mortality for the past two decades. In 2018, cancer contributed to 11.82% of all deaths
in Ministry of Health (MOH) hospitals compared with 9.34% in 2003. The number
of cancer cases reported within the 5-year period of 2007-2011 and 2012-2016 had
increased by 11% for all types of cancer. Cancer of breast, colorectal, lung, lymphoma,
nasopharynx, leukaemia, prostate, liver, cervix uteri and ovary were the ten most
common cancers reported for the year 2012-2016.

Similar to the previous National Strategic Plan for Cancer Control Programme
(NSPCCP) 2016-2020, the NSPCCP 2021-2025 also addressed cancer prevention and
control from a holistic viewpoint that spans across primary prevention, screening, early
detection, diagnosis, treatment, rehabilitation, palliative care as well as traditional
and complementary medicine (T&CM) and research. This new cancer strategic plan
includes monitoring and surveillance of cancer, and human capacity building as new
focus areas. The NSPCCP 2021-2025 identifies ten specific objectives, which are aligned
with the ten focus areas of concern; whereby their respective strategised action plans
and targets are essential for instituting a comprehensive cancer prevention and control
program in the country until 2025. The ability to implement the outlined strategised
action plans is important to enabling Malaysia to effectively manage the increasing
cancer burden in the country.

Last but not least, I would like to express my gratitude to all editors and contributors
from the MOH and all other key stakeholders who were involved in the development
of this new strategic plan. The concerted effort from all stakeholders and commitment
from everyone is very important in ensuring the successful implementation of the
NSPCCP 2021-2025.

…………………………………
TAN SRI DATO’ SERI DR NOOR HISHAM BIN ABDULLAH
Director General of Health Malaysia

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

EXECUTIVE SUMMARY
At the end of 2019, the Cancer Unit under the Non-Communicable Disease Section,
Disease Control Division at the Ministry of Health Malaysia (MOH) initiated the
discussions on the development of the next reiteration of the National Strategic
Plan for the Cancer Control Programme (NSPCCP) for the year 2021-2025. This is
to replace the NSPCCP 2016-2020. A series of discussions and meetings involving
the relevant public health specialists, clinicians from relevant disciplines,
researchers and health education officers from the MOH was conducted, followed
by consultations and meetings with academicians, universities, private healthcare
providers, NGOs and pharmaceutical companies. The meetings addressed related
issues, concerns, strategies and priorities for the cancer control for the country.

The overall objectives of the NSPCCP 2021-2025 are aligned with the objectives
of the National Cancer Control Blueprint (NCCB) 2008-2015, which is to reduce
the negative impact of cancer by decreasing the disease morbidity, mortality and
to improving the quality of life of cancer patients and their families. The NSPCCP
2021-2025 identifies ten specific objectives which are in line with the ten focus
areas of concern; whereby their respective targets and strategised action plans are
essential for instituting a comprehensive cancer prevention and control program
for the country until 2025. Implementation of the outlined strategised action plans
is important to enabling Malaysia to achieve the overall targets of the NSPCCP i.e.,
down-staging cancer at diagnosis, improving survival rates for certain cancers and
reducing the premature mortality due to cancer.

Similar with the previous NSPCCP, the NSPCCP 2021-2025 also addresses cancer
prevention and control from a holistic viewpoint that spans across primary
prevention, screening, early detection, diagnosis, treatment, rehabilitation,
palliative care, as well as Traditional and complementary medicine (T&CM) and
research. This strategic plan also included monitoring & surveillance of cancer
and human capacity building as new focus areas.

MOH calls for support and commitment from all relevant stakeholders in government,
non-government organisations, professional bodies, private cancer centres and
facilities, and pharmaceutical companies to strengthen the existing network and
collaboration, together play our respective important roles in addressing the cancer
burden in the country. Concerted efforts from all, plus continuous monitoring and
evaluation of the various initiatives, are very important in ensuring the successful
implementation of the NSPCCP 2021-2025.

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

NATIONAL STRATEGIC PLAN FOR CANCER CONTROL

PROGRAMME (NSPCCP)
2021-2025

1 INTRODUCTION

Cancer is one of the most important non-communicable diseases (NCDs) globally,

and the incidence is expected to continue to increase. The expected increase in
incidence is mainly due to rapidly ageing populations and behavioural risk factors.

Cancer represents a tremendous burden on patients, families and societies. In

addition to the financial cost of the disease, cancer has important psychosocial
repercussions for patients and their families and remains in many parts of the
world, a stigmatising disease.

It is estimated that one-third of the global burden of cancers are preventable through
vaccination and eradication of modifiable risk factors such as tobacco use. Whilst
systematic screening and access to treatment can lead to effective treatment of a
significant proportion of cancers in high-income countries, late presentation and
limited access to treatment means that 70% of the deaths due to cancer occur in
low- and middle-income countries (LMIC).

1.1 Cancer Situation Worldwide

The World Health Organization (WHO) in its Globocan Report 2020 estimated that
the global burden of cancer was 19.3 million new cases (incidence), 9.9 million
cancer deaths (mortality) and 50 million people living with cancer within five years
of diagnosis (prevalence) (1).

1.2 Cancer Situation in Malaysia

Malaysia, like most developed and advanced developing countries, is also

approaching an epidemiologic transition, where diseases related to lifestyle
particularly cardiovascular diseases and cancers have progressively become more
prevalent.

Malignant neoplasm persisted as one of the five principal causes of national

mortality for the past 20 years and its trend, in terms of absolute numbers, has
increased. In 2019, cancer contributed to 12.18% of all deaths in the Ministry of
Health (MOH) hospitals compared with 9.54% in 2004. The percentage of deaths
in MOH hospitals attributable to cancer over 20 years are displayed in Table 1.

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

The number of cancer cases reported within the 5-year period of 2007-2011 and
2012-2016 had increased by 11% for all cancer sites (2). Meanwhile, the age-
standardised incidence rate (ASR)1 had increased by 2.3 per 100,000 population
in females and slightly reduced by 0.8 per 100,000 population in males. Cancer of
breast, colorectal, lung, lymphoma, nasopharynx, leukaemia, prostate, liver, cervix
uteri and ovary were the ten most common cancers reported for the year 2012-2016.
The ASR of the ten most common cancer by sex is further illustrated in Figure 1
below.

Table 1: Top 5 Principal Causes of Deaths in MOH Hospitals, Malaysia

2004 2009 2014 2019

1st Heart Disease
Diseases of
& Diseases Diseases of
Septicaemia Circulatory
of Pulmonary Circulatory system
(15.10%) system
Circulation (23.34%)
(22.27%)
(16.09%)
2nd Heart Disease
& Diseases Septicaemia Diseases of Diseases of
of Pulmonary (13.82%) Respiratory System Respiratory
Circulation (18.19%) System (21.17%)
(14.52%)
3rd
Certain infectious
Certain infectious
Cancer Cancer & Parasitic
& Parasitic
(9.54%) (10.85%) Diseases
Diseases (14.35%)
(12.47%)

4th Cerebro-vascular
Pneumonia Cancer Cancer
disease
(10.38%) (13.02%) (12.18%)
(8.40%)
5th Diseases of the
Cerebro- External causes of
Accidents genitourinary
vascular disease morbidity and mor-
(6.07%) system
(8.43%) tality (9.30%)
(5.93%)
Source: Health Facts, Ministry of Health (3)

1 ASR is a measure of risk of developing cancer at any given age

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

Source: Malaysia National Cancer Registry (MNCR) 2012-2016 (2)

Figure 1: Age-standardised incidence rate for ten most common cancers in Malaysia,
by sex, 2012-2016

‘Stage’ is a measure of cancer growth and spread, with later stages having poorer
outcomes. Stage at diagnosis is probably the most important determinant of survival.
According to the Malaysian Study on Cancer Survival (MySCan), the relative survival2
was highest at stage I compared to stage IV (Table 2) (4).

Table 2: Relative survival by stage at diagnosis and cancer types, period of diagnosis
2007-2011 and followed up to 2016, Malaysia

Cancer type 1-year relative survival rate 5-year relative survival rate
(%) (%)
Stage I Stage IV Stage I Stage IV
Breast 97.8 66.8 87.5 23.3
Colorectal 87.8 55.1 75.8 17.3
Cervix Uteri 94.3 53.0 75.3 23.0
Lung 63.3 29.6 37.1 6.3
Nasopharynx 94.0 66.2 63.7 26.9

2 Relative survival refers to the probability of being alive for a given amount of
time after diagnosis compared with all mortality in the general population

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

Improving staging at diagnosis can be achieved by earlier detection of cancer.

Certain types of cancer such as breast, colorectal and cervical are possible to
be detected early through screening and early diagnosis. However, the Malaysia
National Cancer Registry (MNCR) 2012-2016 revealed that the stage at diagnosis
for these cancers were mostly at stage III and IV. Figure 2, Figure 3 and Figure 4
showed the percentage of staging for female breast, colorectal and cervical cancer at
time of diagnosis, as reported for the year 2012-2016 (2).

Breast Cancer

Stage I, 17.5%
Stage IV, 22.8%

Stage II, 34.5% Stage III, 25.1%

Figure 2: Percentage for stage at diagnosis for female Breast Cancer, Malaysia, 2012-
2016

Male Female
Stage I, Stage I,
7.4% 6.6%

Stage II, Stage II,

20.2% 20.3%
Stage IV, Stage IV,
39.6% 40.2%

Stage III, Stage III,

32.8% 32.9%

Figure 3: Percentage for stage at diagnosis for Colorectal Cancer, by sex, Malaysia,
2012-2016

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

Cervical Cancer

Stage IV, 18.7%

Stage I, 23.7%

Stage III, 22.3%

Stage II, 35.3%

Figure 4: Percentage for stage at diagnosis for Cervical Cancer, Malaysia, 2012-2016

Cancer survivors faced financial and emotional burden that affect their quality-
of-life following diagnosis and treatment of cancer. A study on economic impact
of cancer on patients and their families in Southeast Asia was conducted by the
ACTION study in 2015 concluded that over 75% of new cancer patients in Southeast
Asia experience financial catastrophe or die within one year (5) we instigated a
study of new cancer patients in the Association of Southeast Asian Nations (ASEAN.
Financial catastrophe here is defined as incurring out-of-pocket medical costs
exceeding 30 percent of annual household income. Out-of-pocket medical costs are
medical care that is not covered by health insurance.

For Malaysia alone, about 45% of Malaysian cancer survivors spend over a third
of their household income for cancer care within the first year of diagnosis (5)we
instigated a study of new cancer patients in the Association of Southeast Asian
Nations (ASEAN. These financial problems may extend to many more years after
diagnosis due to ongoing cancer treatment and care for late effects of treatment.
Being diagnosed with cancer also affect an individual’s ability to work and contribute
to productivity loss in economy. Under the high cost scenario, cancer accounts for
14.1% of productivity loss3 (6).

3 Productivity loss comprise losses due to absenteeism, presenteeism and

death.

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

Apart from productivity losses due to cancer, there is also a health burden incurred
by individuals as a result of loss of healthy life years. The burden of disease,
measured in Disability-Adjusted Life Years (DALYs), combines the potential Years of
Life Lost (YLL) due to cancer deaths and the Years Lost due to Disability (YLD). In
2017, neoplasm accounted for 717,318 DALYs in the Malaysian population (54.3%
males and 45.7% females). The DALY burden of cancer primarily occur in the 50 to
69 age group (47.9%), and the largest burden of diseases losses were from trachea,
bronchus and lung cancer (15%) (6).

2 ACHIEVEMENT OF PREVIOUS STRATEGIC PLAN (NSPCCP 2016-

2020)

The first national strategic plan for cancer control for Malaysia, the National Cancer
Control Blueprint (NCCB) 2008-2015, was published in 2008. The overall aim of
the NCCB 2008-2015 was to reduce the negative impact of cancer and to improve
quality of life of people living with cancer. Under the NCCB, the main achievements
include the introduction of the Human Papillomavirus (HPV) vaccination as a
National Immunisation Program; initiation of the colorectal cancer screening
program using immunological faecal occult blood test (iFOBT); development of a
structured mammogram screening program for high-risk women; initiation of liquid
based cytology (LBC) for cervical cancer screening; and upgrading and development
of various treatment centres and infrastructures, including establishment of the
National Cancer Institute (IKN) in Putrajaya.

The second strategic plan, the National Strategic Plan for Cancer Control
Programme (NSPCCP) 2016-2020, was published in 2017. The aim of the NSPCCP
2016-2020 is similar with the NCCB 2008-2015, and it addressed the cancer care
and management from a holistic viewpoint that spans across primary prevention,
screening, early detection, diagnosis, treatment, rehabilitation, palliative care,
traditional and complementary medicine, as well as research. The achievements
following implementation of the NSPCCP 2016-2020 are elaborated below.

Primary Care : As a continuity of the HPV vaccination program’s success for the
prevention of cervical cancer, in 2019 the MOH was able to start initiate cervical
cancer screening using self-sampling for HPV testing, which is more sensitive
than the conventional Pap smear. The target age group is between 30 to 65 years.
Implementation was planned for four phases and will be continued during the
NSPCCP 2021-2025 period. With this stepwise approach, MOH aims to achieve 40%
coverage of the target group by year 2025.

For detecting cancerous lesion in asymptomatic population, the radiology services

proposed to undertake lung cancer screening using low-dose CT (LDCT) (for time
period 2016-2018). A health technology assessment was conducted by the MOH

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

Health Technology Assessment (HTA) Unit in 2017. The HTA reported that, in
view of LCDT having high sensitivity but low specificity when used for lung cancer
screening among the high-risk group, it was recommended that it may be used for
lung cancer screening among this high-risk group in a research environment or for
research purposes. A lung cancer screening study using LDCT that targeted 14 MOH
hospitals was initiated by the Respiratory Medicine Services of the MOH and the
Clinical Research Centre (CRC), in collaboration with Johnson & Johnson Medical
Malaysia. The study was finally advised to discontinue due to poor response from
the public and target population, as well as budget constraints for the campaign
and promotional activities. The Radiology Department in IKN however decided to
continue the Lung Cancer Screening using LDCT as part of the department routine
services.

Secondary Care : For the period of 2016-2020, the Pathology Services had expanded
the scope of molecular testing to tissue specimens.

For treatment, a budget of RM500 million for the development of the Northern
Oncology Centre was announced by the Prime Minister in 2018. The first Clinical
Oncology Unit (COU) was also established in Hospital Pakar Sultanah Fatimah,
Muar in 2017. Several new services were initiated, including the Stereotactic Body
Radiotherapy (SBRT) in IKN and Stereotactic Radiotherapy and Radiosurgery in
Hospital Sultan Ismail (HSI) Johor Bahru, Hospital Umum Sarawak (HUS) and
Hospital Wanita dan Kanak-Kanak Sabah (HWKKS). Gefitinib and Afatinib (both
tyrosine kinase inhibitors) were listed in the National Formulary as first line
treatments in epidermal growth factor receptor (EGFR) mutated metastatic non-
small cell lung carcinoma, after successfully negotiated to cost-effective pricing
using value-based medicine.

For the year 2016 to 2020, the Radiology Services had successfully installed two
hospitals with the Radiology Information System (RIS), from the initial target of five
hospitals per year. The two hospitals were Hospital Raja Perempuan Zainab II Kota
Bharu (HRPZ II) and Hospital Tuanku Jaafar Seremban (HTJS). For the picture
archiving and communication system (PACS) installation, only one hospital i.e.
HRPZ II was installed with PACS. The initial target was two hospitals per year. For
replacing beyond economic repair (BER) equipment and installing new equipment
based on the norms set out in the MOH Equipment Blueprint, only seven minor
specialist hospital were provided with computerised tomography (CT) scans, out
of the original target of all minor specialist hospitals (28 in total). As for providing
Magnetic Resonance Imaging (MRI) services to all major specialist hospitals, there
are now 12 major specialist hospitals out of 28 major specialist hospitals providing
MRI services. For angiography machines, there were only four units available in
regional hospitals out of the target of six hospitals.

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

The Clinical Haematology Services was able to achieve most of the targets for the
year 2016-2020. Among the milestones achieved were:

• In 2016, a stem cells laboratory was successfully set up and currently operational
in Hospital Queen Elizabeth (HQE), Sabah. As such, the Haematology Unit in
HQE is able to provide complete autologous stem cells transplant services since
2016, which include stem cells collection and infusion for patients undergoing
autologous stem cells transplant.
• The Malaysia Patient Assistance Program (MYPAP) has been sustainable due to
adequate additional budget to support the activities. Owing to the successful
MYPAP program, patients with Chronic Myeloid Leukemia (CML) are able to get
access to Tyrosine Kinase Inhibitor (TKI) therapy, which can usually control the
disease well and allow patients to live normally.

The Breast & Endocrine Surgery sub-specialty centres were established in Hospital
Selayang (January 2016) and HUS (July 2018). Both these centres started with two
Breast & Endocrine surgeons. Hospital Selayang was the first Breast & Endocrine
Surgery sub-specialty centre for Selangor. Previously, most patients were referred
to Hospital Kuala Lumpur (HKL) and Hospital Putrajaya (HPJ). There are now three
Breast & Endocrine Surgery sub-specialty centres in the Central Region. The Breast
& Endocrine Surgery Subspecialty Centre at HUS was very much anticipated as
it would be able to be the centre of excellence for Breast Cancer treatment for
Sarawak. The existing Oncology Services in HUS would be able to support and
complement the treatment for breast cancer patients. This was also the second
centre set up in East Malaysia. The other centre is at Hospital Queen Elizabeth II
(HQE II), Kota Kinabalu. Therefore, MOH now has ten Breast & Endocrine Surgery
Sub-specialty Centres (HKL, HPJ, Hospital Selayang, Hospital Pulau Pinang (HPP),
Hospital Raja Permaisuri Bainun (HRPB) Ipoh, HSI, HRPZ II, Hospital Sultanah Nur
Zahirah (HSNZ), HQE II and HUS.

The Sentinel Lymph Node Biopsy services were established in nine Breast &
Endocrine sub-specialty centres under MOH (i.e HKL, HPJ, Hospital Selayang, HPP,
HRPB Ipoh, HSI, HRPZ II, HQE II and HUS). Similar services are also available in
University Malaya Medical Centre (UMMC) and Hospital Canselor Tuanku Muhriz
UKM (HCTM-UKM).

The Traditional and Complementary Medicine (T&CM) services has set the objectives
of improving the quality of life of cancer patients and allowing the patients to cope
better with the cancer treatment by minimising the side effects of treatment, as
well as relieving pain and suffering. To support these main objectives, the T&CM
services in the area of herbal therapy as an adjunct treatment for cancer patient
and acupuncture for chronic pain was introduced in the T&CM out-patient units
of IKN, Hospital Kepala Batas, HSI Johor and HWKKS. The existing herbal therapy
and acupuncture services were further upgraded, relevant guidelines revised, and

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

facilities upgraded. Acupuncture services to cater to relieve and manage post-

chemotherapy symptoms and side effects such as pain, nausea, vomiting and post-
chemotherapy fatigue were introduced to help patients cope better with cancer
treatment. The effort of the T&CM services involvement in early detection, prevention
and public education has been an on-going activity.

Clinical Guidelines : The Clinical Practice Guideline (CPG) for Management of

Nasopharyngeal Carcinoma and CPG for Colorectal Cancer were published in 2016
and 2017 respectively. The CPG for Management of Breast Cancer (3rd edition) was
completed in 2019 and published in 2020.

Research : The MOH Biobank was formalised in 2019 and is centralised at the
Institute for Medical Research (IMR), National Institutes of Health (NIH), Setia Alam,
Selangor. The MOH Biobank is in the midst of rolling out prospective biospecimen
collection to support cancer research for the country. In collaboration with the MOH
Pathology and Surgical Services, satellite collection sites at major hospitals will be
set up during the NSPCCP 2021-2025 time period. However, currently there is a
lack of manpower to manage the day-to-day operations and strategic planning for
the MOH Biobank.

During this 5-year period, the Clinical Research Malaysia successfully coordinated
95 oncology related industry-sponsored research (ISR).

In the area of research for T&CM services, the effectiveness of acupuncture as a

complementary treatment among opioid dependence patients was successfully
conducted involving patients from HKL, Jinjang Health Clinic and Batu 9 Cheras
Health Clinic. However, unfortunately the finding was inconclusive due to insufficient
sample size.

Human Capacity Building and Development : A 100% achievement was obtained

in producing radiologists with sub-specialty training. These include sub-specialties
in Interventional Radiology (IR), Musculoskeletal, Breast, Thoracic and Paediatric
Radiology. The targets for this activity were to train at least six radiologists every
year in the sub-specialty training programs and to train two radiologists in the IR
sub-specialty training. Similar achievement (100%) was obtained in training and
upgrading the skills of radiographers and nurses. Advanced diploma courses have
been established including breast imaging, cardiovascular imaging for radiographers,
Advanced Diploma in CT and Perioperative Nursing for Radiology. An Advanced
Diploma in MRI will be introduced this year (2020), and the curriculum is currently
being developed.

There was an expansion of 13 training centres for the Gynaecological Oncology

sub-speciality training, in collaboration with Universiti Malaya (UM), Universiti
Kebangsaan Malaysia (UKM) and Universiti Sains Malaysia (USM), and currently

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

there are 23 certified gynaecological oncologists providing services all over the
country. Oncoplastic training has been incorporated in the sub-specialty training,
resulting in more trained Breast & Endocrine Surgeons able to perform the
procedures. Currently, these services are available in seven centres (HKL, HPJ,
Hospital Selayang, HPP, HSI, HSNZ, HRPZ II). As for the number of trained surgeons,
three Breast & Endocrine Surgeons have recently completed their sub-specialty
training, with eight other trainees still undergoing training. Due to limited places
abroad as well as the COVID-19 pandemic, several trainees were sent to do their
training in HCTM-UKM and UMMC. Unfortunately, during this period, seven fully
trained Breast & Endocrine Surgeons have resigned or retired. This net loss affected
greatly in terms of overall manpower development and service coverage for MOH.

T&CM : For T&CM, one foreign expert from Shanghai, China was deputed to facilitate
the T&CM service in HWKKS. Additionally, two MOH medical officers (MOs) with
post-graduate training in T&CM herbal oncology were posted to IKN and HWKKS.
Phase one of the T&CM Act [Act 775] was implemented with the formation of the
T&CM Council. The registration of T&CM practitioners will commence soon.

3 SWOT ANALYSIS

A SWOT analysis consisting of strengths, weaknesses, opportunities and threats in

cancer continuum of care was done based on the achievements and challenges faced
during the NSPCCP 2016-2020. This analysis was done in order to establish a more
comprehensive and improved strategic plan for cancer control in Malaysia. The table
below summarises the SWOT analysis.
Strengths Weakness
1. Existing good healthcare system in 1. Organisational silos between the
the country. Government, private facilities and
2. Extensive primary care services and NGOs.
health clinics under MOH. 2. Healthcare workers under MOH are
3. Universal coverage for public multitasking.
healthcare facilities. 3. High turnover of healthcare workers.
4. Existing MOH policies for screening 4. Uneven distribution of oncologists
services for specific cancers. across Malaysia.
5. Availability of comprehensive cancer 5. Public cancer centres are still not
treatment in public and private enough to cover the entire nation –
facilities. none in East Coast (except USM).
6. There is still a need to buy services
from private healthcare providers.
7. NGOs mainly operate in urban
centres.
8. Health insurance companies mainly
do not include cancer screening
coverage in their policies.
9. Issues on timeliness and
completeness of data submission to
cancer registry and reporting.

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Opportunities Threats
1. Existence of supporting NGOs to 1. Majority of cancers detected are at
complement Government’s outreach late stages.
activities in bridging the gaps. 2. Financial catastrophe faced by 45% of
2. Social media to serve as platform to patients.
distribute health education materials 3. High treatment costs (borne by MOH).
/ health campaigns. 4. Limit or ceiling in insurance coverage
3. Extensive network of private general for treatment.
practitioners throughout the country 5. Service inequity for secondary and
can facilitate specific cancer screening tertiary care such as in rural areas,
(colorectal, breast and cervical) and Sabah and Sarawak (for confirmatory
early detection. diagnosis and treatment).
4. MOH has used pool procurement for 6. Uneven numbers of oncologist in the
other drugs that can be extended for public sector compared to the private
cancer treatment. sector.
7. Patients lost from follow-up (i.e. due
to preference for unproven therapies).
8. Unproven therapies being promoted in
the media.
9. Unproven screening modalities being
promoted by distributors and being
used by private healthcare facilities.

4 POLICY STATEMENT, VISION AND MISSION

4.1 Policy Statement

Prevention, control and management of cancers will be made accessible and

affordable to the population through collaboration with various stakeholders and
integrated into the social, economic and environmental system to establish a
robust platform for effective control of the disease.

4.2 Vision

A nation working together in reducing cancer burden, with optimum involvement

from relevant stakeholders, to improve positive outcomes of cancer by decreasing
disease morbidity, mortality and improving the quality of life of cancer patients
and their families.

4.3 Mission

Through awareness and empowerment, all Malaysians will have an understanding

of cancer, its prevention, screening and early diagnosis, treatment, rehabilitation,
survivorship and possible outcomes.All cancer patients are cared for within a
supportive and caring environment in a holistic approach, which is cost effective
and efficient.

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5 OBJECTIVE

The overall objective of the Malaysian National Strategic Plan for Cancer Control
Program (NSPCCP) 2021-2025 is to reduce the negative impact of cancer by
decreasing the disease morbidity, mortality and to improve quality of life of cancer
patients and their families.

6 SPECIFIC OBJECTIVES

(1) To increase health-seeking behaviour through awareness and knowledge on

common cancers and to strengthen the intervention of specific cancer risk
factors;

(2) To strengthen early detection of cancer;

(3) To improve the accuracy, efficiency, accessibility and timeliness of cancer

diagnosis;

(4) To enhance delivery of cancer therapy services which are timely, equitable
and accessible for cancer patients throughout the country;

(5) To improve wellbeing and health of cancer survivors during and after diagnosis
and treatment by optimising quality of life;

(6) To develop and deliver effective palliative care to all cancer patients in an
equitable and patient-centred manner;

(7) To address cancer research needs in line with overall cancer control;

(8) To allow cancer patients to cope better with side effects of cancer treatment
through traditional and complementary medicine;

(9) To improve cancer surveillance and monitoring through strengthening of

comprehensive cancer data and information systems; and

(10) To build workforce capacity and strengthen human capital development.

7 OVERALL TARGETS

(1) To downstage breast, colorectal and cervical cancer at the time of diagnosis
by 25% by the year 2030 (Baseline MNCR 2012-2016);

(2) To improve 5-year relative survival rate for colorectal, breast and cervical
cancer by 2030 [The overall cancer survival for period of diagnosis 2007-
2011 are 56.8%, 66.8% and 70.6% for colorectal, breast and cervical cancer
respectively]; and

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(3) To reduce the risk of premature mortality rate caused by cancer by one third
by 2030 i.e from 5.7% in 2019 to 3.8% in 2030 [Sustainable Development
Goals 2030, indicator 3.4.1: Reduction for mortality rate by a third attributed
to cardiovascular disease, diabetes, cancer and chronic lung disease by 2030
(7)].

8 FOCUS AREAS OF THE STRATEGIC PLAN

(1) Prevention and Health Promotion

(2) Screening and Early Diagnosis
(3) Diagnosis
(4) Treatment
(5) Survivorship (including rehabilitation and vocational rehabilitation)
(6) Palliative Care (Refer to separate document4)
(7) Traditional and Complementary Medicine
(8) Research and Development
(9) Monitoring and Surveillance
(10) Human Capacity Building and Development

9 PRIORITIES

(1) Intensify prevention and promotional activities as well as health-seeking

behaviours through multiple media platforms;

(2) Increase colorectal screening coverage, early diagnosis and services;

(3) Strengthening patient navigation and cancer treatment services including

establishment of the Northern Cancer Centre;

(4) To improve cancer data submissions, analysis and reporting through the
existing information systems and registry (National Cancer Registry).

4 http://www.moh.gov.my/moh/resources/Polisi/BUKU_NATIONAL_PALLIA-
TIVE_CARE_POLICY_AND_STRATEGY _PLAN_2019-2030.pdf

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10 PLAN OF ACTION
The Plan of Action and Objectives of each component are described below.

10.1 Prevention and Health Promotion

10.1.1 Background

The biggest challenge in cancer prevention is changing the perception and

behaviour among general public on transferring knowledge of risk factors and
correct health seeking behaviour into practice.

According to the WHO, 30 to 50% of cancers can be prevented by avoiding risk

factors and implementing existing evidence-based prevention strategies. About
30% of cancer deaths are due to the five leading behavioural and dietary risks:
high body mass index, low fruit and vegetable intake, lack of physical activity,
tobacco use, and alcohol use. Tobacco use is the most important risk factor for
cancer and is responsible for approximately 22% of cancer deaths.

Currently there is limited national information available on the level of public

knowledge on cancer risk factors, its preventability and on the sign and symptoms.
A study in 2014 served as baseline where general knowledge on cancer risk
factors was 62% and general knowledge on sign and symptoms was 52% (8).

There is no information on the public’s acceptance and behaviours towards

cancer screening and proven or unproven therapies.

A concerted effort must be taken between all stakeholders involved in cancer

prevention and care.

10.1.2 Plan of Action Matrix

Please refer to Appendix 1.

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10.2 Screening and Early Diagnosis

10.2.1 Background

Screening aims to identify individuals with abnormalities suggestive of a

specific cancer or pre-cancer, who are asymptomatic, and refer them promptly
for diagnosis and treatment. Screening is far more complex public health
intervention compared to early diagnosis. It is important to realise that screening
programs should not be introduced unless:

• the burden of the desired type of cancer to be screened is highly significant;

• availability of accepted screening test/method;
• adequate resources to perform the tests; and
• sufficient services and facilities for diagnosis, treatment and follow-up of
individuals with abnormal test results.

The WHO stepwise framework indicated three steps of implementation. The

first step is called the ‘core step’ where intervention is being implemented with
the current feasibility and existing resources. Step Two or ‘expanded step’ is to
implement intervention that is feasible in the medium term, with a realistically
projected increase in, or reallocation of resources. Step Three or ‘desirable step’
is to implement interventions that are beyond the reach of current resources, if
and when such resources become available.

Examples of screening methods are, iFOBT for colorectal cancer, PAP smear
cytology and HPV test for cervical cancer, and mammography screening for
breast cancer.

Currently in Malaysia, there are four screening programs available. The four
programs are screening for breast, colorectal, cervical and oral cancer. The
current policies for these screenings are as below:

1. Breast cancer: The screening for breast cancer in Malaysia comprises of

Clinical Breast Examination (CBE) and Mammogram. The current policy
states that:

(a) For CBE: Woman aged 20 years and above must undergo breast
examination by trained HCPs every three years for age between 20 to 39
years, and annually for age 40 and above.

(b) For mammogram: Woman aged 40 years and above with risk factors, are
recommended to undergo mammogram every year. For women aged 50 to
74 years, mammography may be performed every two years.

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2. Colorectal cancer: Asymptomatic individuals aged 50 to 75 years should

undergo screening using iFOBT to detect blood in stool, followed by
colonoscopy if iFOBT is positive. The current screening interval is every
two years. Asymptomatic individuals who are at higher risk for this cancer
should get medical advice for assessment and screening.

3. Cervical cancer: All sexually active women aged 30 to 65 years using HPV
via vaginal sample (either self-sampling or by a healthcare professional). The
screening interval is every five years for those who are tested HPV negative.

4. Oral cancer: The screening policy for oral cancer involves oral examination
for individuals aged 18 years and above known to have high-risk habits
or living in a community which is more prone to take up that habit. The
high-risk communities identified includes Indian community in rubber and
palm oil estates in Peninsular Malaysia, and other Bumiputera in Sabah and
Sarawak. In addition to that, opportunistic screening is also conducted for
walk in patients to the dental clinic and communities or outreach programs.

Lung cancer is the third most common cancer in Malaysia (2). However, there
is no national lung cancer screening program established yet. As mentioned
earlier, the HTA on LDCT for lung cancer screening conducted by the MOH in
2017 concluded that LDCT had high sensitivity but low specificity when it is
used for lung cancer screening among the high-risk group and recommended
that it may be used for lung cancer screening among this group in research
environment or for research purposes. Lung cancer screening using LDCT scan
among high-risk group is available at certain private hospitals.

Nasopharyngeal cancer (NPC) is fifth most common cancer in Malaysia and its
risk factors include Epstein-Barr virus (EBV) infection and family history of NPC
(2). Hence, EBV serology test is a promising tool for selective screening in those
with a family history of NPC. An HTA conducted in 2011 reported that there was
fair evidence on acceptable diagnostic accuracy for EBV serology test in an NPC
screening program. However, there was no evidence on the cost-effectiveness
and no evidence on the effectiveness of NPC screening in terms of reduction in
mortality or increase in QALY. In view of this, the HTA did not recommend NPC
screening as a public health policy.

Prostate cancer is seventh most common cancer in Malaysia (2). The prostate-
specific antigen (PSA) test may indicate a prostate problem, however the HTA on
prostate cancer screening conducted by MOH in 2011 suggested that screening
for prostate cancer with PSA should only be done for the high-risk group, mainly
close family members. In view of prostate cancer is an indolent cancer, the age
for the close family member to be screened should be taken into consideration.

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Early diagnosis is identifying cancer among those presented with the signs and
symptoms of cancer. When cancer is identified early, cancer is more likely to
respond to effective treatment and can result in a greater probability of surviving,
less morbidity, and less expensive treatment. Significant improvements can be
made in the lives of cancer patients by detecting cancer early and avoiding delays
in care.

Early diagnosis consists of three steps that must be integrated and provided in
a timely manner:
• awareness and accessing care
• clinical evaluation, diagnosis and staging
• access to treatment.

Early diagnosis is relevant in all settings and in the majority of cancers. In the
absence of early diagnosis, patients are diagnosed at late stages when curative
treatment may no longer be an option.

10.2.2 Plan of Action Matrix

Please refer to Appendix 2.

10.3 Diagnosis

10.3.1 Background

Early detection and screening for cancer can reduce morbidity and mortality,
as long as there is a good supportive environment. An accurate diagnosis is
the first step in cancer management. This calls for a combination of careful
clinical assessment and diagnostic investigations including endoscopy, imaging,
histopathology, cytology and laboratory tests. Accessible and affordable
competent diagnostic facilities should be more widely available.

Pathology services for cancer diagnosis and monitoring are mostly carried
out in the state and major specialist hospitals. Anatomical Pathology services
are available in the 14 state hospitals and 8 major specialist hospitals, while
chemical pathology, haematology and microbiology services are available in all
specialist hospitals. Genetic service currently is centralised in Tunku Azizah
Women and Children Hospital in Kuala Lumpur.

Scientific advances and technology development in molecular testing have

revolutionised cancer diagnosis and treatment. Molecular diagnostic tests detect
specific biologic molecules or biomarkers in a patient’s tissue and fluid samples.

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The test can be used to assess a person’s risk of developing cancer, screening for
cancer in a person that may be asymptomatic, provide accurate cancer diagnosis
for informed decision management, and monitoring how a patient is responding
to treatment. In the recent decade, molecular diagnostics have been referred
to as companion diagnostics tests to determine whether a specific cancer
therapy would likely be effective treatment for a specific cancer patient based
on characteristics of or changes in the biomarker. Although the application of
molecular testing is widely applied worldwide, its implementation in Malaysia is
still at a preliminary stage and not yet comprehensive due to the high cost and
low prioritisation compared to other more urgent test demands.

The pathology service had proposed to develop the molecular pathology testing
from as early as the 10th Malaysia Plan (2011-2015), whereby several new
tests were developed in response to clinical demands. For the 11th Malaysia
Plan (2016-2020), the Pathology services has expanded the scope of molecular
testing to tissue specimens. It is hoped that for the 12th Malaysia Plan (2021-
2025), we could expand the service and include proteomics testing in addition
to the genomics tests that will continuously progress. We also hope to establish
a comprehensive digital pathology system to enhance the cancer diagnostics
service better, especially in aspects of training and consultancy to enable quality
diagnostic service particularly diagnostic accuracy and timeliness. Lastly, we
hope to achieve laboratory accreditation for all these laboratories to ensure
reliability of the service provision.

Radiology services are provided in all MOH hospitals and most health clinics.
The services range from special radiological examinations (Ultrasound, CT,
MRI, Mammography, Fluoroscopy, Angiography) and general radiography in
the tertiary and larger hospitals to basic radiographic examination in smaller
hospitals and health clinics.

As of 2020, there are 54 public hospitals with 386 resident radiologists providing
services as below:
• General Radiography services are present in all hospitals and certain major
health clinics.
• Ultrasound services are present in all specialist hospitals and several non-
specialist hospitals.
• CT services are present in 54 MOH hospitals with a total of 68 scanners.
• MRI services are currently provided in 31 hospitals.
• Mammography services are available in 50 hospitals i.e. tertiary, state and
major specialist hospitals.

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• Angiography services are provided in eight hospitals. Interventional Onco-

Radiology services are provided in eight hospitals: HKL, Hospital Selayang,
Hospital Sungai Buloh, IKN, Hospital Sultanah Bahiyah Alor Setar (HSBAS),
Hospital Sultanah Aminah (HSA) Johor Bahru, HUS and HPP by specially
trained radiologists. Basic IR services are provided at all hospitals with
radiologists. There are scheduled visits by IR consultants to perform complex
procedures in the other hospitals as part of IR networking.

All centres with angiography services are function as the IR training centres for
specialty and sub-specialty trainees from MOH, universities and international
trainees. The challenges faced include increasing demand and emergence of
new technologies in cancer treatment delivery by IR due to lack of trained IR
and budgetary constraint. Patient safety has always been an utmost important
aspect of the radiological service especially radiation safety. Continuous ongoing
efforts are undertaken to update the regulations as well as new projects to
enhance the safety efforts. Radiology services are in the process of improving
overall quality performance and obtaining certification from IAEA-QUAADRIL
(International Atomic Energy Agency – Quality Assurance Audit for Diagnostic
Radiology Improvement and Learning) Program in 2021.

Proper planning has to be done in order to optimise the available resources and
overcome the constraints. There are major challenges in terms of procuring and
equipment replacement, manpower (numbers and skills) as well as operational
budget. With the advent of IR into the therapeutic arena, more budgetary
allocation is needed by the radiology departments.

Nuclear Medicine Services was introduced into Malaysia since 1964 at HKL. It
was later expanded to various hospitals in Malaysia in the last two decades. The
nuclear medicine set up under the MOH are categorised into two levels:
• Level 1: Diagnostic & Outpatient Therapy Service
• Level 2: Level 1 + Inpatient Therapy Service

Depending on the availability of equipment and facility, each centre is assigned

with following subsets:
• Subset s: with Single Photon Emission Computed Tomography (SPECT)
service
• Subset p: with Positron Emission Tomography (PET) service
• Subset sp: with both SPECT & PET services

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The MOH has taken a regional approach in delivery of this service. Nuclear
medicine services are currently divided into five regions i.e.:

Peninsular Malaysia
Northern region: HPP (Level 2sp)
Central region: HKL (Level 2s) &
IKN (Level 2sp)
Southern region: HSA (Level 1s)

East Malaysia HUS (Level 2s)

Sarawak: HWKKS (Level 2s)
Sabah:

It has been decided that a nuclear medicine centre providing a regional based
service should be equipped with a Level 2sp facility.

The MOH had installed the country’s first PET/CT back in 2005. In the following
year, the first cyclotron was commissioned. Currently, only the centres at the
Northern and Central Zones are equipped with PET/CT machines. Another has
been planned for the Southern Region since 2006. With the fast-expanding use
of PET-CT in oncology, PET-CT has become an inseparable part for nuclear
oncology service. Unfortunately, at present, only two out of the six nuclear
medicine centres under MOH are equipped with PET-CT machines.

Currently, other than the Southern Zone, in-patient radioiodine treatment for
thyroid cancers is offered in all other nuclear medicine centres under MOH.
In addition, other targeted radionuclide therapies such as radioimmunotherapy
(RIT) for non-Hodgkin lymphoma, radionuclide therapy for pain palliation in
bone metastases and selective internal radiation therapy (SIRT) for liver cancer
have been carried out by specific centres from time to time. The first peptide
receptor radionuclide therapy (PRRT) for neuroendocrine tumors was introduced
in mid-2015, whereas prostatic-specific membrane antigen directed radioligand
therapy (-RLT) was conducted in 2020 at IKN Putrajaya. In the future, we hope
to provide ancillary support for PET/CT-guided radiotherapy planning as well.

A structured post-graduate education and training program was started in year

2008 by USM and, until present, there has been 38 graduates from the Masters
of Medicine in Nuclear Medicine. Separate training modules have been developed
for interested physicians or radiologists to take up this specialty, in addition to
their basic parental specialty.

10.3.2 Plan of Action Matrix

i. Pathology (Appendix 3a)

ii. Radiology (Appendix 3b)
iii. Nuclear Medicine (Diagnosis) (Appendix 3c)

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10.4 Treatment

10.4.1 Background

Cancer is the third leading cause of death in this country, contributing to

11.82% of all deaths in MOH hospitals in 2018 compared to 9.34% in 2003. The
incidence of cancer is expected to rise with the increasing lifespan of the general
population as well as rising unhealthy lifestyle practices. Cancer treatment is
provided by both public and private hospitals and mainly concentrated over
west coast of Peninsular Malaysia. The following are the public oncology centres
around Malaysia which offer both systemic as well as radiotherapy treatment:

1) Hospital Kuala Lumpur

2) Institut Kanser Negara
3) Hospital Pulau Pinang
4) Hospital Sultan Ismail
5) Hospital Umum Sarawak
6) Hospital Wanita & Kanak-Kanak Sabah
7) University Malaya Medical Centre
8) Hospital Canselor Tuanku Muhriz UKM
9) Hospital Universiti Sains Malaysia, Kubang Kerian

Cancer treatment involves multi-disciplinary and multi-modality approach

which includes surgery, radiotherapy, systemic chemotherapy, targeted
therapy, immunotherapy and hormonal therapy. Over the past 15 years, many
advancements have been made in the field of oncology in terms of improved
diagnostic tools, better imaging modalities, state-of-the-art molecular and genetic
testing, as well as enhanced therapeutic options. However, with the advent of
precision medicine, the cost of cancer care especially targeted treatment is
exorbitant. This would increase the strain on national healthcare budget. Thus,
MOH introduced Value Based Medicine, an initiative aimed to measure the value
of the new therapies from different aspects such as utility, emotional, spiritual
and monetary significance. A sound healthcare economic evaluation conducted
from various stakeholders’ perspective is required before approving a therapy to
be implemented in MOH hospitals.

With only six MOH oncology centres which are dealing with the majority of
Malaysians with cancers, limitations in facilities, human resource and funding
are currently huge challenges. Thus, strategies need to be put in place to reduce
long waiting time for curative radiation treatment, better access to formulary
drugs, decentralise the current oncology centres as well as improve access to
oncologist’s consultation.

Oncology surgery services under the MOH is presently available at all state
hospitals and several of the larger district hospitals. These services are provided
by surgeons in various surgical disciplines. For colorectal surgery, there are
currently 64 surgeons trained and registered with the National Specialist
Registry (NSR), however, only 15 surgeons are working at the MOH hospitals.
For breast & endocrine surgery, currently there are 10 sub-specialty centres at
the MOH hospital, and out of the 56 surgeons registered under the NSR, only 22
are working at these centres.

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Psycho-oncology services look at the psychological aspects of the treatment

and management of patients with cancer. It combines the element of
psychology, social, behavioural and ethical aspects of cancer. The availability
of advanced cancer treatment with early detection of cancer have led to more
adults and children earning the title of cancer survivors. However, regardless
of the prognosis, psychological distress particularly anxiety and depression
were reported in at least one third of cancer survivors in a middle-income
country (9). At present, psycho-oncology service is basically provided as a
general ‘consultation’ activity based on referrals to psychiatry in most of the
hospitals. Some degree of psycho-oncology services generally is provided by
all hospitals with general psychiatrists. The approach is mainly focusing on
the treatment of major psychiatric conditions either as a reaction towards
the illness or manifestation of treatment side-effects. The service is limited in
the form of consultation basis as other referrals despite being provided in all
general hospitals.

Haematology services was first established in 1986 under the auspices of the
late Dr Visalachy Purushothaman at HKL. In 1999, the first successful bone
marrow transplant in an adult with chronic myeloid leukaemia was performed
through the establishment of a stem cell transplant service in HKL.

In 2002, with the support of the former Deputy Director General of Health (2000-
2004), Dato’ Dr Ahmad Tajuddin Jaafar, a Department of Haematology was
established that comprised of both clinical and specialised laboratory services.
In 2006, the whole Department of Haematology moved to Ampang Hospital,
which was designated as the national referral centre for haematology. Over the
years, the haematology service has expanded to 13 haematology centres in 11
states. There are four centres with transplant services. Currently, there are 35
clinical haematologists in MOH hospitals.

The objective of the clinical haematology service is to provide excellent patient-

centred care for patients with all types of blood disorders such as leukaemia,
lymphoma and multiple myeloma and non-malignant haematology conditions
like thalassaemia and haemophilia. We also aim to provide prompt and
accurate diagnosis of diseases at presentation by sophisticated laboratory
investigations to risk-stratify patients at diagnosis and guide individualised
treatment, to prevent over-treatment and to provide monitoring for early
detection of treatment failure.

Paediatric Oncology: Childhood cancer make up 3% of all cancers diagnosed

in Malaysia and remain a leading cause of death. In the children below 15
years old, the main cancers were leukaemia (40%) and tumours of the central
nervous system (CNS) (15.2%) followed by lymphoma (10.6%).

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Paediatric Cancer treatment is provided by public, universities and private

sector in Malaysia. The seven regional centres within MOH providing paediatric
haemato-oncology services include:

1) Hospital Tunku Azizah Kuala Lumpur

2) HPP
3) HRPB, Ipoh
4) HSI, Johor Bharu
5) HSNZ, Kuala Terengganu
6) HUS, Kuching
7) HWKKS

The universities include UMMC and HCTM-UKM in the Klang Valley and Hospital
Universiti Sains Malaysia (HUSM) in Kubang Kerian, Kelantan. Private hospitals
are mainly in the Klang Valley and one hospital in Kuching.

Early detection and an accurate diagnosis are the first step towards good
cancer management. A supportive environment is required; detection and
staging require good and timely imaging and biopsies must be done as soon
as possible. Paediatric tumours require good histopathology and cytogenetics
therefore accessible and affordable competent diagnostic facilities should be
readily available to all centres in Malaysia. This will ensure proper stratification
of treatment and good outcome. Treatment must be initiated as soon as possible.
Successful cancer treatment involves multidisciplinary involvement with each
component given in a timely manner.

Transfusion Medicine Service (TMS) : Blood and blood components are a vital
part of patient treatment and management especially for patients with underlying
oncological pathologies. Overall, patients with oncological and haematological
malignancies may use up around 34% of the RBC supply at any one time (10)
few data concerning the urgency of transfusion are available to inform planning.
This study sought to determine the proportion of red blood cells (RBCs. Anaemia
may occur in 90% of patients during chemotherapy and cancer treatments often
cause the loss, destruction, and decreased production of RBCs — all of which
lead to anaemia (11)we investigated the incidence and severity of chemotherapy-
induced anemia caused by the most common chemotherapy regimens, including
the new generation of chemotherapeutic agents, used in the treatment of the
major nonmyeloid malignancies in adults. Five hundred fifty-two patients with
histologically proven carcinoma originating from breast (n = 165. In addition,
cancer patients with anaemia show a decrease in quality of life, increased
cancer-induced fatigue and indicators of poor clinical outcome. This signifies
that blood product supply is very crucial to support the management of these
cancer patients. The fundamental pillar in ensuring adequate, safe and timely
supply of blood, blood products and services for patient needs is by maintaining
the sustainability of blood donation activities through effective blood donation
awareness programs.

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The TMS in Ministry of Health is responsible for ensuring the accessibility

and availability of safe and quality blood products, its appropriate use and
other related services in the country. Service delivery is undertaken through
the network of 1 standalone blood centre (Pusat Darah Negara, PDN), 14 State
Hospital Blood Banks and 119 other hospital blood banks. PDN is the national
reference centre for TMS for the country and is responsible for the development
of policies, standards and strategic plan; coordinates and monitors all blood
transfusion activities carried out in government hospitals; provision of technical
support and consultation in all areas of blood banking. The scope of activities in
the MOH facilities may include the following:

• Clinical transfusion services including pre-transfusion compatibility testing,

appropriate use of blood; Patient Blood Management (PBM) and hospital
blood supply management in 134 MOH hospitals

• Blood donor management and blood collection in 115 MOH facilities

• Blood component preparation- preparation of platelets, fresh frozen plasma,

cryoprecipitate for clinical use in 22 MOH facilities

• Screening of donated blood for transfusion transmissible infections (TTI)

through serology testing and nucleic acid testing, (NAT) as well as ABO & Rh
Grouping in 13 MOH facilities

Each of the activities must occur in the framework of quality management system
to ensure the safety and quality of the products and safety of blood donors
through implementation of Good Manufacturing Practices, GMP and related
laboratory accreditation such as MS ISO 15189. As blood and blood products are
precious national resources, the Transfusion Medicine Service in MOH should
work together and share the available blood and blood products throughout the
country as and when required thus ensuring the accessibility to the blood and
blood products at all time.

There have been several major progresses made in the TMS till date, namely
nationwide increase in blood collection based on 100% voluntary non-remunerated
blood donation prior to Covid19 pandemic with concurrent increase in the
provision of labile blood components as well as ongoing supply of plasma derived
medicinal products. Clinical use of blood has also improved with the expansion
on basic immunohaematology services nationwide and implementation of Patient
Blood Management. Furthermore, TMS was strengthened through training and
placement of Transfusion Medicine Specialists in PDN, state hospitals and
several major specialist hospitals together with the procurement of equipment,
transport and renovation of infrastructure in several MOH facilities.

Recently, TMS has also successfully completed the development and deployment
of the cloud-based Blood Bank Information system (BBISv2) for use in PDN and
21 selected Hospitals which will be expanded to other blood banks in future.
Nationwide expansion of NAT testing to cover the whole country started in 2019
and is estimated to increase coverage from 60% to 100% donation by 2021. This
includes the establishment of 3 of Nucleic Acid Testing (NAT) screening centres
in Kedah, Sabah and Sarawak. Consistent and ongoing training for all categories
of personnel involved in the transfusion process and research activities are
further supported.

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PDN continue to provide transplant related services that include Cord Blood
Banking (from cord blood collection, processing and storage) as a source of
haematopoietic stem cells, Histocompatibility and Immunogenetics Laboratory
and National Stem Cell Coordinating Centre for the coordination of donors and
patients for haematopoietic stem cell transplant especially for haemato-oncology
patients. The expansion of transplant immunology services to support solid
organ transplant and haematopoietic stem cell transplant (HLA typing with High
Resolution, HLA Antibody testing and HLA Cross-matching) started in 2020 and
is planned to be extended nationwide.

TMS is committed to the provision of holistic patient-centred care for all patients
requiring transfusion while maintaining quality of care for blood donors. As
part of the national strategic plan for TMS, several regional blood centres (Pusat
Darah Wilayah, PDW) are being planned apart from PDN, namely PDW Utara,
PDW Sabah, PDW Tengah, PDW Selatan, PDW Sarawak and PDW Pantai Timur.
In RMK 10, two new regional blood centres were approved and PDW Sabah will
be built in Kota Kinabalu, Sabah and PDW Utara in Sg Petani, Kedah. This
will enable the expansion of services and expertise in Transfusion Medicine
Service especially in the field of platelet immunology testing; specialised blood
products supply such as rare phenotype blood and platelet cross match for
platelet refractoriness cases throughout the country. It is therefore critical for
Transfusion Medicine Services nationwide to move in tandem with the NSP CCC
to ensure access and availability to safe, quality and adequate blood supply
nationwide including for cancer patients. Furthermore, the TMS will work toward
ensuring various specific requirements for cancer patients such as irradiated
cellular blood products for haemato-oncology patients, apheresis platelets and
the provision of filtered red blood cells can be met together with expansion of
transplant immunology services.

10.4.2 Plan of Action Matrix

i. Radiotherapy & Oncology (Appendix 4a)

ii. Haematology (Appendix 4b)
iii. Nuclear Medicine (Treatment) (Appendix 4c)
iv. Paediatric Oncology (Appendix 4d)
v. Gynaecology Oncology (Appendix 4e)
vi. Colorectal (Appendix 4f)
vii. Breast & Endocrine (Appendix 4g)
viii. Transfusion Medicine Service (Appendix 4h)

10.5 Survivorship

10.5.1 Background

Cancer survivorship begins at the time of diagnosis until the end of life. It
refers to the process of living with, through and beyond cancer. Internationally,
survivorship care has been developing rapidly in recent years as there are more
patients surviving cancer. However, they may have sequelae of cancer or cancer
treatment which may hamper them physically, cognitively, psychologically

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

and emotionally. These problems may limit one’s ability to do daily activities,
participating in their usual activities or return to work/school. Timely
rehabilitation can help in maintaining or restoring those function depending
on patients’ physiologic or anatomic impairment, environmental limitations,
desires and life plans.

Medical Rehabilitation: Cancer Rehabilitation Program is the first of such

program dedicated to cancer survivor in MOH. It is a reconditioning program
which aims to prevent or lessened the effect of cancer or its treatment through
education series, exercise program, nutritional program and strategies to restore
or maintain physical function. Generally, this program is delivered in the
outpatient setting and introduced to patients as early as possible by the treating
team. Further rehabilitation strategies such as return to work program are applied
according to patients’ needs. Program development and pilot project is currently
ongoing in Hospital Sultan Ismail Johor Bahru. Those with severe disability such
as neurological impairment due to brain or spinal cord involvement, amputation
or joint replacement should be referred to a Rehabilitation Physician.

Medical Rehabilitation services are available in all MOH hospitals, delivered

through different levels of care. In most facilities, care is delivered by allied
health professionals (i.e. Physiotherapist and Occupational Therapists). Medical
Rehabilitation Specialist care is available in almost all state hospitals and several
major district hospitals. This creates an opportunity to develop and run this
program especially in hospitals with Rehabilitation Physicians and Oncologists.

The common challenges faced in delivering rehabilitation service includes:

1) Limited number of human resources particularly for allied health
professionals i.e., physiotherapist and occupational therapist,
rehabilitation nurse, counsellors and dietitian.
2) Limited space to run the program as most physiotherapy and occupational
therapy area are not at the same location, small gymnasium or therapy
areas.
3) Limited budget for equipment purchasing/replacement and training.

Nevertheless, this program is feasible (within facility capability) and may be

expanded to a survivorship program as it matures. Future plans should include
development of the National Consensus and service standards.

Vocational Rehabilitation is a series of services to facilitate the entrance

into or return to work of individuals with disabilities. It provides vocational
and rehabilitative services to individuals to help them secure, regain or retain
employment. Based on the MNCR report 2012-2016, the incidence of all cancers
in males and females increased after the age of 30 years old, which is an age where
career plays an important role in one’s life (2). Employment is also reported to be
one of the unmet needs in Asian patients living with cancer in a middle-income
setting (12). This shows that employment is associated with higher quality of life.

However, a meta-analysis and meta-regression of 36 studies assessing the

association of cancer survivors and unemployment has reported that cancer
survivors are 1.37 times more likely to be unemployed than healthy control
participants. The report also stated that job discrimination, difficulty combining
treatment with full time work, and physical or mental limitation may be the
major causes of unemployment (13). Therefore, a strategic plan for vocational

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

rehabilitation in cancer patients during survivorship is essential and collaboration

with various related agencies is also crucial in executing this plan.

Vocational rehabilitation services are not readily available within government

facilities in Malaysia. Most of the vocational rehabilitation are implemented by
professional bodies and non-governmental organisations (NGOs). The Cancerfly
Networks is one NGO that aims to provide employment and advertising
opportunities to cancer survivors and to their next of kin. They organise a
series of events that encourage cancer survivor’s participation and provide a
platform of job opportunities for cancer survivors. They often collaborate with
other agencies such as the MOH, Ministry of Human Resource, other NGOs and
professional bodies. They have launched a Cancerfly employment portal and
Canbazaar HKL in 2017 and co-organised the first job fair for cancer survivors
called ‘CanMERDEKA Career Carnival’ on 17 October 2019 in collaboration with
the Faculty of Medical and Health Sciences Universiti Putra Malaysia (UPM),
Cancer Resource and Education Centre UPM and JobsMalaysia.

10.5.2 Plan of Action Matrix

Please refer to Appendix 5.

10.6 Palliative Care

10.6.1 Background

Palliative care is an approach that improves the quality of life of patients and
their families facing the problems associated with life threatening illness through
the prevention and relief of suffering. It is a field that has been developing in
Malaysia since the early 1990s and continues to grow. Specialised services have
been developed in several state and major specialist hospitals, and NGO hospices
are also available in almost all states across the nation.

In October 2019, a National Palliative Care Policy and Strategic Plan 2019-2030
was published. It provides a framework for the development of a nationwide
palliative care program that is more out-reaching and equitable for the entire
population. The vision is to provide a minimum standard of palliative care for all
who need it wherever they may be in the country.

10.6.2 Plan of action matrix

Please refer to the National Palliative Care Policy and Strategic Plan 2019-2030,
accessible via the following webpage:
http://www.moh.gov.my/moh/resources/Polisi/BUKU_NATIONAL_PALLIATIVE_
CARE_POLICY_AND_STRATEGY _PLAN_2019-2030.pdf

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10.7 Traditional and Complementary Medicine

10.7.1 Background

In the MOH, the role of T&CM services for cancer is mainly to improve the quality
of life of the patients, allowing them to cope better with treatment by reducing
the side effects, as well as relieving pain and suffering. A nationwide survey
conducted in 2004 found that 69.6% of the population had used T&CM in their
lifetime while 55.6% had used T&CM in the last 12 months prior to the survey.
The results of the National Health and Morbidity Survey (NHMS) 2015 also
showed that 29.5% of survey participants had used T&CM with consultation.

At present, T&CM in Malaysia exhibits four unique features. Firstly, it is highly

diversified in terms of heritage, history, language, philosophy, ethnic origin,
geographical distribution and stages of development of each practice. Secondly,
T&CM is strongly linked to the culture and heritage of each ethnic group in
Malaysia. Thirdly, the provision of T&CM services in Malaysia is dominated by
the private sector (mainly sole proprietors) with limited involvement of the public
sector. Fourthly, Malaysia’s rain forest is rich in flora and fauna. This rich
natural and cultural resources possess a great potential to make advancement
in developing a lucrative herbal industry and also to support long term research
in the field of natural product. All these features are exerting strong influences
on the healthcare system in Malaysia.

The diversity of T&CM practice areas recognised in Malaysia poses a challenge

to the legislative efforts, and thus, the T&CM Acts 2016 has to be implemented
using a phased approach. In addition, the concept of “appropriateness” when
developing legislation and suitable healthcare models for T&CM should be
emphasised. A “one size fits all” concept is definitely not suitable for T&CM in
Malaysia as it is not possible to have a single management approach that would
apply uniformly across each practice area.

10.7.2 Plan of Action Matrix

Please refer to Appendix 6.

10.8 Research and Development

10.8.1 Background

Cancer is the second most common cause of death in Malaysia after cardiovascular
diseases. Most cases still present at late stages, resulting in poor survival. The
direct and indirect costs of cancer is high and is rising further. There is a need to
increase impact on cancer control and care with limited resources (value-based
medicine). Research in Malaysia is mainly carried out by government research
institutes, public and private universities, as well as NGOs.

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The 5-year goals of the NSPCCP in Research are:

1. To better manage cancer through breakthroughs in cancer screening,

diagnosis and treatment.
2. To consolidate research groups across the country to address national
cancer research needs.
3. To improve cancer patient management via improvements in process
triangulation and modelling.
4. To translate research findings into implementable policies.
5. To better facilitate entry of cancer patients into clinical trials for improved
survivability.
6. To improve private-public partnership in cancer research.

Strategies:

1. Develop research in priority areas (see below).

2. Align individual research to the national needs.
3. Consolidate research and develop long term research programs to ensure
continuity to address complex research questions.
4. Establish scientific advisory boards which carry out periodic reviews and
advisory sessions at national, institutional and program levels.
5. Improve support for researchers:
(a) To facilitate sharing of facilities and laboratories at national level.
(b) To facilitate local and international collaborative research and
promote partnerships between public and private sectors.
(c) To build up the capability of researchers to reach excellence at
international level.
6. Encourage novel and impactful research which ultimately benefit health
and improve healthcare of cancer patients.
7. Strengthen human resource capacity and expertise:
(a) Facilitate recruitment and retention of experienced researchers to
develop critical mass of the expertise.
(b) Develop staff-exchange program.
(c) Improve opportunity for training of researchers.
(d) Establish post-doctoral fellowships.
(e) Increase number of laboratory support staff.

Research priority areas [the sequence does not indicate level of importance]:

1. Screening and early detection of major cancers:

(a) Evaluation and improvement of existing cancer screening programs,
cancer prevention and promotional program.
(b) Development and evaluation of biomarkers and other modalities
for screening and early detection of cancers.

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2. To study the cancer risk factors in order to develop new ways to prevent,
detect and treat cancer
(a) Identification of cancer burden attributable to modifiable risk
factors.
(b) Studies on environmental and dietary factors in cancer development.
(c) Identification and development of biomarkers for cancer prevention.
(d) Studies on awareness, knowledge, attitude and practice of general
public on cancer risk factors to identify strategies for behavioural
intervention.
3. Diagnostics:
(a) Develop new biomarker-based diagnostic, predictive and prognostic
tools.
(b) Enhance accessibility, efficiency and timeliness of diagnostic
services (pathology and diagnostic imaging).
4. Treatment of major cancers:
(a) Research to provide evidence for the implementation of value-based
medicine (especially for precision medicine & immunotherapy) for
cancer patients.
(b) Improve accessibility to new drugs by conducting clinical trials for
cancer treatments.
(c) Treatment de-escalation and drug repurposing.
(d) Research to provide evidence for the implementation of supportive
treatments for cancer patients.
(e) Improve the rate of treatment completion.
5. Research on rehabilitation and palliative care:
(a) Delivery and performance of rehabilitation and palliative care
services.
(b) Accessibility to facilities and provision of pain management.
6. Psycho-socio-economic impact and improvement in cancers
(a) Financial impact of cancer control in the country and nation.
(b) Cancer survivors and caretakers:
i. Quality of life
ii. Psychological consequences
iii. Self-help and peer support groups
iv. Follow-up and after care
v. Impact on social life
vi. Functioning
7. Cancer health literacy of general population, patients and healthcare
practitioners:
(a) Cancer health literacy and its relation to cancer prevention, early
detection, diagnosis, treatment and palliative care
(b) Studies on cancer patients and its associated factors with non-
compliant, default or refusal of cancer treatment
(c) Studies to address causes of late presentation of cancers (population
behavioural issues & health system issues).

10.8.2 Plan of Action Matrix

Please refer to Appendix 7.

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

10.9 Monitoring and Surveillance

10.9.1 Background

Accurate and comprehensive data coverage are essential for planning and
evaluating cancer control policies, planning public health program and improving
patient care. In 2019, online notification of cancer cases via the Malaysian Health
Data Warehouse (MyHDW) has commenced through Patient Registry Information
System (PRIS). Still in the early phase, training for data submission, monitoring
of data quality and system improvements are the focus by the Malaysian National
Cancer Registry (MNCR). Appropriate infrastructure and trained personnel need
to be available in the MNCR and all facilities to support the system. The second
five-year report “MNCR 2012-2016” was published in 2019. The report also
included the comparison with the first MNCR report with information on the
trend and the burden of cancer in Malaysia for the period of ten years (2007-
2016).

10.9.2 Plan of Action Matrix

Please refer to Appendix 8.

10.10 Human Capacity Building and Development

10.10.1 Background

The number of cancer cases in Malaysia continues to increase. In 2007 to

2011, a total of 103,507 cancer cases were reported to MNCR, and the number
had increased to 115,238 cases in 2012 to 2016. In view that more people are
affected by cancer, there is also a rapid growth in demand of cancer healthcare
services. In order to ensure high-quality cancer care services, it is essential to
have a skilled and sustainable workforce in the field. There is also the need to
overcome the shortages in some areas of essential workforce.

10.10.2 Plan of Action Matrix

Please refer to Appendix 9.

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11 PATIENT NAVIGATION

Patient navigation is a community-based healthcare delivery support system

advocating timely diagnosis and treatment of cancer patients across the healthcare
continuum by eliminating barriers to care. The Patient Navigation Program (PNP)
was first initiated in 1990 at Harlem Hospital Centre, New York by Dr Harold P.
Freeman following a report issued by the American Cancer Society on ‘Report to the
Nation: Cancer in the Poor’. The program focused on saving lives from cancer by
eliminating barriers to timely care between the point of a suspicious finding and the
resolution of finding by further diagnosis and treatment (14).

Based on the MNCR 2012-2016 report, 64% of all cancer cases were detected
at Stages III and IV at time of diagnosis. Late-stage diagnosis affects treatment
outcomes and reduce the chance of survival. There were many factors contributing
to the majority diagnosed at late-stage. According to a meta-synthesis study in 2015
on ‘Exploring barriers to health seeking behaviour among Malaysian Breast cancer
patients’ (15) the common barriers identified consist of:

1. Lack of knowledge in symptoms appraisal as a factor in delayed presentation:

Non-recognition of cancer symptoms and seriousness of symptoms; Unawareness
of being at risk effecting immediate treatment.
2. Psychological burden as factor of delay treatment: Denial and psychological stress
leading to delay in treatment-seeking.
3. Socio-cultural effects on health decision: Cultural beliefs towards traditional care
and friends and family member’s advice hindering immediate access to medical
diagnosis and care.
4. Health system issues: Delays in referral and appointments to diagnostic facilities
indirectly affect early diagnosis and treatment outcome; lack of communication
between healthcare provider and patient may result in misunderstanding that
reduces patient’s trust and compliance to care.

In order to overcome these barriers to care, a patient navigation program is a potential

community-based solution to improve survivorship of cancer. The scope of patient
navigation covers across the entire healthcare continuum, including prevention,
detection, diagnosis, treatment and survivorship to the end of life.

In Malaysia, PNP was initiated in 2014 spearheaded by the Cancer Research Malaysia
(CRM) in collaboration with the MOH, aiming to manage breast cancer patients
especially those from the B40 community. The pilot program involving the Hospital
Tengku Ampuan Rahimah Klang (HTAR) and CRM aimed to overcome barriers faced
by patients in the continuum of care by allocating a meeting room, known as the
Pink Ribbon Centre (PRC) as the location for the hospital-based navigation.

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In 2015, the program in this centre alone has successfully navigated 669 breast
cancer patients and recorded a total of 7,585 registered visits to the PRC. In 2019,
through collaborative efforts, the PNP has expanded to other centres i.e., HQE II,
HTJS and HUS.

Following the success of the PNP in breast cancer patients, further implementation
of the PNP in other cancer of national interest will be carried out. As the philosophy
of patient navigation encourages a system of healthcare delivery by supporting
timely movement of individual patient through healthcare system, barriers to timely
care across healthcare continuum are expected to be further eliminated.

12 ACTION WITH OTHER NON-GOVERNMENT STAKEHOLDERS

Like most other countries, Malaysia has a dual-tiered healthcare system; one is
by government-run public services and another by the private sector. The private
sector comprises of private clinics and hospitals, private companies (laboratories,
ambulance services and pharmaceuticals), several NGOs and other privately-owned
health-related services. With regards to cancer care, the private sectors play a
significant role particularly in providing healthcare services through private clinics
and private hospitals, providing pharmaceutical assistance, organising cancer
awareness campaigns, providing supportive services as well as welfare support for
cancer patients.

Hence, to ensure a comprehensive and holistic approach in cancer control program,

involvement with other stakeholders at every level is important. Further collaboration
with relevant agencies, NGOs, professional bodies and other stakeholders is
addressed accordingly in this strategic plan.

The involvement and collaboration of other stakeholders; particularly NGOs, private

healthcare sector and Academia (Universities) in this strategic plan is summarised
according to focus areas below:
Focus Area 1: Prevention and Health - NGOs, private healthcare sectors
Promotion
Focus Area 2: Screening and Early - NGOs, private healthcare sector,
Diagnosis Universities
Focus Area 3: Diagnosis - Private healthcare sectors,
Universities
Focus Area 4: Treatment - NGOs, Universities
Focus Area 5: Survivorship - NGOs
Focus Area 7: Traditional and - NGOs, private healthcare sectors
Complementary Medicine
Focus Area 8: Research and Development - Universities, NGOs, private
healthcare sectors
Focus Area 9: Monitoring and Surveillance - Private health sectors, Universities

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13 CONCLUSION

The NSPCCP 2021-2025 provides the framework for all relevant stakeholders in
cancer prevention and control in Malaysia to work together in reducing the negative
impact of cancer by decreasing the disease morbidity, mortality and to improve the
quality of life of cancer patients and their families.

Similar with the previous NSPCCP 2016-2020, this new strategic plan also
addresses cancer prevention and control from a holistic viewpoint that cuts across
the continuum, spans from prevention and health promotion, screening and early
diagnosis, diagnosis, treatment, survivorship, palliative care as well as T&CM
and research. Ten specific objectives which are in line with the ten focus areas
of concern are identified; where their respective targets and strategised action
plans are essential for instituting a comprehensive cancer prevention and control
program for the country until 2025. Accurate and timely cancer information will not
be obtained without systematic and timely data collection and reporting. Likewise,
access to cancer care will not be improved without improving the required human
capacity. This NSPCCP sees these two important aspects as new focus areas that
must be addressed.

The ability to implement the outlined strategised action plans is important to enable
Malaysia to achieve the overall targets set in this strategic plan. Sufficient resources
together with continuous support and commitment from all relevant stakeholders
in government, NGOs, professional bodies, private cancer centres and facilities as
well as pharmaceutical companies is required to reduce the cancer burden in the
country.

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K.M., Goh P.P., Yip C.H. & Bhoo-Pathy N. (2018). Health-related quality of life
and psychological distress among cancer survivors in a middle-income country.
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15. Yu F.Q., Murugiah M.K., Khan A.H., Mehmood T. (2015). Meta-synthesis exploring
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APPENDICES

Appendix 1 Prevention and Health Promotion

Appendix 2 Screening and Early Diagnosis
Appendix 3a Pathology
Appendix 3b Radiology
Appendix 3c Nuclear Medicine (Diagnosis)
Appendix 4a Radiotherapy and Oncology
Appendix 4b Clinical Haematology
Appendix 4c Nuclear Medicine (Treatment)
Appendix 4d Paediatric Oncology
Appendix 4e Gynaecology Oncology
Appendix 4f Colorectal
Appendix 4g Breast & Endocrine
Appendix 4h Transfusion Medicine Service
Appendix 5 Survivorship
Appendix 6 Traditional and Complementary Medicine
Appendix 7 Research and Development
Appendix 8 Monitoring and Surveillance
Appendix 9 Human Capacity Building and Development

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 APPENDIX 1

FOCUS AREA 1: Prevention and Health Promotion

Coordinating /
Performance
No Specific Objectives Strategic Actions Target collaborating
Indicator
Agencies
1 To increase health- 1.1 Develop a Strategic Plan developed 2022 MOH (to
seeking behaviour Communication Plan – to address coordinate)
through awareness and stigma against cancer
knowledge of general
public and healthcare 1.2 Development of a dedicated Landing page 2022 MOH (BKP,
providers (HCPs) on landing page of Malaysian Cancer developed BPK, IKN)
common cancers Awareness in MyHealth Portal.
Portal will consist of:
a) Resources for public and
caregivers, common signs and
symptoms of common cancer
and risk factor.
b) E-learning for HCPs
c) E-learning for NGO (knowledge
for advocacy)

1.3 Increase promotional activities During each 8 topics per year MOH (BPK,
for the general public (prevention/ awareness months, at BKP, BPKK,
modifiable risk factors, signs and least: OHP, IKN),
symptoms of common cancers, • 2 infographics NGO, Academy
importance of screening, unproven (Malay & English) of Family
therapies) via conventional media • 1 slot at TV Physicians of
(TV channels - RTM, TV3, Astro, • 2 slots at radio Malaysia
Radio). Proposed themes: • 1 factsheet
• Cervical Cancer Awareness   
Month – January
• World Cancer Day – February
• Colorectal Cancer Awareness –
March
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

37
 APPENDIX 1

38
FOCUS AREA 1: Prevention and Health Promotion

Coordinating /
Performance
No Specific Objectives Strategic Actions Target collaborating
Indicator
Agencies
• NPC Awareness Month – April ·        
• Prostate Cancer Awareness
Month – September
• Breast Cancer Awareness Month
– October
• Lung Cancer Awareness Month –
November
• Mouth Cancer Awareness Week
– November

1.4 Increase promotional activities Number of reach and Increase 5% of MOH (BPK,
via new media for general public views views/year BKP, IKN),
(prevention/modifiable risk factors, Increase number NGOs,
signs and symptoms of common Number of promotion of posts on social Private sectors
cancers, importance of screening, activities on social media by 25%/year
unproven therapies): media

• Portal MOH/BPK/IKN/ Baseline for MOH

MySejahtera social media 2019
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

• Social Media (Facebook, (Twitter, Facebook,

Instagram, Telegram, Twitter) Instagram)5:
Total number of
cancer-related posts:
18

Total number of
reach/views: 28,143

5 Source: Information from Portal MYHEALTHKKM

 APPENDIX 1

FOCUS AREA 1: Prevention and Health Promotion

Coordinating /
Performance
No Specific Objectives Strategic Actions Target collaborating
Indicator
Agencies
1.5 Development of promotional Number of Infographics: 24/6 MOH (BPK,
materials for dissemination through publication on months BKP, IKN),
media / outreach program: infographics/videos/ NGOs,
• Infographics printed materials Videos: 5/year Private sectors
• Videos
• Printed materials Printed materials: 3
topics/year

1.6 Cancer Outreach programs by Number of programs One (1) activity / MOH (JKN,
PKD conducted per year district / year PKD)
conducted by PKD at
district level

1.7     Cancer Outreach programs Number of programs At least two (2) MOH (NCD),
with NGOs per year organised by programs per year NGOs
MOH at HQ level

1.8 Cancer Outreach programs Number of KOSPEN At least one (1) MOH (BKP,
with KOSPEN / COMBI. Cancer / COMBI localities activity/locality/ JKN/PKD
topics: Risk factors, importance conducting cancer year and KOSPEN,
of cancer screening and patient outreach program per COMBI)
navigation included in every year
outreach program at community-
level organised by HQ, State,
District
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39
 APPENDIX 1

40
FOCUS AREA 1: Prevention and Health Promotion

Coordinating /
Performance
No Specific Objectives Strategic Actions Target collaborating
Indicator
Agencies
1.9 Training of HCPs (public and Number of HCPs At least 500 new MOH (BKP,
private) using e-learning modules. in private and HCPs (public and JKN, PKD),
The same modules can be used by government health private) completed Professional
the Academy of Family Physician to centre completed e-learning module Bodies, NGOs
train the GPs e-learning module per year

1.10 Training of NGOs using Number of NGOs Two (2) NGOs/ MOH (BPK,
e-learning module. The modules trained state/ year BKP)
can also be used by other agencies

1.11 Specific promotion activities At least one (1) One (1) activity/ MOH (BPK,
for colorectal cancer. Priority to program per year state/ year JKN)
promote to high-risk population6 conducted by JKN at
State level
*Further detail for strategised
actions on colorectal cancer can be
referred at the National Strategic
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

Plan for Colorectal Cancer 2021-

2025

1.12 To create awareness on Frequency of posting Twice a month MOH (BPKK)

performing Breast Self-Examination (early and end of
(BSE) among Malaysian women and the month)
to encourage Malaysian women to
come forward for CBE via social
media platform (Facebook, Twitter
and Instagram)

6 Clinical Practice Guidelines: Management of Colorectal Carcinoma, Ministry of Health Malaysia (2017) (16)
 APPENDIX 1

FOCUS AREA 1: Prevention and Health Promotion

Coordinating /
Performance
No Specific Objectives Strategic Actions Target collaborating
Indicator
Agencies
1.13 To encourage Malaysian Frequency of posting 4 times per year MOH (BPKK)
woman to come forward for
Pap Smear examination or HPV
testing via social media platform
(Facebook, Twitter and Instagram)
1.14 To promote Breast Care and Frequency of breast Once a month MOH (BPKK,
Cervical Cancer Awareness during cancer and cervical JKN, PKD)
waiting time in clinics cancer awareness
shows or talks given
by HCPs

1.15 To strengthen women’s Frequency of 2 times a year MOH (BPKK,

health literacy through provision community surveys JKN)
of animated materials and conducted via social
infographics on breast and cervical media.
cancers

1.16 To strengthen the skill among Percentage of new Yearly performance MOH (BPKK)
new HCPs in conducting CBE by HCPs involved in 90%
introducing Mentor Mentee Program Mentor-Mentee
Program

1.17 Collaborate with intra-/inter- Number of oral 10% increase yearly MOH (OHP),
agencies on Oral Cancer Awareness cancer awareness OCRCC,
activities activities conducted NGOs (MDA,
Baseline data 2019: Number through collaboration MPDPA)
of activities conducted: 11,576
activities (source: PKP201C, Oral
Health Program, 2019)
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

41
 APPENDIX 1

42
FOCUS AREA 1: Prevention and Health Promotion

Coordinating /
Performance
No Specific Objectives Strategic Actions Target collaborating
Indicator
Agencies
1.18     Oral Cancer Training for Number HCP involved 5% increase yearly MOH (OHP,
HCPs in Oral Cancer JKN/PKD),
Baseline data 2019: 18,049 training OCRCC,
personnel involved in Oral Cancer NGOs (MDA,
Training and 25 trainers (source: MPDPA, MMA)
Appendix 7 Latihan Berkaitan
Program Kanser Mulut, Program
Kesihatan Pergigian, 2019)
2 To strengthen the 2.1 To strengthen the MOH
intervention of specific implementation of Tobacco (BKP),mQuit
cancer risk factors Control Programme to reduce partners, WHO
the national smoking prevalence. FCTC Steering
Substantial articles of World Committee
Health Organization Framework and 10 related
Convention on Tobacco Control Ministries
(WHO FCTC) to be strengthened:
• Article 6: Price and tax measures Increase tax imposed Tax imposed
to reduce the demand for from retail price (most increased from
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

tobacco popular brand) current 45% to 70%

• Article 8: Protection from Increase number in All public places

exposure to tobacco smoke public places gazetted gazetted as no
as no smoking area smoking area/place
/ places (current 23
area/ places gazetted)
 APPENDIX 1

FOCUS AREA 1: Prevention and Health Promotion

Coordinating /
Performance
No Specific Objectives Strategic Actions Target collaborating
Indicator
Agencies
• Article 11: Packaging and Implementation PHW implemented
labelling of tobacco products of pictorial health on all tobacco
warning (PHW) on all products
tobacco products packaging and
plain packaging
implemented
• Article 12: Education, Prevalence of smoker Prevalence of
communication, training and in Malaysia (21.3% in smoker reduced
public awareness AND Article NHMS 2019) to <5% in 2045
14: Demand reduction measures (tobacco endgame)
concerning tobacco dependence
and cessation
• Article 16: Sales to and by Improve regulation Sales by minor not
minors on sales by minor (< allowed
18 years old currently
still allowed)
2.2 To reduce obesity prevalence in *To refer NPANM III7 *To refer NPANM III MOH (Nutrition
Malaysia by strengthening obesity (Enabling Strategy (Enabling Strategy Division),
intervention implementation 4: Preventing and 4: Preventing and Professional
Controlling Obesity Controlling Obesity bodies, NGOs
and Other Diet- and Other Diet-
Related NCDs) Related NCDs)

2.3 To promote and support *To refer NPANM III *To refer NPANM III MOH (Nutrition
healthier food choices particularly (Enabling Strategy 2: (Enabling Strategy Division), MOE,
high consumption of fruit and Promoting Healthy 2: Promoting Professional
vegetables, and low fibre diet by Eating and Active Healthy Eating and bodies, NGOs
continue healthy eating intervention Living) Active Living)
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

43
7 National Plan of Action for Nutrition of Malaysia III, 2016-2025 (17)
 APPENDIX 1

44
FOCUS AREA 1: Prevention and Health Promotion

Coordinating /
Performance
No Specific Objectives Strategic Actions Target collaborating
Indicator
Agencies
2.4 To continue implementation Index score for Increment of index MOH (BPK)
of healthy lifestyle initiatives to physical activity score for physical
increase active living among adult. behaviour among activity behaviour
adult (Malaysia among adult
Healthy Lifestyle
Index)
2.5 To sustain the implementation Percentage of 13 Yearly performance MOH (BPKK)
and monitoring the National HPV years old girls being >80% from target
immunisation program vaccinated and population
completed 2nd dose
vaccination

2.6 To sustain the implementation Completed 3rd dose Yearly performance MOH (BKP,
and monitoring of the National Hep B Vaccination >95% BPKK)
Hepatitis B immunisation program
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025
 APPENDIX 2
FOCUS AREA 2: Screening and Early Diagnosis

Coordinating /
Performance
No Specific Objectives Strategic Actions Target collaborating
Indicator
Agencies
1. To increase and
strengthen early A. Colorectal Cancer: Increase accessibility and capacity of colorectal cancer
detection of cancer screening services
(screening and early 1.1 To equip all cluster Availability of By 2025 all cluster MOH (BPP)
diagnosis) hospitals and/or hospital colonoscopy services hospitals are
with visiting specialists in all cluster hospitals equipped with
with colonoscopy services and/or with visiting colonoscopy set and
specialists hospital with visiting
specialist/district
hospitals to at least
have the service
using portable
colonoscopy:
By 2022 (First
phase): 9 portable
colonoscopies for
Kedah, Pahang,
Johor, Kelantan,
Terengganu,
Sarawak (2), Negeri
Sembilan and
Selangor
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

45
 APPENDIX 2

46
FOCUS AREA 2: Screening and Early Diagnosis

Coordinating /
Performance
No Specific Objectives Strategic Actions Target collaborating
Indicator
Agencies
1.2 To increase screening Percentage of Coverage increased MOH (BKP),
coverage screening coverage from 10.8% (NHMS Private sectors,
2019) to 30% at SOCSO, NGO
NHMS 2023

a) To encourage GPs to To initiate discussion By 2021, AFPM MOH (BKP)

participate in colorectal with AFPM in 2021 started to participate AFPM
cancer screening and and AFPM supports in colorectal cancer
early detection, with the initiative screening
support of the Academy
of Family Physicians of
Malaysia (AFPM)
By 2025, 80% of
b) To expand iFOBT Implementation of all eligible KOSPEN MOH (BKP),
screening at KOSPEN iFOBT screening volunteers screened JKN, PKD
and screen the eligible for the KOSPEN using iFOBT
volunteers volunteers
iFOBT screening
c) To explore the Discussion with services included MOH (BKP),
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

possibilities of adding SOSCO’s officials in in SOCSO’s Health SOCSO

iFOBT screening 2022 Screening Program/
under SOSCO’s Health activity by 2025
Screening Program
iFOBT screening
d) iFOBT screening iFOBT screening in services included MOH (BKP),
included in PeKa B40 PeKa B40 Health in PeKa B40 Health Protect Health
Screening Scheme Screening Scheme
by 2025
 APPENDIX 2
FOCUS AREA 2: Screening and Early Diagnosis

Coordinating /
Performance
No Specific Objectives Strategic Actions Target collaborating
Indicator
Agencies
1.3 To strengthen Development of Navigation and MOH (BKP,
navigation, referral navigation and referral referral pathway JKN, PKD),
pathway and supportive pathway developed / NGOs
care for colorectal cancer incorporated under
Guideline for
Screening & Early
Detection and being
used as reference
1.4 To promote and Screening for By 2021, screening MOH
encourage screening for asymptomatic first- for first degree (BKP/BPP/
asymptomatic first-degree degree relatives relatives of colorectal BPKK / JKN)
relatives of Colorectal included in the cancer is being
Cancer using current Colorectal Cancer promoted and
modalities Screening and Early practised
Diagnosis Programme

B. Breast Cancer
1.1To enhance knowledge Percentage of HCPs At least 80% of MOH (BPKK,
on latest information, trained primary HCPs BPP, JKN,
management and trained every year PKD),
treatment of breast cancer Universities,
as well as to improve the NGOs,
quality of clinical breast Professional
examination by continuous bodies.
training of primary HCPs
through various platform
(CME, CNE, webinar etc.)
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

47
 APPENDIX 2

48
FOCUS AREA 2: Screening and Early Diagnosis

Coordinating /
Performance
No Specific Objectives Strategic Actions Target collaborating
Indicator
Agencies
1.2 To reinforce navigation Refinement of Patient To be ready by 2021 MOH (BPKK,
and effective referral Navigation Guideline JKN, PKD)
pathway in breast cancer in Brest Cancer
prevention and early
diagnosis

1.3 Early referral to Percentage of ≥80% (3 monthly) MOH (BPKK

Surgeons from other patients at high risk (NB: Old KPI – Family
healthcare facilities for all of having Breast dropped in 2020) Medicine
suspected breast cancer Cancer and/or having Specialists,
cases (clinical/radiological suspicious symptoms Liaison Officer/
symptoms) and facilitating of malignancy / dedicated MO,
the process of getting early lump / lesion should JKN)
appointment be given an early
appointment within ≤
14 working days

1.4 To increase CBE Percentage of women 30% population MOH (BPKK,

NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

coverage and early aged 20 to 65 years coverage JKN, PKD)

detection examined per year by
each nurse and doctor

1.5 To foster smart Percentage reduction 25% reduction from MOH (BPKK,
partnership with other in the average the average waiting JKN),
agencies and NGOs in waiting time for time (e.g., average Hospitals
improving access for mammography waiting time: 8
women screened at appointment months, the target is
primary care facilities to 6 months
undergo mammography
examination
 APPENDIX 2
FOCUS AREA 2: Screening and Early Diagnosis

Coordinating /
Performance
No Specific Objectives Strategic Actions Target collaborating
Indicator
Agencies

C. Cervical cancer

1.1 Implementation of more Number of states Phase 1: 2019 MOH (BPKK)

effective cervical cancer implementing HPV started in 3 states
screening program through testing (Kuala Lumpur &
self-sampling HPV testing Putrajaya, Kedah
as primary screening test and Kelantan)
among women age 30-65 Phase 2: 2020 add
years another 4 states
(Negeri Sembilan,
Selangor, Penang
and Sarawak)
Phase 3: 2021 add
another 3 states
(Kuala Terengganu,
Johor, Melaka)
Phase 4: 2022 add
another 4 states
(Perak, Pahang,
Perlis and Sabah)

Nationwide by
2024/2025

1.2 To increase effective Percentage of women 40% by 2025 MOH (BPKK,

screening coverage on the aged 30-65 years JKN, PKD),
targeted population and screened for cervical NGOs
improve early detection cancer
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

49
 APPENDIX 2

50
FOCUS AREA 2: Screening and Early Diagnosis

Coordinating /
Performance
No Specific Objectives Strategic Actions Target collaborating
Indicator
Agencies
1.3 To foster smart Percentage of women 40% by 2025 MOH (BPKK),
partnership with other aged 30-65 years NGOs
agencies and NGOs in screened for cervical
enhancing cervical cancer cancer
screening coverage among
women aged 30-65 years

1.4 To ensure a prompt Percentage of Waiting time <2 MOH (BPKK,

intervention after positive confirmed cases seen weeks BPP)
diagnosis of HPV infection by gynaecologist in 2
weeks (after getting
result)

1.5 To improve the quality Percentage of HCPs At least 80% of MOH (BPKK,
of cervical cancer screening trained primary HCPs JKN, PKD)
continuous training of trained every year
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

primary HCPs through

various platform (CME,
CNE, webinar etc)

1.6 Use of Liquid Base Percentage of LBC pap Target 80% from MOH (BPKK)
Cytology (LBC) for all pap smear used in clinics target population by
smear and hospitals. This 2022/2023
is for screening and
follow-up of cervical
and endometrial
cancer patients
 APPENDIX 2
FOCUS AREA 2: Screening and Early Diagnosis

Coordinating /
Performance
No Specific Objectives Strategic Actions Target collaborating
Indicator
Agencies
D. Oral cancer
*Oral Cancer Screening Program, refer to Guidelines on Primary Prevention and Early
Detection of Oral Potentially Malignant Disorders and Oral Cancers (2018)
1.1 Increase coverage of Percentage of 10% increase MOH (OHP),
opportunistic screening for opportunistic oral every year for NGO,
oral cancer cancer screening for opportunistic MPDPA
walk-in patients screening

Baseline data 2019:

Total 112,748
patients (age 18 year
and above)

1.2 Improve coverage Number of people in 10% increased every MOH (OHP),
of high-risk community high-risk community year NGO,
screening for Oral Cancer (>18 years old) MPDPA
screened for Oral Baseline data 2018:
Cancer 2,972 patients

1.3 Increase early detection Percentage of Oral 30% of oral cancer MOH (OHP),
of Oral Cancer cases Cancer cases detected detected at Stage 1. NGO,
at Stage 1 MPDPA
Baseline data 2019:
15.6% (MNCR 2012-
2016)
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

51
 APPENDIX 2

52
FOCUS AREA 2: Screening and Early Diagnosis

Coordinating /
Performance
No Specific Objectives Strategic Actions Target collaborating
Indicator
Agencies
E. Monitor Cancer Screening
Monitor screening activities An online cancer By 2025, an online MOH (BKP,
through an online system screening database cancer screening BPM)
is developed and database is
operational developed and can
be used (an online
screening data base
with sub-modules
for colorectal, breast,
cervical (pap smear
and HPV DNA)
and oral cancers
under the e-CDC
platform where
all information on
screening until
diagnosis are
registered)
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025
 APPENDIX 3a
FOCUS AREA 3: Diagnosis (Pathology)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
1. To upgrade the scope A. Anatomical Pathology
and efficiency of
existing laboratory 1.1 To establish a. To enhance molecular- By 2025, all centres MOH
diagnostic services in IHC, ISH, PCR and based IHC in centres with with subspecialty
all national, regional sequencing-based subspecialty services services will be able
and state hospitals to molecular tests at (HKL, HSBAS, HTAA) for to provide molecular-
provide total support identified centres on colorectal cancer and based IHC
for cancer patients in solid tumours. brain tumours
the disciplines of:
b. To expand ISH-testing To expand ISH-testing MOH
at identified centres for for lymphoma, soft
solid tumours at identified tissue tumours and
centres (HKL, HRPB Ipoh paediatric malignancies
and HQE Sabah). in HKL by 2025 To
procure FISH testing
equipment, reagents
and consumables for
lympho-proliferative
malignancies in HQE
Sabah and HRPB Ipoh
by 2025

c. To establish PCR and To establish PCR and MOH

sequencing diagnostics in sequencing diagnostics
HKL focusing primarily on in HKL by 2022 for
solid tumours colorectal carcinoma
and other cancers by
2025
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

53
 APPENDIX 3a

54
FOCUS AREA 3: Diagnosis (Pathology)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
d. To expand molecular Renovation of testing MOH
service to HUS focusing on site in HUS Sarawak by
lung cancer 2022

To procure PCR-based
equipment, reagents
and consumables for
molecular service in
HUS Sarawak by 2023
To provide the
molecular service
focusing on lung cancer
in HUS Sarawak by
2025

1.2 To strengthen To strengthen PCR To establish testing MOH

molecular testing and high-through put on liquid biopsy for
on liquid biopsy sequencing diagnostics screening, treatment
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

samples for cancers focusing on liquid biopsy monitoring, recurrence

for disease monitoring and metastasis in
cancers by 2025
 APPENDIX 3a
FOCUS AREA 3: Diagnosis (Pathology)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
B. Chemical Pathology
1.3 Expand the a. To offer newly Achieve all of the MOH
range of new introduced tumour tumour markers by
tumour markers markers internationally 2025
for testing in IKN. recognised and accepted
(List of tumour for cancer monitoring
markers: calcitonin,
chromogranin A,
HE4, HER2-neu, b. To upgrade and back 100% of equipment
PIVKA2, CYFRA 21-1 up first equipment shall be placed and
and PROGRP) added

1.4 Establish To renovate testing site Renovation of testing MOH

proteomics testing and to procure equipment site shall be completed
for oncology in IKN and reagents in IKN by 2025

100% of equipment
and reagent shall be
procured by 2025
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

55
 APPENDIX 3a

56
FOCUS AREA 3: Diagnosis (Pathology)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies

C. Haematology
1.5 To start and a. To expand molecular By 2023, Hospital MOH
expand molecular detection of common Tunku Azizah will be
services translocations in able to take over up to
leukaemia at Hospital 50% of the service from
Tunku Azizah and to take IMR
over service from IMR as
referral centre To upgrade equipment
and procure reagents,
consumables and EQA
by 2023

b. To start molecular By 2022, HQE will be MOH

detection of common able to start the service
translocations in
leukaemia at HQE, Sabah To procure equipment,
regents, consumables
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

and EQA by 2022

c. To start new service By 2023, Hospital MOH

(AML Mutation Study) at Tunku Azizah will take
Hospital Tunku Azizah over the service from
and to take over from IMR IMR as referral centre
as referral centre
To procure reagents,
consumables and EQA
by 2023
 APPENDIX 3a
FOCUS AREA 3: Diagnosis (Pathology)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
d. To expand Major BCR- By 2021, will start the MOH
ABL1 quantification service at:
service for monitoring of 1. HQE, Sabah
CML cases using existing 2. Hospital Melaka
platform at identified 3. HTAA Kuantan
locations
To procure reagents,
consumables and EQA
by 2021
e. To change chimerism By 2022, HTA will MOH
assay method at HTA be able to change
from STR to Real Time chimerism assay
Quantitative PCR method from STR to
Real Time Quantitative
PCR

To optimise the
method and to procure
reagents, consumables
and EQA by 2022
1.6 To strengthen a. To start bone marrow By 2023, HUS MOH
the bone marrow cytogenetic service at HUS will establish the
cytogenetic service. cytogenetic service

To procure equipment,
reagents, consumables
and EQA by 2023
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

57
 APPENDIX 3a

58
FOCUS AREA 3: Diagnosis (Pathology)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
b. To expand cytogenetic By 2021, HPP will MOH
service at HPP expand the service
other than FISH for
BCR-ABL1 for Northern
Region

To procure reagents,
consumables and EQA
by 2021

1.7 To strengthen a. To expand the MRD By 2021, Hospital MOH

flowcytometry monitoring at Hospital Tunku Azizah will be
service Tunku Azizah for adult able to expand the MRD
Acute Lymphoblastic monitoring for adult
Leukaemia cases Acute Lymphoblastic
Leukaemia cases

To procure reagents,
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

consumables and EQA

by 2021
 APPENDIX 3a
FOCUS AREA 3: Diagnosis (Pathology)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
b. To start MRD Will start the service by MOH
monitoring for adult 2021 at:
and paediatric Acute 1.HSA Johor Bahru
Lymphoblastic Leukaemia 2.HPP
cases using local
standardised protocol To procure reagents,
(Modified Euroflow consumables and EQA
protocol) 8 colours by 2021
flowcytometry at two
centres

c. To start diagnostic By 2021, HUS will be MOH

service for leukaemia/ able to start the service
lymphoma and MRD
monitoring service using To procure reagents,
8 colours flowcytometry at consumables and EQA
HUS Sarawak by 2021

1.8 To strengthen To upgrade Stem Cell By 2022, HTA will be MOH

the Stem Cell Laboratory and to include able to upgrade Stem
Laboratory service clean room facility for Cell Laboratory and
cellular therapy as part to include clean room
of upgrading of IPHKL facility for cellular
project RMK-12 therapy as part of
upgrading of IPHKL
project RMK-12
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

59
 APPENDIX 3a

60
FOCUS AREA 3: Diagnosis (Pathology)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
2. To provide A. Digital Pathology
comprehensive
pathology services 2.1 To establish a a. To set up a pilot project By 2023 the completion MOH
for cancer diagnosis digital pathology in HKL and HUS of the pilot project
and to be delivered in system involving with improvement for
a timely manner by MOH hospitals expansion
appropriately qualified
and trained medical b. KIV to expand the By 2025, at least two MOH
professionals service to other regional regional centres have
centres after exploring the established the service
uses (Sabah and East Coast)

B. Accreditation
2.2 Accreditation a. To achieve accreditation To upgrade and achieve MOH,
of molecular ISH in centre providing the accreditation in the Accreditation
test at identified ISH service testing centre (HKL) by Body (DSM)
Anatomic Pathology 2025.
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

centre
b. For HKL to become For HKL to become the MOH,
the EQA provider for ISH EQA provider for ISH Universities,
(DDISH for breast cancer) by 2025 Private sectors

2.3 Accreditation of To achieve accreditation To achieve accreditation MOH,

Molecular test at all at Hospital Tunku Azizah by 2023 Accreditation
centres providing the and HQE Body (DSM)
test
 APPENDIX 3a
FOCUS AREA 3: Diagnosis (Pathology)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
2.4 Accreditation of To achieve accreditation at To achieve accreditation MOH,
Cytogenetic test at HUS by 2025 Accreditation
identified centres. Body (DSM)

2.5 Accreditation To achieve accreditation To achieve accreditation MOH,

of Flowcytometry at all centres providing by 2022 Accreditation
Service at all centres flowcytometry service Body (DSM)
providing the test.

C. Human Resource & Training

Refer to Appendix 9 (Focus Area 10: Human capacity building and development)
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

61
 APPENDIX 3b

62
FOCUS AREA 3: Diagnosis (Radiology)
Coordinating /
Performance
No. Specific Objective Strategic Action Target collaborating
Indicators
Agencies
1 To reduce waiting 1.1 Staging to be Percentage of cases with 90% by 2025 MOH
time for staging carried out within 2 staging done within
and image guided weeks of confirmed 2 weeks of confirmed
procedures diagnosis by HPE. diagnosis by HPE

1.2 Urgent image Percentage of 80% by 2025 MOH

guided procedure urgent image guided
performs for clinical procedures perform
/ radiological within 1 week for cases
diagnosis with clinical/radiological
‘consistent with/ diagnosis of cancer
suspicious for/
probable’ (≥75%
level of certainty) of
cancer to be done
within 1 week.

2 To upgrade and 2.1 To replace Number of At least 6 Mammography MOH

NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

replace aging Mammography Mammography machine machines yearly (In centres

radiology equipment machine more replace yearly assigned by year as below):
than 10 years old
with Digital Breast 2021
Tomosynthesis. Hospital Ampang, Hospital
Melaka, Hospital Seberang
Jaya, HRPB, HPP, HSA
 APPENDIX 3b
FOCUS AREA 3: Diagnosis (Radiology)
Coordinating /
Performance
No. Specific Objective Strategic Action Target collaborating
Indicators
Agencies
2022
HTAA, HTJS, HSBAS,
Hospital Selayang, HSNZ,
HIS
2023
HUS, HRPZ II, Hospital
Miri, Sungai Buloh, Sultan
Abdul Halim, Taiping
2024
HQE, HWKKS, Sibu,
Bintulu, Teluk Intan, Pakar
Sultanah Fatimah, Muar,
Pakar Sultanah Nora Ismail
2025
Serdang, Langkawi,
HOSHAS, Kemaman,
Kajang, Seri Manjung,
Tuanku Ampuan Najihah

2.2 To replace CT Number of CT Scan At least 6 CT Scan MOH

scan machine more machines replace yearly machines yearly (in centres
than 10 years old. assigned by year as below):
2021
HKL, HUS, HTJS, HRPB,
HTAR
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

63
 APPENDIX 3b

64
FOCUS AREA 3: Diagnosis (Radiology)
Coordinating /
Performance
No. Specific Objective Strategic Action Target collaborating
Indicators
Agencies
2022
Sungai Buloh, HQE, HRPZ
II, Segamat, Serdang, Pusat
Jantung HUS
2023
Pakar Sultanah Fatimah,
Muar, Sultan Abdul Halim,
HKL, IKN, Sibu, Kulim
2024
Ampang, Bintulu, HTAA,
Labuan, Enche’ Besar
Hajjah Khalsom, Kluang,
Taiping
2025
Miri, HWKKS, Lahad Datu,
Sarikei, Limbang, Kajang,
Shah Alam
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

2.3 To replace Number of Fluoroscopy At least 5 Fluoroscopy MOH

conventional machines replace yearly machines yearly (In centres
fluoroscopy assigned by year as below):
machine with 2021
multipurpose Sultan Ismail, Selayang,
C-arms. Melaka, Miri, HRPB,
Seberang Jaya
 APPENDIX 3b
FOCUS AREA 3: Diagnosis (Radiology)
Coordinating /
Performance
No. Specific Objective Strategic Action Target collaborating
Indicators
Agencies
2022
Sungai Buloh, Ampang,
Bintulu, Serdang, HTAR,
HQE, HUS
2023
HPP, Sultan Abdul Halim,
HSBAS, HTAA, HAS, HTJS
2024
HRPZ II, HOSHAS, Seri
Manjung, Sultanah
Fatimah, Tuanku Fauziah
2025
Sarikei, HKL, HWKKS,
Enche’ Besar Hajjah
Khalsom, Taiping
2.4 To replace Number of General 25 General Radiography MOH
General Radiography machine machines yearly.
Radiography replace yearly 2021
machine Direct Digital
Radiography (DDR)
Selayang, HSBAS, HRPB,
HTAR, Sungai Buloh,
HSNZ, Teluk Intan, HTJS,
HOSHAS, HKL, Sibu,
Sultan Abdul Halim, HSI,
HTAA, HAS, Serdang
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

65
 APPENDIX 3b

66
FOCUS AREA 3: Diagnosis (Radiology)
Coordinating /
Performance
No. Specific Objective Strategic Action Target collaborating
Indicators
Agencies
Analogue
Dalat, Besut, Kota Belud,
Jasin, Pekan, Sungai
Bakap, Jerantut, Gerik,
Kota Tinggi, Kudat, Kunak,
HTAA
2022
Direct Digital
Radiography (DDR)
HQE, Ampang, Melaka,
Banting, HUS, HKL,
HSBAS, Miri, Kajang, HPP,
Selayang, HPJ, Sungai
Buloh, HTJS, Melaka, HSI,
HOSHAS
Analogue
Beluran, Lahad Datu,
Bahagia Ulu Kinta,
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

Sultanah Hajjah Kalsom,

Cameron Highland, Ranau,
Raub, Lawas, Labuan
2023
Direct Digital
Radiography (DDR) Bukit
Mertajam, Tuanku Ampuan
Najihah, HUS, Pusat
Jantung Sarawak,
 APPENDIX 3b
FOCUS AREA 3: Diagnosis (Radiology)
Coordinating /
Performance
No. Specific Objective Strategic Action Target collaborating
Indicators
Agencies
HSA, HPP, Seberang Jaya,
HRPB, Taiping, HWKKS
Analogue
Temenggung Seri Maharaja
Tun Ibrahim, Mukah,
HQE, Tanah Merah, Bau,
Sarikei, Tanjong Karang,
Inst. Perubatan Respiratori,
Tumpat, Gua Musang, Jeli,
Kuala Lipis, Parit Buntar,
Port Dickson
2024
Direct Digital
Radiography (DDR)
Bintulu, HSNZ, Serdang,
Kulim, Segamat, Sultanah
Nora Ismail, HRPZ II,
Kemaman, HQE II, HQE,
Sultan Abdul Halim
Analogue
Lundu, Daro, Slim River,
Pontian, Mersing, Sik,
Kuala Kangsar, Tapah,
Kampar, Tengku Anis, Pasir
Puteh, Tuaran, Yan
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67
 APPENDIX 3b

68
FOCUS AREA 3: Diagnosis (Radiology)
Coordinating /
Performance
No. Specific Objective Strategic Action Target collaborating
Indicators
Agencies
2025
Direct Digital
Radiography (DDR)
Selayang, Sungai Buloh,
HSBAS, Serdang, Ampang,
HTAR, HSI, Sultan Abdul
Halim, HOSHAS, HUS,
Sultanah Fatimah
Analogue
Parit Buntar, Baling,
Kuala Nerang, Pasir
Mas, Machang, Jengka,
Muadzam Shah, Betong,
Sungai Siput, Rompin,
Batu Gajah, Jelebu, Kuala
Krai, Jitra
2.5 To upgrade Number of MRI At least 2 MRI machines MOH
and replace MRI machines replace yearly yearly.
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

machine. 2021 - HTAR, Pusat

Jantung Sarawak, Sibu
2022 – HQE II, Sultanah
Fatimah, Muar
2023 - Miri, HWKKS
2024 - Selayang, IKN
2025 - Taiping, HKL,
Sultanah Nora Ismail
 APPENDIX 3b
FOCUS AREA 3: Diagnosis (Radiology)
Coordinating /
Performance
No. Specific Objective Strategic Action Target collaborating
Indicators
Agencies
2.6 To replace Replacement of 2021 - HKL (Hybrid), MOH
Angiography angiography machine in HSBAS (Bi-Plane)
machine. major centre 2022 - HUS (Bi-Plane)
2025 - HKL (Bi-Plane)

2.7 To replace Number of Ultrasound 30 Mid-High Range MOH

Ultrasound machine replace yearly Ultrasound machines
machine. yearly

3 To expand diagnostic 3.1 Mammography Mammography Machine Mammography machine is MOH

and therapeutic machine. to minor specialist available in each centre by
radiology services. Hospital and Level 1 year indicated:
Health Clinic. 2022 - Labuan
2023 - Kuala Lipis
2024 - Keningau
2025 - Klinik Kesihatan
Kuala Lumpur

3.2 CT scans. a. Number of CT Scan At least 2 CT Scan MOH

machines install in machines to be install in
minor specialist hospital minor specialist hospitals:
2021 - Bukit Mertajam,
Slim River
2022 - Sri Aman, Gua
Musang
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69
 APPENDIX 3b

70
FOCUS AREA 3: Diagnosis (Radiology)
Coordinating /
Performance
No. Specific Objective Strategic Action Target collaborating
Indicators
Agencies
2023 - Beaufort, Kota
Marudu
2024 - Banting, Besut
2025 - Port Dickson, Inst.
Perubatan Respiratori

b.   To install second CT At least 2 CT Scan MOH

Scan in hospital in state machines yearly:
and major hospital with 2021 - HSI, HRPB
high workload.
(Peninsular Malaysia: 2022 - HSBAS, HUS
15,000 cases per year; 2023 - Pulau Pinang,
Sabah and Sarawak: Melaka
12,000 per year) 2024 - HTJS, HTAR
2025 - Seberang Jaya,
HQE, Sibu
3.2 Multipurpose Number of Multipurpose Two (2) units of MOH
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

C-arm. C-Arm install to minor Multipurpose C-Arm to

specialist hospitals minor specialist hospitals:
2023 - Hospital Labuan
2025 - Hospital Langkawi

3.3 Biplane Unit of Bi-plane 1 unit of Bi-plane MOH

Angiography Angiography in regional Angiography for regional
machine. Hospital hospital:
2021 - HQE
 APPENDIX 3b
FOCUS AREA 3: Diagnosis (Radiology)
Coordinating /
Performance
No. Specific Objective Strategic Action Target collaborating
Indicators
Agencies
3.4 Ablation Unit of Ablation therapy 1 unit for each cancer MOH
therapy machine machine for each cancer centre:
(RFA/Cryoablation/ centre 2021 - HUS
microwave) 2022 - HPP
2023 - HSI
2024 - HWKKS
2025 - HSBAS, HRPZ II

3.5   Mobile Unit of mobile 1 units mobile Ultrasound MOH

Ultrasound Ultrasound in all in all angiography facilities:
angiography facilities HSBAS, HPP, HKL,
Selayang, Sungai Buloh,
IKN, HSA, HUS

3.6   Establish Outsourcing service for 100% MOH

public private planning CT Scan/ MRI
partnership (PPP). if waiting time exceed 2
weeks.

3.7   Install RIS- Number of centres with 4 regional Oncology Centre. MOH
PACS for all centre RIS-PACS installed 2021 - HKL
with oncology
services 2022 - HUS
2023 - HPP
2024 – HWKKS
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71
 APPENDIX 3b

72
FOCUS AREA 3: Diagnosis (Radiology)
Coordinating /
Performance
No. Specific Objective Strategic Action Target collaborating
Indicators
Agencies
3.8   Consumables Number of cases yearly MOH
for interventional for each interventional
oncology for oncology services
following service:
• TACE • 950 cases /year
• RFA • 600 cases/year
• Cryoablation • 160 cases/year
• Microwave • 400 cases/year
• SIRT • 150 cases/year (6
centres)

4 To improve radiology 4.1 To produce Producing the Oncology- Oncology-Radiology MOH

reporting standard, Oncology-Radiology Radiology Reporting Reporting proforma is
training and research. Reporting proforma. proforma produced by 2025

4.2  To update To establish standard Oncology Radiology report MOH

Oncology-Radiology structured reporting that is based on standard
report using template for following structured reporting
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

standard structured imaging/ procedures: template is establish by

reporting template. i)   CT colonography year 2025
ii)  Lung nodule
iii) Prostate imaging
 APPENDIX 3b
FOCUS AREA 3: Diagnosis (Radiology)
Coordinating /
Performance
No. Specific Objective Strategic Action Target collaborating
Indicators
Agencies
4.3 To update i)   To incorporate Cancer staging reporting MOH
cancer staging American Joint based on AJCC Staging
reporting Committee on Cancer System and latest criteria
(AJCC) Staging System for cancer surveillance is
in routine reporting incorporated by 2025
of cancer cases (TNM
staging)
ii) To incorporate latest
criteria for surveillance
of cancer.
(e.g.: RECIST/
mRECIST/ PERCIST/
CHOI relevant cases)

4.4 ‘Advance Number of Senior 2 senior consultants in 5 MOH

competency Consultants undergoing years
program/training’ ‘Advance competency
(sabbatical or program/training’
equivalent leave
given to Senior
Consultants in area
of subspecialty
working in MOH)
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73
 APPENDIX 3b

74
FOCUS AREA 3: Diagnosis (Radiology)
Coordinating /
Performance
No. Specific Objective Strategic Action Target collaborating
Indicators
Agencies
4.5  To support Scientific paper MOH
research presentation/
participation and publication local and
new practices. international. Peer
reviewed/High index
journal.

4.6  Lung cancer To incorporate LDCT in LDCT for early Lung cancer MOH
screening - LDCT Lung cancer screening detection is incorporated
screening in high- for high-risk group as part of the Radiology
risk group. Service.

4.7  Colorectal To equip Automated Automated CO2 insufflation MOH

cancer detection CO2 insufflation system system with a software
using CT with a software for CT- for CT-colonography is
Colonography. colonography at state available at state Hospitals.
Hospitals.

4.8 Multiparametric Availability of Selected MRI facility may MOH

NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

MRI for Prostate multiparametric MRI for offer the service

cancer imaging. Prostate cancer imaging
5 To strengthen our
human capital Refer to Appendix 9 (Focus Area 10: Human capacity building and development)
development
 APPENDIX 3c
FOCUS AREA 3: Diagnosis (Nuclear Medicine)
No Specific Objective Strategic Actions Performance Target Coordinating/
Indicators collaborating
agencies
1 To ensure all the 1.1        To establish Establishment of By 2025 at least two Level MOH
regions in Malaysia at least two new centres at: 2sp nuclear medicine
have nuclear regional nuclear 1. HSI, Johor – centres, one for southern
medicine centres medicine centres southern region region and the other for
that are capable to to provide the (approved under RMK- east coast region are set
provide the essential latest diagnostic 10) up.
supportive oncology and therapeutic 2. As part of Northern
services outpatient Cancer Centre,
and inpatient Sungai Petani, Kedah
radionuclide (approved)
services for
oncology. 3. Kuala Terengganu or
Kuantan – east coast
region

1.2        To replace To ensure all operating All existing regional MOH

all the old SPECT SPECT-CT & SPECT nuclear medicine centres
machines with new machines are within the should have at least 1
SPECT-CT units. operational lifespan of SPECT-CT machines (<10
<10 years. years).

1.3        To ensure The nuclear medicine All existing regional MOH

all the existing centres at the Sabah, nuclear medicine centres
nuclear medicine Sarawak and Northern should have at least 1
centres could Cancer Centre shall be PET-CT machine.
provide the essential equipped with PET-CT.
oncological PET-CT
services.
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75
 APPENDIX 3c

76
FOCUS AREA 3: Diagnosis (Nuclear Medicine)
No Specific Objective Strategic Actions Performance Target Coordinating/
Indicators collaborating
agencies
1.4 To establish A self-sufficient supply Allowed all the PET- MOH,
a cyclotron and of PET radiotracers for CT operation in East IAEA
related hotlab East Malaysia. Malaysia to have sufficient
facility for East radiotracer to perform
Malaysia, in Sabah >2,000 patients/year
or Sarawak. for each PET-CT unit
installed in Sarawak &
Sabah.
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025
 APPENDIX 4a
FOCUS AREA 4: Treatment (Radiotherapy & Oncology)
Coordinating/
Performance
No Specific Objective Strategic Actions Target collaborating
Indicators
agencies
1 To improve access to 1.1 Increase number a. Establishing Northern Oncology MOH (BPP,
oncology services in of cancer treatment Northern Oncology Centre operating in 2025 Planning &
MOH facilities within Centre equipped Development
MOH with radiotherapy, Division, BPL,
chemotherapy and BSKB),
basic nuclear medicine MOF,
services. SPA,
JKR
b. Establishing Sarawak Sarawak Cancer Centre
Cancer Centre expected to be operating
by 2025.
c. Establishing East East Coast Oncology
Coast Oncology Centre Centre expected to be
at Kuantan/ Kuala operating by 2030.
Terengganu

1.2        To establish Developing Clinical COU to be set up in MOH (BPP,

Clinical Oncology Oncology Units (COU) in Hospital Selayang and hospital
Units (COU) at MOH Periphery Hospitals: Batu Pahat by 2021 and directors, State
hospitals 1. Hospital Selayang Hospital Tawau by 2025 Health Directors)
2. Hospital Batu Pahat
3. Hospital Tawau
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77
 APPENDIX 4a

78
FOCUS AREA 4: Treatment (Radiotherapy & Oncology)
Coordinating/
Performance
No Specific Objective Strategic Actions Target collaborating
Indicators
agencies
2 To provide 2.1  Upgrade of HKL MOH (BPP)
radiotherapy services Radiotherapy • To replace CT CT simulator to be
in timely manner facilities within simulator (2002) replaced by 2022
MOH. To replace Linear Linear accelerators
Accelerators (2002 replaced by 2021-2022
and 2009)
• To increase
treatment planning
system
IKN
• To add 5th Linear New Linear accelerator
Accelerator installed by 2021.
• To add treatment
planning system
• HSI Johor
• To replace
Brachytherapy
System
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

• To replace Linear
Accelerator (2005)
HSI Johor
• To replace New brachytherapy
Brachytherapy system to be replaced by
System 2021
• To replace Linear Linear accelerator
Accelerator (2005) replaced by 2022
 APPENDIX 4a
FOCUS AREA 4: Treatment (Radiotherapy & Oncology)
Coordinating/
Performance
No Specific Objective Strategic Actions Target collaborating
Indicators
agencies
HUS
• To add CT simulator New CT simulator to be
installed by 2022
• To replace CT CT simulator to be
simulator (2008) replaced by 2023
• To replace LINACs Old Linear Accelerator to
(2008 and 2009) be replaced in 2021 and
new one to be installed in
2023
HWKKS
• To add CT simulator New CT simulator to be
installed by 2021
• To replace LINAC Linear accelerator
(1997) at HQE2 replaced by 2023

2.2        To To outsource Patients from Perak get

outsource radiotherapy services to radiotherapy treatment at
radiotherapy private oncology centre private centre by 2023
services to private for patients in Perak.
oncology centres.

3 To strengthen
manpower and
improve career Refer to Appendix 9 (Focus Area 10: Human capacity building and development)
development within
MOH
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

79
 APPENDIX 4a

80
FOCUS AREA 4: Treatment (Radiotherapy & Oncology)
Coordinating/
Performance
No Specific Objective Strategic Actions Target collaborating
Indicators
agencies
4 To establish Value To request for HTA Effective price MOH
Based Medicine as a for new targeted negotiation-based HTA (Pharmaceutical
strategy to maintain therapies that are recommendations Services
sustainability of being requested to that are derived from Division, HTA),
treatment be included in MOH threshold and the use of MOF,
Formulary protocol guidelines NGOs,
JPA,
Other third-
party payors

5 To improve access to 5.1  To request Patients to get targeted MOH

targeted therapies additional Oncology therapies in timely (Pharmaceutical
Budget (additional manner Services
budget for targeted Division),
therapies for Pharmaceutical
medication in Blue Industries,
book based on the Ministry of
cancer incidence). Finance
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

5.2 To improve Oncology

access to new centres, MOH
targeted therapies (Pharmaceutical
via Early Access Services
Program/ Patient Division)
Assisted Program by
submitting for DG of
Health approval
 APPENDIX 4a
FOCUS AREA 4: Treatment (Radiotherapy & Oncology)
Coordinating/
Performance
No Specific Objective Strategic Actions Target collaborating
Indicators
agencies
5.3  To start Percentage of ≥90% All Oncology
systemic patients started on centres
chemotherapy as chemotherapy within
early as possible two weeks from the date
from the time of of decision
decision made.

6 To improve 6.1.To form To increase number All oncology centres (six MOH
personalised care of multidisciplinary of oncologists in each centres) to have MDT
cancer patients teams in all oncology centre teams/meetings for
oncology centres common cancer sites by
and state hospitals 2025.

6.2 To tailor To work together with All oncology centres with MOH
the systemic molecular pathologists molecular pathology
therapy based on to establish the service laboratory will decide
biomolecular profile the treatment of cancer
of the cancer patients according to
molecular profiling by
2025.
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

81
 APPENDIX 4b

82
FOCUS AREA 4: Treatment (Haematology)
Coordinating/
Performance
No Specific Objective Strategic Actions Target collaborating
Indicators
Agencies
1 To strengthen 1.1 To strengthen a.    By 2025 these To have dedicated ward MOH (State
haematology services haematology services hospitals will have and day-care in HKL, Health
in HKL, HTJS, dedicated Haematology HTJ, HSNZ and Hospital Departments)
HSNZ and Hospital ward and day-care Taiping.
Taiping.
b.   To be able to >80%
*Two (2) provide established first
haematologists line cancer treatment
have been posted in patients with haem
to Seremban and malignancies
HKL, while 1
haematologist each
in Terengganu and
Taiping in 2016-
2020

1.2 To develop Establishment of To have designated CDR MOH (State

cytotoxic drug designated CDR Unit in unit in HTAR Health Dept,
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

reconstitution unit HTAR in 2021-2025 Pharmacy Dept)

in HTAR.

1.3 Strengthen By 2024, stem cell To have a well- MOH (State

stem cell transplant complex completed in established stem cell Health
service in HA, HQE Penang. transplant centre in Departments)
and HPP. HA, HPP and HQE with
*The stem cell a separate transplant
complex in Penang budget
which includes the
 APPENDIX 4b
FOCUS AREA 4: Treatment (Haematology)
Coordinating/
Performance
No Specific Objective Strategic Actions Target collaborating
Indicators
Agencies
stem cell lab and 6 By 2025 the stem cell To have a fully
transplant rooms transplant in HA, HPP operational stem cell
has completed and HQE are fully complex in HPP
tender evaluation operational and well
phase in Aug 2019 equipped.
but need to resubmit

1.4 Develop stem By 2025, another two Establishment of two (2) MOH (State
cell transplant (2) additional transplant more transplant rooms Health
service in HAS Johor rooms for allogeneic with HEPA flow Departments)
Bahru stem cells transplant Need a separate stem cell
* Two (2) transplant transplant budget
rooms completed in
Sept 2016 funded
by study fund and
Yayasan Kanser
Laksamana Johor

1.5  Strengthen By 2025, both HA and HPP have well MOH

molecular and cytogenetics and established cytogenetics
cytogenetics services molecular services are and molecular services
in HA and HPP fully established in
*HA has purchased HA and HPP and can
1 PCR unit in 2016- provide essential and
2020 important tests
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83
 APPENDIX 4b

84
FOCUS AREA 4: Treatment (Haematology)
Coordinating/
Performance
No Specific Objective Strategic Actions Target collaborating
Indicators
Agencies
1.6 Strengthen Budget for Malaysian i.   Budget for MyPAP MOH
treatment services Patient-assisted program for treatment
by budget increment Program for CML of chronic myeloid
for haematology (MyPAP) program and leukaemia increased 20%
drugs. Monoclonal antibodies every two years
and targeted therapies
increased in 2021-2025 ii.   Additional budget
of RM30 mil. with
increment by 10% every
year for purchase of
Monoclonal antibodies
(e.g. rituximab,
brentuximab,
daratumumab,
blinatumumab) and
novel therapies (e.g.
bortezomib, ruxolitinib,
ibrutinib, lenalidomide,
pomalidomide)
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

1.7  Laboratory By 2021 Molecular At least 10% of patients MOH

monitoring for STOP Laboratory is able to who achieve deep
TKI program fully support the STOP molecular response and
TKI program which fulfil criteria can stop TKI
requires frequent
molecular monitoring
 APPENDIX 4b
FOCUS AREA 4: Treatment (Haematology)
Coordinating/
Performance
No Specific Objective Strategic Actions Target collaborating
Indicators
Agencies
1.8  Minimal By 2025 MRD MRD monitoring service MOH
residual disease monitoring service is is available and provided
(MRD) monitoring fully established for leukemia cases
by molecular-
important to monitor
disease response
to treatment in
leukemia
1.9 Diagnostics – By 2025 the service to Molecular markers tests MOH
molecular markers do molecular markers for targeted therapy is
for targeted therapy. for targeted therapy is available and provided for
New tests for fully established indicated cases
molecular diagnosis.
Additional budget
for HA

1.10 Develop CAR-T By 2025, CAR-T CAR-T therapy is MOH (NIH)

therapy - innovative therapy service is fully available in local setting
therapy with high established in KKM. and can be provided
response and Hematologist will carry for indicated cases like
CR rate. CAR-T out T-cell apheresis and refractory leukemia,
laboratory will be administration of CART lymphoma and multiple
set up in local GMP cell therapy myeloma
certified lab.
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

85
 APPENDIX 4b

86
FOCUS AREA 4: Treatment (Haematology)
Coordinating/
Performance
No Specific Objective Strategic Actions Target collaborating
Indicators
Agencies
2 To strengthen human
capital development
in Haematology Refer to Appendix 9 (Focus Area 10: Human capacity building and development)
services
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025
 APPENDIX 4c
FOCUS AREA 4: Treatment (Nuclear Medicine)
Coordinating/
Performance
No Specific Objective Strategic Actions Target Collaborating
Indicators
Agencies
1 To expand the types 1.1  Thyroid CA: All existing Level 2sp A total of at least 300 MOH,
and widen the range I-124 dosimetry nuclear medicine cases are performed each IAEA
of theragnostic for optimisation centres should provide year
nuclear medicine in therapy. this service
cancer management
1.2   Colorectal All existing Level 2sp A total of at least 150 MOH,
liver metastases / nuclear medicine cases are performed each IAEA
hepatocellular CA: centres should provide year
SIRT. this service

1.3 Neuroendocrine All existing Level 2sp A total of at least 150 MOH,
tumour theranostic: nuclear medicine cases are performed each IAEA
Ga-68 SST centres should provide year
ligands (diagnosis this service
& staging), Lu-
177 SST ligands
(therapy).

1.4 Prostate CA All existing Level 2sp A total of at least 150 MOH,
theranostic: Ga-68 nuclear medicine cases are performed each IAEA
PSMA (diagnosis centres should provide year
& staging), Lu-177 this service
PSMA (therapy).
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87
 APPENDIX 4d

88
FOCUS AREA 4: Treatment (Paediatric Oncology)

Coordinating /
No Specific Objective Strategic Actions Performance Indicators Target collaborating
Agencies
1 Strengthen Paediatric 1.1  Creation of a Increase of budget Proposal submitted MOH (BPP),
Oncology Services separate subcode for allocation for approval MOF
paediatric haematology
oncology (separate from
paediatrics subcode)
to increase the budget
for medications and
consumables.

1.2 Improve access Availability of drugs New drugs will be MOH

to new medications available to patients (Pharmacy,
or patient-assisted by 2025 Cawangan
medications programs. Perkembangan
Perubatan)
1.3   Standardised Availability of protocol Protocols to be Paediatric
evidence-based protocol that can be utilised in all utilised in all centres Oncologists in
for the treatment of centres by 2025 MOH
childhood cancer among
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

all MOH centres in

Malaysia that will be
revised regularly.
 APPENDIX 4d
FOCUS AREA 4: Treatment (Paediatric Oncology)

Coordinating /
No Specific Objective Strategic Actions Performance Indicators Target collaborating
Agencies
1.4  Drugs used in Availability of drugs to Drugs used in MOH (Pharmacy
standardised protocols be utilised in all centres standardised Division)
must be made available protocols are available JKTU Onkologi
in the national in all centres by 2025
formulary.

1.5  PET scan and Availability of services PET scan & MIBG Nuclear
MIBG. beyond Klang Valley: services available medicine
east coast & southern beyond Klang Valley
region by 2025

1.6 Improve pathology Availability of tests Tests available by Pathology

services and improve 2025 Services
access to special stains
and molecular services:
• MRD detection for
acute leukemias
• Availability of
flowcytometry in
HUS
• BCR -ABL
quantification
• Availability of
molecular tests to
paediatrics -n-myc,
WT1 & special stains
for brain tumours
and Ewings
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

89
 APPENDIX 4d

90
FOCUS AREA 4: Treatment (Paediatric Oncology)

Coordinating /
No Specific Objective Strategic Actions Performance Indicators Target collaborating
Agencies
2 Upgrading of existing 2.1  Proper negative Upgrading negative Negative pressure MOH (Hospital
facilities pressure isolation rooms pressure isolation room isolation room director, HOD)
for infective patients. upgraded by 2025 MOF

2.2  Proper positive Upgrading positive Positive pressure

pressure rooms for pressure isolation room isolation room
autologous transplants upgraded by 2025
and severely
immunocompromised
patients.

2.3  HEPA filtration of Number of HEPA At least 4-6 HEPA

all paediatric haemato- filtration negative/ filtered negative/
oncology units. positive pressure positive pressure
isolation rooms in all isolation rooms in
paediatric haemato- each centre
oncology unit
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

2.4   Increasing number Hospital Tunku Azizah: • Hospital Tunku

of beds in Hospital Refurbishment of Azizah to 48 beds,
Tunku Azizah, Hospital current IPHKL to fulfil • Hospital
Permaisuri Bainun Ipoh bed requirement Permaisuri Bainun
and HSI to 20 beds Increased beds in other Ipoh to 20 beds
centres • HSI to 20 beds
 APPENDIX 4d
FOCUS AREA 4: Treatment (Paediatric Oncology)

Coordinating /
No Specific Objective Strategic Actions Performance Indicators Target collaborating
Agencies
3 Establishment of Develop 4 Clinical Establishment of COU COU in respective MOH (BPP,
Clinical Oncology Oncology Units (COU) in in respective hospitals hospitals are Hospital
Units (COU) at MOH Tertiary Hospitals together with travelling established by 2025 Directors, HOD
tertiary hospitals 1.   Alor Setar budget to manage Paeds)
2.   Kuantan diseases of mild -
3.   Miri moderate complexity.
4.   Sandakan/Tawau

4 Establishment of new Specialised Late Effects At the moment, there Long Term Survivors MOH (Hospital
service clinic in the existing is no designated clinic Clinic in hospitals Directors/ HOD
oncology clinic for cancer survivors. with Paediatric Paeds)
Most will attend general Oncology Services
oncology clinic with established by 2025
patients on active
treatment. All hospitals
with paediatric oncology
services should have a
dedicated Long-Term
Survivors Clinic.

5 Human resources
Refer to Appendix 9 (Focus Area 10: Human capacity building and development)
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

91
 APPENDIX 4d

92
FOCUS AREA 4: Treatment (Paediatric Oncology)

Coordinating /
No Specific Objective Strategic Actions Performance Indicators Target collaborating
Agencies
6 Research 6.1  To study late effects
in previously treated
Refer to Appendix 7
paediatrics oncology
(Focus Area 8: Research, on sub-topic F: No.2)
patients.

6.2  Collaboration Number of publications 2 per year Paed oncology

between MOH and fraternity,
academia to conduct MOH,
research in paediatric Universities
oncology.
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025
 APPENDIX 4e
FOCUS AREA 4: Treatment (Gynaecology Oncology)

Coordinating/
No Specific Objective Strategic Action Performance Indicator Target Collaborating
agencies
1 To strengthen Gynae- 1.1  Human capital
oncology services development and Refer to Appendix 9 (Focus Area 10: Human capacity building and
training. development)

1.2  Upgrade the Number of Gynae-Onco Number of operated MOH (Head of

surgical equipment cases operated in each cases increase about O&G Services)
and facilities including centre 1.5 to 2.0 folds within 5
operating time and years
post-operative care.

1.3  Adequate funding Number of Gynae-Onco Number of instruments:

for consumables and equipment in each 14 Laparoscopic
other surgical related centre systems
therapy. 16 colposcopes
20 hysterectomy
instrument sets
20 units of Yellowfin/
stirrup
10 units of retractors

1.4        Strengthen the Establishing Referral Referral Policies MOH (BPP)

patient referral system Policies established
from the primary,
secondary or tertiary
care centres and vice
versa.
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93
 APPENDIX 4e

94
FOCUS AREA 4: Treatment (Gynaecology Oncology)

Coordinating/
No Specific Objective Strategic Action Performance Indicator Target Collaborating
agencies
1.5  Increase operating 1) Reduction of Cancer surgery waiting Head of
time (OT) through Gynaecological cancer time is maintained Anaesthetic
implementation of surgery waiting time. between 2 to 4 weeks Services
decentralisation and 2) Increase number of
cluster hospital. cases operated.
(Surgical OT time is
main problem in many
hospital)
2 Update knowledge 2.1   To collaborate with Number of workshop 5 Colposcopic MOH
and enhance society to organise more and conferences workshops, 1 GO MGCS, OGSM,
surgical skill on workshops, conferences (Colposcopy Workshop, conference, 2 surgical Universities
Gynae-oncology and CME program. National Gynae Onco workshop and 2 GO
management Conference, Tricks and Consensus Meeting
Tip in O&G Surgery,
Gynae Onco 4U)

2.2   To produce Number of Gynae Onco • Update Cervical MOH,

more Clinical Practise CPG and Consensus Cancer CPG 2016 GO
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

Guidelines and Guideline • Update Guidebook subcommittee,

Consensus Statement/ Cervical Cancer JKPPOG,
Guidelines. Prevention Program Society
• Guideline for Primary
HPV Testing in
Cervical Cancer
Screening
• GO Consensus
meeting twice a year
 APPENDIX 4e
FOCUS AREA 4: Treatment (Gynaecology Oncology)

Coordinating/
No Specific Objective Strategic Action Performance Indicator Target Collaborating
agencies
2.3 To incorporate Increasing number of To ensure all centres MOH,
intermediate and early endometrial and are well equipped with Gynae
advance laparoscopic ovarian cancer surgery laparoscopic systems Endoscopy
surgery in being performed and laparoscopic Society Malaysia
gynaecological oncology laparoscopically. surgical instrument (GESM),
subspeciality training. JKKPPOG
(Need to add
laparoscopic
attachment/rotation
during sub-speciality
training) as this is also
align with Pain free
hospitals protocols.

3 Research 3.1        Collaboration Number of research As a start 2 to 3 papers MOH,

between MOH and papers published in a year. Universities
Academic Institution to
conduct more research
in Gynae Cancer.

3.2        All Gynae Number of Research At least 1 per Gynae

Cancer Unit should Assistant in Gynae Cancer Unit
have at least one Cancer Unit
Research Assistant
to help conducting
research.
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95
 APPENDIX 4e

96
FOCUS AREA 4: Treatment (Gynaecology Oncology)

Coordinating/
No Specific Objective Strategic Action Performance Indicator Target Collaborating
agencies
4 One Stop Cancer To complete existing a.    Increase in number Within 2 to 3 years MOH (BPP),
Centre (OSCC) facility i.e. IKN with adjuvant treatment Head of Surgical
adequate Surgical given to patients Services.
Expertise (Colorectal b.   Shorter waiting time
surgeon/ Upper for adjuvant & neo-
GI surgeon, ENT, adjuvant treatment
Urologist) which can c.    Increase in
expand the services research performed
under one stop centre. d.   Increase in number
As already availability of trainees across all
of nuclear medicine, specialities
medical oncologist and
radiation oncologist
services is a plus point
to be tapped at this
centre.
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025
 APPENDIX 4f
FOCUS AREA 5: Treatment (Colorectal)
Coordinating/
Performance
No Specific Objective Strategic Actions Target Collaborating
Indicators
Agencies
1 Increase capacity 1.1  Increase the number All Major Specialist 30 Colorectal Surgeons MOH
and quality in of centres providing Hospitals has a by 2025
colorectal sub- colorectal sub-speciality Colorectal Surgeon in 2 per training centre
speciality services services. residence. [2x5=10]
within MOH 1 per Major Hospital.
facilities 1.2  Providing adequate All Major Hospitals 1 Colonoscopy per 350 MOH
infrastructure and with Specialists procedures
equipment to support the equipped with Portable Scope for
service. Colonoscopy. Hospitals without
resident Specialist
To train staff
To provide infrastructure

1.3  Increase human Percentage of patients >80% MOH

resource by ensuring with waiting time of
uptake of two Scholarships ≤4 weeks for colorectal
per year to pursue training cancer surgery is
is approved. increased

1.4 Planning in terms Rate of unclear surgical <5 % MOH

of state-based centres margins in colorectal
with Colorectal services surgery
to ensure performance
quality.
1.5  Enhance centres Number of Major 90% by 2025 MOH
with minimally invasive Hospitals with
surgeries. Colorectal Surgeons
providing minimally
invasive surgery
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97
 APPENDIX 4g

98
FOCUS AREA 4: Treatment (Breast & Endocrine)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
1 Early Diagnosis 1.1 To have dedicated Establishment of To have at least one MOH (BPP),
and Early Breast Clinic in all centres dedicated Breast Clinic in clinic session per Head of:
treatment with Breast Surgeons/ Major Specialist Hospital week at each Major - General
General Surgeons with including: Specialist Hospital Surgical Services
special interest in Breast - Breast &
Cancer. • Breast Care Nurse Endocrine
Team Surgery Services
• Portable Ultrasound - Anaesthesiology
Preferably to have “One Machine – Bedside tool Services
Stop Breast Centre” in as diagnostic aid - Head of Nuclear
highly populated area Medicine Services,
to reduce multiple clinic HODs of Surgery;
appointments as well as to “One Stop Breast Centre” Radiology;
reduce waiting time. should include the Pathology,
services of mammogram/ Hospital Director,
breast ultrasound; fine Nursing Director/
needle aspiration/breast Coordinator
biopsies/ image-guided
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

biopsies on the same day

of visit.
 APPENDIX 4g
FOCUS AREA 4: Treatment (Breast & Endocrine)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
1.2 Definitive diagnosis Percentage of breast ≥80% of cases Head of services
of Breast Cancer should imaging performed within for:
be made early. This one week of consultations - General Surgical
includes the “Triple Services
Assessment” approach. Percentage of turnaround ≥80% of cases - Breast &
Breast Imaging performed result of Biopsy specimen Endocrine
in timely manner. Biopsy within one week Surgery Services
of the suspicious lesions - Anaesthesiology
(including image-guided Services
biopsy) is performed - Head of Nuclear
urgently after breast Medicine Services,
imaging. HODs of Surgery;
Radiology;
* Any delay in diagnosis Pathology,
will result in increasing Hospital Director
number of cases presented
at more advanced stage of
breast cancer.

1.3  Definitive surgical Percentage of breast ≥75% of cases Head of services

treatment to be done in cancer patients going for (3 monthly) for:
timely manner as to avoid definitive surgery within (≤) - General
worsening of disease and 4 weeks of the diagnosis. (NB: Old KPI. Surgical Services
increased morbidity & Dropped in 2020) - Breast &
mortality due to delay in Endocrine
treatment Surgery Services
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99
 APPENDIX 4g

100
FOCUS AREA 4: Treatment (Breast & Endocrine)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
To have enough manpower - Anaesthesiology
to achieve this target: Services
• Breast Surgeons - Head of Nuclear
• General Surgeons Medicine Services.
• General Surgeons HODs of Surgery;
with special interest in Radiology;
Breast Cancer Pathology.
• Anaesthesiologists Hospital Director.

To have enough
“operating theatre’’ time
to accommodate cases for
operations

1.4        MDT – Multi- MDT should be formed in MDT meeting to be HODs of:
disciplinary team centres where Oncology held at minimum at - Dept of Surgery
Management must be services are available. monthly basis. - Dept of
advocated wherever Networking should Radiotherapy &
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

possible in managing be considered if it is Oncology

breast cancer patients not available. - Dept of
as this will ensure a Pathology
holistic approach and - Dept of
comprehensive treatment Radiology,
given. - Hospital
Director.
 APPENDIX 4g
FOCUS AREA 4: Treatment (Breast & Endocrine)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
2 Adjuvant All patients that require Percentage of new Oncology Services to Head of
treatment of adjuvant treatment cases that were given be available in Major Radiotherapy &
Breast Cancer – namely Chemotherapy, appointment for first Specialist Hospitals Oncology Services
accessibility and Radiotherapy and/or consultation within (≤) 2 Where the services
timely treatment Targeted therapy should weeks at Radiotherapy and are not available,
be able to access to these Oncology Clinic networking should
treatments in a timely Percentage of patients be in place
manner who were started on
chemotherapy within (≤)
2 weeks from the date of
decision

3 Oncoplastic 3.1 Breast conserving Percentage of breast ≥20% HKL

Breast Surgery surgery using oncoplastic conserving surgery versus (3 monthly) HPJ
Services techniques can be mastectomy in patients H. Selayang
performed in complex with breast cancer HPP
breast cancer cases that (Oncoplastic surgery HRPZ II
are not suitable for simple should be performed in HSNZ
wide local excision. Major Specialist Hospitals HIS Johor
* Since there are with oncoplastic breast HQE II
increasing number of surgeons)
trained oncoplastic breast
surgeons, oncoplastic
surgery can be performed
with acceptable cosmetic
and oncological outcomes.
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101
 APPENDIX 4g

102
FOCUS AREA 4: Treatment (Breast & Endocrine)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
3.2  Breast reconstruction Percentage of breast ≥ 5% HKL
should be offered to reconstruction (either (3 monthly) HPJ
women who are going autologous, implant or H. Selayang
for mastectomy or had combination of both) HPP
mastectomy surgery. in patients with breast HRPZ II
Breast reconstruction cancer HSNZ
surgery should be HIS Johor
performed in Major HQE II
Specialist Hospitals
with oncoplastic breast
surgeons.

4 CPG should be 4.1  The 3rd edition of CPG Usage of CPG in managing The CPG should be MOH (HTA),
revised on regular on breast cancer is going breast cancer patients by revised every 5 years Head of Services
basis to be launched in 2020. relevant parties for:
Dedicated team members -     Breast
selected to look into CPG & Endocrine
for interval updates/ Surgery
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

revision -     Radiotherapy

& Oncology
-     Radiology
-     Pathology,
University
Counterparts,
NGOs & Breast
cancer Advocacy
Groups.
 APPENDIX 4g
FOCUS AREA 4: Treatment (Breast & Endocrine)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
4.2  CPG for breast cancer Development team Development team is MOH
in pregnancy. consisting of breast established
surgeon, radiologist,
pathologist, oncologist,
obstetrician, neonatologist
& anaesthesiologists
should be formed to
address this issue since
there is no local CPG on
breast cancer in pregnancy

4.3  Molecular Profiling in Analysis of feasibility To request for HTA MOH (HTA)

Breast Cancer patients. and cost effectiveness to perform mini-
of molecular profiling HTA/Technical Brief
strategy

5 Breast & 5.1  Breast & Endocrine Number of new centres set Setting up new MOH (BPP),
Endocrine Surgery Centres at all up centres: Head of Services
Subspecialty regions. for:
Services Current Centres (Number Suggested centres to -     General
of BNE Surgeons in be opened: Surgery
parenthesis): Central (HTAR, -     Breast
Central – HKL (3), HPJ (3), HTJS), Malacca, & Endocrine
Hospital Selayang (1) North (Hospital Surgery
North – HPP (3), HRPB (1) Sultan Abdul Halim), -     Radiotherapy
South – HSI (2) East Coast: (HTAA) & Oncology
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103
 APPENDIX 4g

104
FOCUS AREA 4: Treatment (Breast & Endocrine)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
East Coast – HRPZ II (3), Sarawak (Hospital -     Radiology
HSNZ (2) Sibu, Hospital Miri) -     Pathology,
Sabah – HQE II (1) Hospital
Sarawak – HUS (2) Directors,
BNE Surgeons: 22 HOD of Surgical
BNE Trainees: 10 (+ 1 new Department
intake) of respective
Hospitals.

5.2  Subspecialty At each Breast & This is to ensure MOH (BPP),

Collaboration Services. Endocrine Surgical Centre, that the services Head of Services
other specialty that should are handled and for:
be available include run by trained -     Breast
the Breast Radiologist; team/personnel for & Endocrine
Breast & Endocrine optimum service Surgery
Pathologist and Medical delivery -     Radiotherapy
Endocrinologist (to & Oncology
accommodate Endocrine -     Radiology
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

Services) -     Pathology

-    Endocrinology.
 APPENDIX 4g
FOCUS AREA 4: Treatment (Breast & Endocrine)
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
5.3  Sub-specialty To produce enough At minimum, 20 MOH (BPP, BPL),
Training: numbers of Breast & trainees need to be JPA,
Endocrine Surgeons for trained in next 5 Head of Services
To increase number of each existing subspecialty years i.e. 4 trainees/ for:
intake of trainees for centres AND the newly set- year -    General
subspecialty program. up centres Surgery
Current Training Centres: (*Current practice: -    Breast &
HKL, HPJ, Hospital 1-2 trainees intake Endocrine
Selayang, HIS, HPP, HSNZ, per year) Surgery.
HRPZ II, HQE II
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105
 APPENDIX 4h

106
FOCUS AREA 4: Treatment (Transfusion Medicine Service)
Coordinating/
Specific
No Strategic Actions Performance Indicators Target Collaborating
Objective
Agencies
1 To ensure access Enhance the information, a. Strengthen social Provision of adequate MOH/ other
to adequate, communication, education marketing activities on budget together with ministries like
safe and timely programme on voluntary blood blood donation an increase in the KPM, KKMM,
supply of blood donation for public including number of Medical Army, Police,
and blood in schools Officers and Health PBT
products Improve access and Education Officers in Social
convenience for public to TMS Influencer
donate blood Media
Increase donor base through b. Increase number of Increase blood Private Sector
retention of regular blood fixed donation sites in collection to 2.5-3% NGO
donors strategic location and / 1000 population Professional
procurement of 25 mobile by 2025 (35,0000- Associations
blood donation bus 50,000/year)
nationwide

c. Establish ‘Regular Increase collection

Blood Donor Loyalty’ of blood from 60% to
programme that include 70% regular blood
annual celebration of donors by 2025
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

World Blood Donor Day

and other community-
based activities
 APPENDIX 4h
FOCUS AREA 4: Treatment (Transfusion Medicine Service)
Coordinating/
Specific
No Strategic Actions Performance Indicators Target Collaborating
Objective
Agencies
2 To enhance the 2.1 Provision of irradiated Availability of blood 5 blood irradiator to MOH
provision of blood for all blood and irradiators in all regional be procured by 2025
specific blood blood products to inactivate centres including:
products for lymphocytes to prevent • PDW Utara
cancer patient transfusion associated graft- • PDW Sabah
management. versus-host disease • PDW Selatan
• PDW Sarawak
• PDW Pantai Timur

2.2 Provision of pre-storage Procurement of pre- Additional 35% of

filtered blood for all red storage filtration sets all red cells to be
cell concentrate (RCC) to ensure residual filtered annually to
to reduce the risk for leucocytes content less cater the transfusion
transfusion reaction such than 1 x 106 per unit requirement for
as febrile non-haemolytic cancer patients
transfusion reaction and other
complications

2.3 Provision of platelet Procurement of platelet Increase 50% of the

apheresis products for patient apheresis collection bags. platelet apheresis
requiring platelet support collection to cater for
to reduce donor exposure haemato-oncology
and for patient with platelet and paediatric cancer
refractoriness. patients
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107
 APPENDIX 4h

108
FOCUS AREA 4: Treatment (Transfusion Medicine Service)
Coordinating/
Specific
No Strategic Actions Performance Indicators Target Collaborating
Objective
Agencies
2.4 Facilitate the work up To expand the Availability of GMP
for patients with complex Immunohaematology lab in PDN for cellular
requirement such as platelet and H & I services in all therapy
antibody testing, platelet regional centre including: Availability of
crossmatching, red cell • PDW Utara equipment, reagents,
genotyping, HLA typing • PDW Sabah consumables & EQA
and complex antibody • PDW Selatan for PDW on
identification • PDW Sarawak Immunohaematology
• PDW Pantai Timur and H & I laboratories
by 2025
3 To enhance Train TM specialists, scientific 3 candidates per year for 15 specialists with MOH,
workforce officers , Medical Laboratory Subspecialty Transfusion subspecialty training Universities,
capacity and Technologists and technical Medicine programme with by 2025 in the area Private Sector
strengthen staff to strengthen specialised HLP. of PBM and IH, Blood
human capital human resource by having Donor Management,
development qualified and highly skilled Quality Management,
Transfusion Medicine Regulation and
Specialist (TMS), scientific Haemovigilance,
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

Officers, Medical Laboratory Component, Inventory

Technologists (MLT), Nurses and Fractionation
and Public Relation Officers Management,
(PRO) provide comprehensive Regenerative
transfusion service which Medicine, and
involve donor management, Transplant
product management as well Immunology
as patient management.
 APPENDIX 4h
FOCUS AREA 4: Treatment (Transfusion Medicine Service)
Coordinating/
Specific
No Strategic Actions Performance Indicators Target Collaborating
Objective
Agencies
10 candidates per year At least 30 new
for Transfusion Medicine TM Specialist to be
Master in Medicine gazetted by 2025
programme with HLP.
Scientific Officer: to 5 Scientific Officers to
be train as Subject be trained by 2025
Matter Expert (SME)
Transfusion Microbiology/
Immunohaematology/
Quality Management/
H&I
MLT to be train in 50 MLTs to be trained
advance diploma in blood by 2025
transfusion including
Immunohaematology
Nurses to be trained New advance diploma
in advance diploma in in Transfusion
Transfusion Medicine Medicine develop
programme to train 10 nurses
annually by 2025
MO, HEO, PRO to be train 100 MO, HEO and
in-house/local training PRO in TMS to be
and workshops (local trained in social
training/short course) in marketing, use of
social marketing, use of social media and
social media and donor donor retention by
retention 2025
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

109
 APPENDIX 5

110
FOCUS AREA 5: Survivorship

Coordinating/
Performance
No Specific Objective Strategic Actions Target Collaborating
Indicators
Agencies
A.   Medical Rehabilitation
1 To provide Cancer 1.1  To develop a a.   Percentage Reconditioning MOH
Rehabilitation reconditioning Program- of hospitals with Program-based
Services (CRS) to based rehabilitation service Rehabilitation Rehabilitation are
patients who would for those who needs rehab Specialist adopting the in place in 50%
need and benefit post cancer treatment based program of MOH hospitals
from rehabilitation on Dietz classification and with Specialist
medicine services so ECOG level. b. Percentage of Rehab Care
as to improve their Patients completing the
quality of life program

1.2 Cancer Survivorship A section on cancer Development of MOH,

training Program. rehabilitation in the Rehabilitation Universities
Cancer Survivorship Component within (UM)
Guide by 2025 the protocol

2 Establish a national 2.1 To develop workflow Number of training To reach MOH (BSKB)
consensus for Cancer for cancer rehabilitation session for cancer consensus among
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

Rehabilitation program and encourage rehabilitation. all rehabilitation

Services practice sharing amongst physicians and
practitioners. allied health on
specific programs
for cancer patients

2.2 To develop Dietetic a. Number of DSC All tertiary MOH, NCI,

Support Centre (DSC) in Oncology centres NCSM, MAKNA
tertiary Oncology centres have DSC
 APPENDIX 5
FOCUS AREA 5: Survivorship

Coordinating/
Performance
No Specific Objective Strategic Actions Target Collaborating
Indicators
Agencies
b. Number of cancer 10% of oncology
patients and survivors admission receive
who get dietetic support DSC services
through the centre.

B.   Vocational Rehabilitation

1 To provide a pathway 1.1  To foster engagement Number of cancer To bridge the MOH (PKD),
for vocational with Government / Private patients being referred employability gap Agencies under
rehabilitation, aimed job portals, as well as to employers for return among cancer KSM
to empower financial employers, to educate them to work. patients (i.e.JobsMalay-
independence and on the need to provide sia,
improve the quality of employment opportunities to Socso, NIOSH).
life of cancer patients cancer survivors
as part of tertiary
prevention of cancer. 1.2  To provide briefing to Number of cancer
employers on the 5-year patients who have
survival rate, to ensure successfully obtained
greater understanding on an employment.
cancer survivorship. For
example, explaining to
employers on how thyroid
cancer has better survival
as compared to liver cancer,
based on the available data
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

111
 APPENDIX 6

112
FOCUS AREA 7: Traditional and Complementary Medicine
Coordinating/
Performance
No Specific Objective Strategic Actions Target Collaborating
Indicators
Agencies
1 To integrate T&CM Organise workshops to Number of workshops At least two (2) IKN (T&CM Unit)
practitioners into update the knowledge conducted (with pre- workshops/year
early detection and of T&CM practitioners and post-workshop
prevention of cancer about the management of survey indicating The knowledge of
cancer in MOH healthcare increased in knowledge) T&CM practitioner
facilities (e.g. early detection towards the early
of cancer, risk factors, detection and
screening, treatment and prevention of
rehabilitation). cancer is enhanced
2 To allow cancer 2.1  To enhance best Number of personnel At least ten (10) T&CM Division
patients to cope practice by providing who have received personnel/ year
better with cancer training opportunities T&CM related training
and cancer treatment for medical doctors and
by building human pharmacist working in
capacity to enhance T&CM-related areas in MOH.
best practice and
providing evidence- 2.2  To enhance the Implementation of Phase 2 of T&CM Division
based adjunct professionalism of Phase 2 of the T&CM T&CM Act 2016
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

treatment for cancer T&CM practitioners by Act 2016 implemented fully

patients implementing Phase 2
of T&CM Act 2016 (Act
775) whereby the T&CM
practitioners shall be
registered with the T&CM
Council.

2.3   Research – Refer to Appendix 7 (Focus Area 8: Research)

 APPENDIX 6
FOCUS AREA 7: Traditional and Complementary Medicine
Coordinating/
Performance
No Specific Objective Strategic Actions Target Collaborating
Indicators
Agencies
3 To increase the 3.1 To participate in Number of programs Participated in 2 IKN (T&CM
awareness and cancer awareness programs participated programs per year Unit),
knowledge of the organised by public and
public and all HCPs private agencies as panels or
regarding the roles speakers.
of T&CM in cancer 3.2   To organise public Number of programs 5 programs over 5 NGO
management education activities conducted years
regarding the role of T&CM
in cancer management (e.g.
community level, hospital
level and the mass media).
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

113
 APPENDIX 7

114
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies

A. Research on Strengthening
1 Develop the MOH 1.1 Obtain necessary a.   Initiation of Pilot program for MOH (NIH -
Biobank to support documentation, prospective collection prospective collection by IMR), Pathology
cancer research infrastructure, project focusing on end of 2021 Services
programs in manpower and cancers of national
Malaysia documentation for interest (approved by
functional operation of MOH Biobank Scientific
MOH Biobank Committee).
b. Publications/
presentations/ patents/
policies etc. arising from
research done utilising
resources from the
biobank.

1.2   Develop and Establishment of Established biobanking

establish a network of biobanking network network between
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

satellite collection sites between government government hospitals

at major hospitals for hospitals and MOH and MOH Biobank for
collection of specimens biobank for collection of collection of specimens
and data. specimens and data and data by end of 2025

2 Research Capacity
Building Refer to Appendix 9 (Focus Area 10: Human capacity building and development)
 APPENDIX 7
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
3 To strengthen Maintain and properly a.    Veterinarians and At least 1 veterinarian MOH (NIH -
facilities for the run the in vivo core experienced researchers is employed to run the IMR)
development of facility in IMR for the in small animal research facility properly
cancer models for development of cancer are employed to run the
preclinical drug models and preclinical facility.
testing cancer drug testing
b.   Cancer patient- At least 5 cancer PDXs
derived xenografts (PDXs) are established and
are established and characterised
characterised for cancers
of national interest.

4 Develop oncology 4.1 To consider Number of hospital and Establish a research MOH (NIH
clinical research Research development oncology centres with committee in each - ICR),
as a key performance research committee and oncology centre Universities,
index for all the regional actively running research Medical-related
oncology centres in projects industries,
Malaysia. NGOs

4.2  Collaborate between a. Number of oncology 3 meetings/ year

all key stakeholders meetings/ year
including public
and private oncology
centres, pharmaceutical b.  Number of oncology At least 2 on-going
industry, academia collaborative research research projects/
as well as agencies in projects/ year oncology centre
particularly from NIH.
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115
 APPENDIX 7

116
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
5 To improve 1.1. Promote Number of promotional At least 1 promotional MOH (NIH -
accessibility to participation in clinical activities done in MOH activity per year to be ICR),
new drugs by trials among patients hospitals conducted in each MOH hospitals,
conducting clinical and HCPs. oncology centre Medical-related
trials for cancer industries
treatments
1.2. Improve the Number of oncology trials At least 30% increment
supportive infrastructure (ISR/ IIT) conducted in the number of
for clinical trials. across MOH Hospital oncology trials from the
past years
1.3. Succession Number of oncology At least 80% of
planning, training of industry-sponsored oncologists’ involvement
oncologist/ trialist. research and in- house in research
trainings conducted
across MOH hospitals.
1.4.  Training/ building Establishment of in-house In-house research
in-house monitor to research training team training team
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

encourage/ prepare for in each MOH oncology established in each

in-house training. centre. MOH oncology centre

1.5. Upgrade Establishment of clinical At least 1 of the MOH

infrastructure and trial ward in MOH oncology centres being
devices to support oncology centres. equipped with a clinical
clinical trials in MOH trial ward.
oncology centres.
 APPENDIX 7
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
6 To strengthen and 6.1. Convene task Establishment of task Task force is formed by MOH (NIH -
improve scientific force to bring together force 2022 JPP-NIH),
rigour of research research groups Universities,
and align research from MOH, MOHE, Medical-related
to national needs Non-governmental industries,
organisations, industry. NGOs

6.2. To establish Establishment of a National scientific

national scientific national scientific advisory advisory board
advisory boards. board established

6.3. Carry out periodic a.   Scientific advisory

reviews and advisory board review sessions
sessions at national,
institutional and b. Strategic plans for
program levels to research on cancers of
develop strategic plans national interest
for cancers of national
interest.

B. Research on Prevention and Health Promotion

1 To assess cancer 1.1  Assessment on Estimation of cancer Proposal of strategies MOH (NIH -
literacy and cancer health literacy of health literacy among the to improve cancer IHBR, IKU),
uptake of cancer the general public and general public. prevention and health Universities,
prevention its relation to cancer promotion, based on the NGOs
strategies prevention, screening, result findings
diagnosis and treatment.
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117
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118
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
1.2 Assessment of Estimation of cancer Proposal of strategies MOH (NIH -
awareness and practice awareness among the to improve cancer IHBR, IKU),
of cancer screening general public. prevention and health Universities,
among the general promotion, based on the NGOs
public. result findings

1.3   Exploration of best Identification of effective Proposal of the best

modality/ channel in platform in disseminate platform to disseminate
educating the general medical information cancer health
public about cancer, information, according
according to specific to the target audience
population.

1.4   Conduct survey Publication of the study Survey conducted by MOH (NIH -

on public awareness on findings 2025 IHBR)
cancer risk factors. Universities
(baseline 2014: 62%)
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

1.5   Conduct survey on Publication of the study Survey conducted by MOH (NIH -

general public knowledge findings 2025 IHBR)
on signs and symptoms Universities
of cancer.
(baseline 2014: 52%)
 APPENDIX 7
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
2 To study the 2.1   Study the role Publications of novel Novel discoveries on MOH (NIH -
aetiopathogenesis of environmental, discoveries. the mechanism of IMR),
of cancers of dietary, pathogens, carcinogenesis and new Hospitals,
national interest and host factors in ways to modulate the NGOs,
to assist in carcinogenesis. process Universities
prevention 2.2        Map molecular
pathways involved in
carcinogenesis.

C. Research on Screening and Early Diagnosis

1 To explore the 1.1   Experience Completion of research Baseline result on MOH (NIH -
underlying exploration for patients projects and publications/ the timeliness and IHSR)
phenomenon of undergoing diagnosis presentations/ policies timeliness assessment Universities
delayed diagnosis and treatment. arising from completed from symptom
and treatment research presentation, diagnosis
amongst cancer to treatment initiation
patients in
Malaysia 1.2   Understanding Acceptance of diagnosis
ideas and perception and treatment by
of the patients upon cancer patients
diagnosis of cancer
and prior to starting
treatment.
1.3   Explore existing Barriers and facilitators
facilitators and barriers during cancer diagnosis
to initiate and maintain and treatment identified
cancer treatment.
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119
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120
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
1.4   Any studies on Completion of research Survey conducted by MOH (NIH-
cancer patients seeking projects and publications/ 2023 IHBR),
alternative therapy and presentations/ policies Universities
understanding therapy arising from completed
choice preferences. research
2 To improve the 2.1  Assessment Completion of research Proposal of strategies MOH (NIH –
detection of of general public’s projects and publications/ to improve the cancer IHBR),
cancer amenable knowledge, attitude and presentations/ policies screening program is Universities,
to screening practice towards cancer arising from completed published/presented NGOs
procedures screening research. leading to improvements
in cancer screening
2.2  Assessment of programs and timely MOH (NIH –
inequity and inequalities referral for intervention IHSR),
in cancer screening. Universities,
NGOs
2.3 Exploration of Identification of barriers
healthcare system and and facilitators for cancer
HCPs challenges in screening program.
implementing cancer
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

screening program.
3 To develop Development of novel Completion of research Molecular screening MOH (NIH
accurate (high screening assays for projects and publications/ tests of high clinical -IMR),
sensitivity & identification of high- presentations/ policies accuracy is developed Universities,
specificity) risk biomarkers in arising from completed by 2025 NGOs
molecular pre-cancer/ early-stage research.
screening tests for cancer patient.
cancers of national
interest
 APPENDIX 7
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
4 To evaluate To evaluate the positive Completion of research • Verify clinical utility MOH (NIH -
molecular predictive value, projects and publications/ of screening tests ICR),
screening tests negative predictive presentations/ policies • Generate evidence Universities,
for cancers of value, cost-effectiveness arising from completed for policymakers to NGOs
national interest and feasibility of novel research. improve strategies
in clinical/ screening assays in for cancer screening/
community clinical/ community early diagnosis
trial setting setting.
(prospective pilot
studies)

D. Research on Diagnostics
1 To identify To identify and validate Completion of research Identification and MOH (NIH-
predictive and potential biomarkers for projects and publications/ validation of predictive IMR/ICR),
prognostic patient risk stratification presentations/ policies and prognostic Universities,
biomarkers and treatment planning arising from completed biomarkers for NGOs
for companion as well for detection research. companion diagnostics
diagnostics of recurrence and/ or
distant metastasis for
cancers of national
interest.
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121
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122
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
2 Clinical validation 2.1 Clinical studies a. Completion of clinical • Verification of MOH (NIH -
of biomarkers to evaluate the studies clinical utility ICR),
for companion clinical utility of b. Clinically validated of biomarkers Universities,
diagnostics and/ novel biomarkers for novel biomarkers for companion NGOs,
or prognosis to companion diagnostics diagnostics and/or industries
improve patient and/or prognosis prognosis to improve
management to improve patient patient management
management • Protocol for use
of biomarkers for
2.2  Clinical studies clinical care
to integrate novel and • Evidence for
known biomarkers into policymakers to
clinical care. improve strategies
for cancer treatment
and/ or management

E. Research on Treatment
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

1 To develop 1.1 Assessment of Identification of cancer • Report on equity and MOH (NIH -
research activities inequity and inequality patients receive care equality cancer care IHSR),
which help to of cancer treatment. equally. for cancer patients in Universities,
improve cancer Malaysia NGOs
equity in quality • Proposal of strategies
cancer treatment 1.2  Mapping the Identification social to improve equity
available resources determinants affecting cancer care
and demand of cancer cancer care.
treatment.
 APPENDIX 7
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
1.3 Exploration of Identification of barriers in • Report on equity and MOH (NIH -
the needs, barriers, accessing cancer care. equality cancer care IHSR),
challenges, and factors for cancer patients in Universities,
associated with the Malaysia NGOs
accessibility of cancer • Proposal of strategies
treatment. to improve equity
cancer care
2 Develop research 2.1 Investigating the Time from the detection Proposal of strategies MOH (NIH -
activities which timeline taken for of cancer up till cancer to improve the cancer IHM),
help to shorten the the process of inter- treatment being delivered. treatment timeline Universities,
timeline of cancer departmental/inter- NGOs
treatment hospital referral.

2.2  Exploration of the
frequency and timeline
taken for cancer
treatment (e.g. biopsy,
surgery, chemotherapy,
radiotherapy, etc.).

2.3 Developing MOH (NIH -

intervention to reduce IHM),
timeline of referral Universities,
and cancer treatment NGOs
timeline.
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123
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124
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
2.4  Exploration the Number of patients Proposal of strategies MOH (NIH -
prevalence and factors who defaulted cancer to improve the cancer IHSR),
associated with patients treatment and their treatment timeline Universities,
who non-compliant reasons. NGOs
with/ missed/ defaulted
cancer treatment.

2.5  Development of Number of patients

shared decision-making who were discussed by
tool in the process of oncologists/surgeons on
deciding the option for treatment options.
cancer treatment.

3 To assess the 3.1  Evaluation of the Number of patients who Timely cancer treatment MOH (NIH -
quality of current treatment process received treatment in delivery IHSR)
cancer treatment pathway for different time (e.g. radiotherapy - No delay in cancer Hospitals,
cancer in the oncology treatment commencement treatment Universities,
centre. date) and the ratio of - Evading cancer NGOs, and
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

cancer patients to treating progression while other research

3.2  Assessment of Oncologists waiting for treatment groups
the variation in cancer
treatment and its
performance across
different settings.
 APPENDIX 7
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
3.3  Review of Usage of cancer treatment Better access and usage MOH (NIH -
oncology drugs drugs which are not in of recommended drugs IHSR)
listed in Malaysia’s the Malaysian’s drug for cancer treatment Hospitals,
drug formulary formulary Universities,
and identification NGOs, and
of discrepancies other research
between Malaysia groups
and internationally
recommended cancer
treatment.

3.4  Conduct HTA on the HTA conducted MOH (HTA)

latest cancer treatment
options/ cancer drugs.

3.5   An economic Cost-effectiveness and Value-based medicine MOH (HTA)

evaluation of specific repurposing of cancer practice
cancer treatments/ drugs
drugs.
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125
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126
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
4 To develop new 4.1  Establishment a.  Establishment of new Candidate drugs/ MOH (NIH -
cancer therapies of model systems for targets and therapies herbal/ biologics/ IMR),
and repurpose therapeutic studies. for cancers of national immunotherapy with Universities,
existing drugs interest. evidence to justify private
clinical trials companies,
4.2  Identify new b. Establishment of novel Cancer
therapeutic targets and cell-based therapies Research
develop new therapeutic for haematological Malaysia
agents for cancers of malignancies.
national interest.

4.3  Form strategic c.  Patents/ publications/

partnerships for presentations from
the development of research done.
affordable effective
therapeutic agents for
major cancers.
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

5 Study of newly Carry out clinical a.   Completion of Phase I/ Successful completion MOH (NIH -
developed/ trials to assess efficacy II studies. of Phase I/II clinical ICR),
repurposed of newly developed trials of newly Universities,
therapeutic therapeutic agents. b.   Publications/ developed/ repurposed NGOs
agents in human presentations/ policies therapeutic agents
(investigator- arising from research
initiated clinical done.
trials)
 APPENDIX 7
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
6 To determine the To trace patients who Long term outcome Information on long MOH (NIH -
outcome of cancer had defaulted treatment “real life” data of cancer term survival of cancer IKU)
treatment in and study the effects treatment in Malaysia. patients
Malaysia of treatment default on
survival

F. Research on Rehabilitation and Survivorship

1 To strengthen 1.1 Identification of Patient experience of Proposal of MOH (NIH -
research activities cancer survivors’ needs. cancer care rehabilitation services IHSR),
in improving to be implemented Universities,
survivorship 1.2  Mapping of the Accessibility of based on the needs of NGOs
available resources and rehabilitation services cancer survivors
the burden.

1.3   Evaluation of
the existing cancer
rehabilitation services.

1.4   Exploration of Identify challenges and Proposal of strategies

the challenges and view of HCPs in cancer in improving/
view of HCPs in cancer rehabilitation services implementing
rehabilitation services. rehabilitation services
for cancer survivors
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127
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128
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
1.5  Conduct review/ Review/HTA conducted Proposal of strategies MOH (NIH -
HTA on different models in improving/ IHSR),
in delivering cancer implementing Universities,
supportive care services rehabilitation services NGOs
at the community level. for cancer survivors
1.6  To identify barriers Identification of barriers
and facilitators at and facilitators to
primary level, secondary implement/ improve
level, patient level and rehabilitation services
HCP level to implement/
improve rehabilitation
services
2 To study late Explore the late effects Identification of late effects Report on information MOH (NIH -
effects in in patients who were of treated paediatric on late effects of treated ICR),
previously treated treated for cancer in oncology patients. paediatrics oncology Hospitals,
paediatrics childhood. patients Universities
oncology patients
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

G. Research on Palliative Care

1 To assess the 1.1  Assessment of Estimation of population Proposal of strategies to MOH (NIH
needs and cancer patients’, require palliative care improve the delivery of - IHSR),
conduct studies caregivers’, and HCPs’ services. palliative care services Universities,
to strengthen needs in palliative care and NGOs
the quality services.
and delivery in
palliative care
services
 APPENDIX 7
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
1.2  Exploration of the Estimation of population Proposal of strategies to MOH (NIH
knowledge, attitude require palliative care improve the delivery of - IHSR),
and practices of general services. palliative care services Universities,
public and HCPs and NGOs
towards palliative care
services.

1.3   Mapping the Mapping of mismatch

available resources between the demand and
with the palliative care supply of palliative care
services provided by services.
MOH.

1.4   Conduct review/
HTA on different models
in delivering palliative
care services at the
community level.

1.5    Estimation of
human resources
required to deliver
palliative care services at
hospital and community
level.
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129
 APPENDIX 7

130
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
2 To assess 2.1  Estimation of the Understand the Proposal of strategies MOH (NIH -
and improve prevalence of pain and epidemiology of pain to improve pain ICR),
accessibility of other health related control status in cancer management for cancer Universities,
pain management suffering among cancer patients and its delivery patients NGOs
for cancer patients patients. system.

2.2   Exploration
of cancer patients’
understanding towards
analgesia (opioid).

2.3   Estimation of
probable analgesia
(opioid) usage in
Malaysia for cancer pain.

2.4   Developing Identification of
interventions/ systems barriers and facilitators
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

to streamline the process in delivering pain

of prescription and management for cancer
dispensation of analgesia patients.
for cancer patients.

2.5   Exploration on the

challenges faced in the
accessibility of analgesia
among cancer patients.
 APPENDIX 7
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
H. Research on Traditional and Complementary Medicine
1 To allow cancer 1.1  To conduct a Number of research paper Presented or published IKN (T&CM
patients to retrospective study on presented/ published. at least 1 research Unit)
cope better the safety of the herbs paper each year
with cancer and used in herbal therapy
cancer treatment as an adjunct treatment
by building for cancer patients.
human capacity
to enhance 1.2   To conduct a study
best practice on the effect of herbal
and providing therapy on the quality
evidence- based of life of cancer patient
adjunct treatment and practitioners in
for cancer patients Malaysia.

I.    Research on Cancer Impact on Economy

1 To evaluate the 1.1  Measure the degree Degree of disease burden Clearer insight of MOH (NIH -
economic impact of disease burden/ of cancers, e.g. Disability- the disease burden IKU),
of cancer from collect and analyse the adjusted life years (productivity loss) Universities
the perspective of information available for (DALYs), Quality-adjusted caused by cancers
society disease burden life years (QALYs).
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131
 APPENDIX 7

132
FOCUS AREA 8: Research and Development

Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
1.2   Estimate the value Loss of productivity cost Clearer insight of MOH (BKP)
of productivity loss per cancer death/ case. the disease burden
as a result of cancer (productivity loss)
mortality and morbidity, caused by cancers
e.g. absence from work,
premature mortality

1.3   Assessment of Estimation of catastrophic Proposal of strategies to MOH (BKP),

financial toxicity among health expenditure of improve equity cancer Universities
cancer patients undergo cancer patients. care
cancer treatment.

2 To evaluate cancer Collect and analyse Estimation of cancer Fully understand the MOH (BKP),
care expenditure data on cost per management cost from the cost of each cancer Universities
in healthcare cancer patient HCPs’ perspective. management to support
system management (from the practice of value-
screening/ diagnosis to based medicine (at least
rehabilitation/ palliative for the most common
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

care): cancers in Malaysia)

- cancer specific
- stage specific
 APPENDIX 8
FOCUS AREA 9: Monitoring and Surveillance
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
1 Strengthening of 1.1   MNCR and State a.  Number of facilities All government and MOH (BKP, PIK,
comprehensive and Health Departments - to notify via Patient private hospitals BPP, OHP),
good data quality Training on notification of Registry Information notify all newly MHTC,
compilation and cancer and ICD-O coding System (PRIS) diagnosed cancer MAOMS,
information systems via Patient Registry b. Number of facilities cases via PRIS by MOS
(MNCR & PRIS) Information System with ICD-O trained 2025
(PRIS-M2b) officer

1.2   MNCR with support

from MHTC, and MOS- to
improve the notification
submission rate among
specialists and MOs in
private health facilities

1.3   Audit visits to Number of facilities High accuracy of data MOH (BKP, PIK,
facilities including private evaluated per year submitted BPP),
sectors. MHTC,
MOS

1.4   MyHDW: PIK Number of state and PRIS and LIS has MOH (PIK),
to strengthen all LIS specialist hospitals with interface in all Pathologists
available in the state and LIS interfaced with PRIS. state and specialist
specialist hospitals to hospitals by 2025
support MNCR in cancer
surveillance
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133
 APPENDIX 8

134
FOCUS AREA 9: Monitoring and Surveillance
Coordinating/
No Specific Objective Strategic Actions Performance Indicators Target Collaborating
Agencies
1.5   To improve data Cancer data entered into By 2023, all data on MOH (PIK)
submission of specific PRIS new cases for specific
cancer registries under cancer registries
PRIS under PRIS are
submitted
2 Comprehensive 2.1   Establishing a a. Comparable and 3-years / 5-years MOH (BKP,
cancer data analytics networking between comprehensive data data reported by the Sub-module
and timely cancer MNCR, other sub-module coverage subsequent 2 years cancer
surveillance reports cancer registries and registries),
Universities b. Support of evidence- Universities
based cancer clinical
management and cancer
prevention decision
makings

2.2   Short term High quality of data MOH (BKP),

training in cancer data IARC
epidemiology analysis
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

and quality management

2.3   Recruitment of 2 research officers / PSH MOH (BSM,

research officers trained BKP, IKN)
for checking accuracy
of data, active search
of unnotified cases in
facilities and key in data
into the system
 APPENDIX 9
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
1 To build workforce A. Pathology
capacity and
strengthen 1.1  To strengthen To create more posts By 2025, all centres MOH
human capital human resource by for Cytology Scientific shall have at least
development creating additional posts Officer: 10 more posts for one cytology-trained
for Cytology Scientific centres without Cytology Scientific officer
Officers Scientific Officers

1.2   To strengthen a.   To create more posts: By 2023, Hospital MOH

human resource for 2 U29 Medical Laboratory Tunku Azizah will have
haemato-oncology Assistant (MLT), 1 U32 additional 2 U29 MLT,
molecular services by MLT and 1 C41 Scientific 1 U32 MLT and 1 C41
creating additional posts Officer (S0) to expand Scientific Officer trained
the molecular service at in Molecular Pathology
Hospital Tunku Azizah

b.   To create more posts: By 2022, HQE will have MOH

1 U29 MLT and 1 C41 1 U29 MLT and 1 C41
Scientific Officer post Scientific Officer trained
to start the molecular in Molecular Pathology
service at HQE

1.3   To strengthen the To create more posts: 3 By 2023, HUS will MOH
human resource for U29 MLT and 1 C41 SO have 3 U29 MLT and
bone marrow cytogenetic to start the cytogenetic 1 C41 SO trained in
service by creating service at HUS cytogenetic service
additional posts
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135
 APPENDIX 9

136
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
1.4   To strengthen the a.   To create more By 2021, HUS will have MOH
human resource for posts: 3 U29 MLT and 1 3 trained MLT and 1
flowcytometry service by C41 Scientific Officer to trained Scientific Officer
creating additional posts expand the cytogenetic
service at HUS
b.   To create more By 2021, HSI Johor MOH
posts: 1 MLT and 1 Bahru and HPP will
Scientific Officer post at have additional 1 MLT
both centres to run the and 1 Scientific Officer
flowcytometry service at
HSA Johor Bahru and
HPP

c.   To create more posts: By 2021, Hospital MOH

1 U29 MLT and 1 C41 Tunku Azizah will have
Scientific Officers to run additional 1 MLT and 1
the service at Hospital Scientific Officers
Tunku Azizah.
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

1.5   Strengthen a.   Pathologist: one One (1) Pathologist to be MOH,

specialised human candidate under trained abroad by 2025 Universities,
resource by having Subspecialty program Private Sector
qualified and highly with Hadiah Latihan
skilled Pathologists, Persekutuan (HLP) for
Scientific Officers and Molecular Pathology
Medical Laboratory
Technologist trained in
Molecular Pathology
 APPENDIX 9
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
b.   Scientific Officer: to Five (5) Scientific MOH,
train one candidate per Officers to be trained by Universities,
year for Subject Matter 2025 Private Sector
Expert (SME) trained
in Molecular Pathology
in solid tumours and
Bioinformatics as Subject
Matter Expert (SME)

c.   Scientific Officer Five (5) officers to be MOH,

and Medical Laboratory trained by 2025 Universities,
Technologist: In-house/ Private Sector
local training and
workshops: one candidate
per year
1.6   Train professional, a.    Pathologist: one Five (5) cyto-pathologists MOH,
scientific and technical candidate per year under to be trained abroad by Universities,
staff to strengthen Subspecialty program 2025 Private Sector
specialised human with HLP
resource by having
qualified and highly
skilled Pathologists,
scientific Officers and
Medical Laboratory
Technologist provide
comprehensive cytology
service as first line
diagnostic test for cancer
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137
 APPENDIX 9

138
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
b.   Pathologist: one Five (5) cyto-pathologists MOH,
pathologist to be to be trained locally by Universities,
trained locally and sit 2025 Private Sector
for the Fellowship of
International Academy
of Cytology (FIAC)
examination

c.   Cytology Scientific Six (6) Scientific Officers MOH,

Officer: to train for to be trained by 2025 Universities,
Subject Matter Expert Private Sector
(SME) in Cytology:
Advance in Cytology
(CTIAC)

d.   Cytology Scientific Three (3) Scientific MOH,

Officer: to train for Officers to be trained by Universities,
Subject Matter Expert 2025 Private Sector
(SME) in Cytology:
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

Molecular Cytopathology
(long course): at least one
candidate per year.

e.   Scientific Officer: In- Five (5) Scientific MOH,

house/local training and Officers to be trained by Universities,
workshops (local training/ 2025 Private Sector
short course) in cytology.
 APPENDIX 9
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
f.    Cytotechnologist: Completion of the MOH
Revision of the current revised module by 2023.
Advanced Diploma
Fifteen (15) MOH
in Cytology and to
Cytotechnologists to be
incorporate Molecular
trained by 2025
technology module into
the program.

1.7 Train professional, Training for Pathologists, Pathologists, Scientific MOH,

scientific and technical Scientific Officers and Officers and MLTs are MOHE
staff to provide MLT to expand the to be trained by 2023 at
comprehensive molecular molecular service at Hospital Tunku Azizah
service by skilled and Hospital Tunku Azizah
competent staff and to start the service at Pathologists, Scientific MOH,
and HQE Officers and MLT are to MOHE
be trained by 2022 at
HQE
1.8 Train professional, Training of Pathologists, Pathologists, Scientific MOH,
scientific and technical Scientific Officers and Officers and MLT are to MOHE
staff to provide MLT to start cytogenetic be trained by 2023 at
comprehensive service at HUS and HUS
cytogenetic service by expand the service at
skilled and competent HPP. Pathologists, Scientific MOH,
staff. Officers and MLT are to MOHE
be trained by 2021 at
HPP
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139
 APPENDIX 9

140
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
1.9  Train professional, a.    Training for Pathologists, Scientific MOH
scientific and technical Pathologists, Scientific Officers and MLT are to
staff to provide Officers and MLT in order be trained by 2021
comprehensive to start flowcytometry
flowcytometry service by service at HUS.
skilled and competent
staff. b.   Training of Pathologists, Scientific MOH
Pathologists, Scientific Officers and MLT are to
Officers and MLT in be trained by 2021
order to expand the MRD
service at Hospital Tunku
Azizah and to start MRD
service at HSA Johor
Bahru and HPP.

1.10 Train professional, Training of Pathologists, Training of Pathologists, MOH,

scientific and technical Scientific Officers and Scientific Officers and MOHE
staff to provide MLT once new method MLT once new method
comprehensive stem cell has been established. has been established by
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

laboratory service. 2021

B. Radiology
1.11  To further expand Number of sub-specialist 5 sub-specialists MOH
Radiology sub-specialty trained in interventional trained in interventional
training into: Onco-radiology / Onco- Onco-radiology / Onco-
• Interventional Onco- radiology. radiology within 5 years
Radiology
• Onco-Radiology
 APPENDIX 9
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
1.12  To strengthen the Number of trainees yearly. 4 Interventional MOH
Radiology sub-specialty: Radiologist Trainee
• Interventional yearly
Radiology
• Body-Thoracic 2 Radiologists for each
Radiology sub-specialty training
• Body-Onco Radiology apart from IR yearly
• Body-Urogynae
Radiology
• Neuro-Head and Neck
Radiology
• Neuro-Neuroradiology
• Breast Radiology
• Musculoskeletal
Radiology
• Paediatric Radiology

1.13  Increase Number of radiologists 300 new radiologists MOH

production of radiologist over the next 5 years.
by Masters/ parallel
pathway program.
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141
 APPENDIX 9

142
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
1.14  Radiographers to Number/percentage of 10 radiographers yearly MOH
go for short courses/ Radiographers to go for for CT and MRI
intensive training/ short courses/intensive
advance diploma training/advance diploma 20% of radiographer
programs locally or programs. should obtain
abroad to be modality Advance Diploma
expert certification training in
• CT breast imaging/ CT/
• MRI Cardiovascular and
• Mammography future program
• Angiography
(To be integrated the
training program with
existing advance diploma
in cardiovascular
imaging)

1.15  Radiology Nurse Number of nurses who 20 nurses to undergo MOH

Training. undergo Radiology Nurse Advance Diploma
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

Training. Perioperative Nursing

(Radiology) over the next
5 years.

1.16  Pegawai Sains Number of Pegawai Sains All Pegawai Sains (Fizik) MOH
(Fizik). (Fizik) obtaining Post should obtain a Post
Graduate Qualification. Graduate Qualification
after 5 years in service.
 APPENDIX 9
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
C. Clinical Haematology
1.17  Training for 2021-2025 Post-basic To increase number MOH
nurses. training centres for of training centres –
nurses are set up in Penang, Johor Bahru,
Penang, Johor Bahru, Sabah, Sarawak (Post-
Sabah and Sarawak. basic training for nurses
In 2025 KKM is able to are mainly in the Klang
train 50 post-basic nurses valley)
in hemato-oncology
yearly. To produce 50 post-
basic nurses in hemato-
oncology every year
1.18   Training for By 2025 each To have adequate MOH
laboratory technician haematology laboratory laboratory technicians
and scientists will have adequate and scientists for the
technicians and increasing workload
scientists.
1.19  Training for By 2025, about 35 to 45 To increase the number MOH
Haematologists. new haematologists will of doctors trained in
*Total no. of be trained and completed haematology (both
haematologists in MOH training. laboratory and clinical)
in 2019 is 35. such that by 2025
there will be 70 to 80
haematologists
To encourage parallel
pathway e.g. RCPath
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and RCPA

143
 APPENDIX 9

144
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
D. Radiotherapy & Oncology
1.20  Clinical To maintain at least 10 Aim to have 50 MOH (BPL and
Oncologists. candidates per intake Oncologists by 2025 Planning &
in Masters in Clinical Development
Oncology. Division),
Universities
1.21  Physicists. a.  To increase higher PhD: 1 physicist/year MOH (BPL,
rank posts for Physicists BSM),
Strengthening Medical with Masters/PhD. JPA
Physicist through
education and b.  To retain those trained The expected increment
Structured Training in radiotherapy to be in number of posts as
Program specialising in kept in that field upon follows:
Radiotherapy promotion by increasing HUS - 6 posts
number of promotional HSI - 9 posts
posts in radiotherapy. IKN - 6 posts
HWKKS - 5 posts
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

HKL - 1 post
Northern cancer centre -
10 posts
1.22  Radiation a.    To enrol 10 radiation 50 radiation therapists MOH (BPL)
Therapists. therapists every year with Advanced Diploma
in Advanced Diploma by end of 2025
Program.
 APPENDIX 9
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
b.   To enrol 10 to 15 30 radiation therapists Head of
radiation therapists for with Degree by end of Profession
every 2 years. in Degree 2025 for Radiation
Program in Radiotherapy Therapist
c.    To enrol one radiation 4 radiation therapists UKM
therapist every year with Masters in Science
in Masters in Science (Radiotherapy) by end of
(Radiotherapy) under HLP 2025
d.   To enrol one radiation 2 radiation therapists
therapist every 2 years with PhD in Science
in PhD in Science (Radiotherapy) by end of
(Radiotherapy) (three-year 2025
program)
e.  To create post- Two radiation therapists JPA,
Subject Matter Expert in to be gazetted as Subject BSKB
Radiotherapy for level 1 Matter Experts in
(from grade U44 to U48) radiotherapy
f.   To increase the intake 30% of the oncology MOH (Clinical
for post-basic nursing nurses completed oncology,
every year post basic training in Haematology,
Oncology. Paediatric
Oncology,
Gynae
oncology),
Private hospitals
with oncology
services,
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

KSKB

145
 APPENDIX 9

146
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
1.23 Onco Trained a.    To increase the 30% of the oncology MOH (Clinical
Nurses. intake for post basic nurses completed oncology,
nursing every year. post basic training in Haematology,
Oncology. Paediatric
Oncology,
Gynae
oncology),
Private hospitals
with oncology
services,
KSKB

b.   To train nurses in All oncology patients Oncology

periphery hospitals for 2 should receive Centres,
weeks on chemotherapy chemotherapy by nurses Hospital
administration at trained in chemotherapy directors
Oncology Centres. administration at
Oncology centres.
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

1.24  Pharmacists. a.    To credential at least Preceptorship training MOH (Pharmacy

2 Oncology pharmacists -At least 1 trained Services)
in all states depending on preceptor in each
the number of established training centre
Oncology Departments/
Clinical Oncology Units
nationwide
 APPENDIX 9
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
b.   To conduct in-house All pharmacists working All MOH
CDR training for all in Pharmacy Oncology facilities with
pharmacists working in Units (CDR unit) should CDR services
Pharmacy Oncology Units undergo this training. and qualified
(CDR unit) by oncology CDR cleanroom
pharmacy preceptor. (17 facilities
currently)
c.    Preceptorship 8 trained preceptors in Pharmaceutical
training: At least 1 trained oncology centres Services
preceptor in each training Program
centre.
d.   To ensure sufficient 1 centre (160 Pharmaceutical
number of pharmacists in preparations): 8 Services
each Pharmacy Oncology oncology pharmacists Program,
Units. One Oncology MOH,
CDR unit: 20 pharmacist in every JPA
preparation/day = oncology ward in each
1 oncology trained centre
pharmacist
Oncology ward: 1
oncology pharmacist /
ward
e.    To create Subject At least 1 Subject Matter JPA, BFF
Matter Expert in Expert in each oncology
Pharmacotherapy in related discipline.
Oncology for level 4 (UF56
– JUSA C).
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147
 APPENDIX 9

148
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
E. Paediatric Oncology
1.25  Increase number All regional centres have At least 9 more MOH (BPP),
of paediatric oncologists only one or two resident paediatric oncologists JPA
in each centre outside paediatric oncologists. to existing number 14
Klang Valley - 7 regional The aim is to have 3 (minimum 23 for the
centres. paediatric oncologists whole country)
in all regional centres
outside of Klang valley.
1.26 Creation of more Number of hospitals At least 2 JUSA C posts MOH (BPL and
posts for paediatric which fulfil the posts. and 1 UD56 post in each Planning &
oncologist. centre Development
Division),
JPA

1.27  Allocation of Availability of lead person 2 per year MOF, BPL

budget for short term for specific tumour.
training in various solid
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

tumours so that the

trained person can be a
lead person for specific
tumours e.g. lymphoma
/ brain tumours etc.
 APPENDIX 9
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
1.28  Increase oncology Number of trained 2 oncology pharmacists Universities
pharmacists per centre. pharmacists per centre (local and
• ·All oncology international),
pharmacists to be MOH,
credentialed JPA,
• Curriculum of Pharmacy
training program Services
outlined and
application for
program approval

1.29 Increase number Percentage of nurses 75% of nurses in each Universities

of nurses with post basic with post basic oncology regional centre has post (local and
oncology training. training basic oncology training international),
MOH,
JPA,
Nursing
Division
1.30  Increase numbers Number of nurses 1 nurse to 4 patients Nursing
of nurses following Division,
norms. JKN

F. Gynaecology Oncology
1.31  Human capital Number of new posts At least 4 posts/year MOH (BSM,
development through created in the various BPP)
establishment of new hospitals
posts and targeted
training programs.
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149
 APPENDIX 9

150
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
1.32  Increase the Establishment of Gynaecological Oncology MOH
number Gynaecological Gynaecological Oncology Unit established
Oncology Unit. Unit in all major
Government Hospital/
States Hospital
1.33  Increase trained Number of O&G 73 Gynae Oncologists
Gynae-Oncologist to Departments with in 37 hospitals
meet the requirement Gynaecological Oncology throughout Malaysia.
throughout Malaysia sub-specialty services We need another 50
(Currently all major Gynae-Oncologist to
hospital in all 14 states provide service for
has at least one Trained entire population of the
Gynae Oncologist. In country.
2019 there are 23 Gynae
Oncologist placed in
government hospital in
the country, 17 trainees
undergoing training in the
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

country)
1.34  Improve training GO committee,
program in terms of JKPPOG, MOH
selection of candidates,
training program and
proper assessment
during exit certification
by:
 APPENDIX 9
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
• Setting the standard Number of certified At least 20 GO Trainers
criteria for trainers Gynae Oncology Trainer in all MOH training
and training centres. (currently 11 qualified centres.
Trainer - Certified trainers had been At least 4 intakes/year
by Gynaecological appointed) At least 2 trainees/year
Oncology Committee, From 2020, proper
MOH and perform at assessment of trainee will
least 50 major cases/ be conducted:
year 1) 6 monthly assessment
• Increase intake of (assessment form fill-up
trainees. by trainer)
• Trainee must undergo 2) Yearly surgical skill
test and assessment assessment
at the end of 3 years 3) Final examination
training. at the end of 3rd year
in form of viva, MCQ
and surgical skill
assessment conducted by
independent trainers from
other training centre
Number of trainee intake
per year (current intake: 2
candidates/year)
Number of Trainees
completed training and
received certification
and NSR registration as
certified Gynaecological
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

Oncologist after this

151
assessment
 APPENDIX 9

152
FOCUS AREA 10: Human Capacity Building and Development
Coordinating /
Specific
No Strategic Actions Performance Indicator Target Collaborating
Objectives
Agencies
G. Medical Rehabilation
1.35   Dietitian - to a. Number of post By 2025, all centres JPA, MOH
create at least one post shall have at least
of Dietitian in each one Dietitian post
Rehabilitation Center with flexible grade
(Dietetic Support) U41/44/48/52/54
b. To create Subject At least 1 Subject JPA, MOH
Matter Expert in Dietetic Matter Expert in each (Dietetics
Oncology Rehabilitation Center. Speciality
Committee)

H. Research
1.36 Increase expertise Number of researchers 10 trained (at PhD level) MOH,
in cancer research. undergoing postgrad or cancer researchers by MOHE (IPTA,
postdoc training. 2025 IPTS),
NGOs
NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025
 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

ABBREVIATIONS

ABBREVIATION EXPLANATION

AJCC American Joint Committee on Cancer

AML Acute Myeloid Leukemia
ASR Age-Standardised Rate
BCR-ABL Breakpoint Cluster Region Abelson murine Leukemia
BER Beyond Economic Repair
BKP Bahagian Kawalan Penyakit (Disease Control Division)
BNE Breast and Endocrine
BOR Bed Occupancy Rate
BPF Program Perkhidmatan Farmasi (Pharmaceutical Services
Division)
BPK Bahagian Pendidikan Kesihatan (Health Education
Division)
BPKK Bahagian Pembangunan Kesihatan Keluarga (Family
Health Development Division)
BPL Bahagian Pengurusan Latihan (Training Management
Division)
BPM Bahagian Pengurusan Maklumat (Information
Management Division)
BPP Bahagian Perkembangan Perubatan (Medical
Development Division)
BSE Breast Self-Examination
BSKB Bahagian Sains Kesihatan Bersekutu (Allied Health
Science Division)
BSM Bahagian Sumber Manusia (Human Resiurce Division)
CAR-T Chimeric Antigen Related T-cell
CBE Clinical Breast Examination
CDC Centers for Disease Control
CDR Cytotoxic Drug Reconstitution
CME Continuing Medical Education
CML Chronic Myeloid Leukemia
CNE Continuing Nursing Education
CNS Central Nervous System
COU Clinical Oncology Unit
CPG Clinical Practice Guideline
CRC Clinical Research Centre – now also known as Institute
for Clinical Research (ICR)

153
 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

ABBREVIATION EXPLANATION

CRM Cancer Research Malaysia

CRS Cancer Rehabilitation Services
CT Computerised Tomography
CTIAC Cytology: Advance in Cytology
CYFRA 21-1 Cytokeratin 19 fragments
DALY Disability-Adjusted Life Year
DDISH Dual-colour Dual-hapten in-situ hybridization
DDR Direct Digital Radiography
DSM Department of Standards, Malaysia
ECOG Eastern Cooperative Oncology Group
EGFR Epidermal Growth Factor Receptor
EQA External Quality Assessment
FCTC Framework Convention on Tobacco Control
FIAC Fellowship of International Academy of Cytology
FISH Fluorescence in situ hybridisation
Ga-68 Gallium-68
GESM Gynae Endoscopy Society Malaysia
GO Gynae-Oncology
GPs General Practitioners
HA Hospital Ampang
HCP Healthcare provider
HCTM-UKM Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan
Malaysia
HE4 Human Epididymis Protein 4
HEPA High efficiency particulate air
HER2 Human Epidermal Growth Factor Receptor 2
HKL Hospital Kuala Lumpur
HLP Hadiah Latihan Persekutuan (Federal Training Award)
HOD Head of Department
HOSHAS Hospital Sultan Haji Ahmad Shah
HPB Hepato-Pancreatico-Biliary
HPE Histopathological Examination
HPJ Hospital Putrajaya
HPP Hospital Pulau Pinang
HPV Human Papilloma Virus
HPV DNA Human Papilloma Virus DNA
HQ Headquarter

154
 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

ABBREVIATION EXPLANATION

HQE Hospital Queen Elizabeth

HQE II Hospital Queen Elizabeth II
HR Human Resource
HRPB Hospital Raja Permaisuri Bainun
HRPZ II Hospital Raja Perempuan Zainab II
HSA Hospital Sultanah Aminah
HSBAS Hospital Sultanah Bahiyah Alor Setar
HSI Hospital Sultan Ismail
HSNZ Hospital Sultanah Nur Zahirah
HTA Health Technology Assessment
HTAA Hospital Tengku Ampuan Afzan
HTAR Hospital Tengku Ampuan Rahimah Klang
HTJS Hospital Tuanku Jaafar Seremban
HUS Hospital Umum Sarawak
HUSM Hospital Universiti Sains Malaysia
HWKKS Hospital Wanita dan Kanak-Kanak Sabah
IAEA International Atomic Energy Agency
ICG Fluorescent dye indocyanine green
ICR Institute for Clinical Research
iFOBT immunological Faecal Occult Blood Test
IHBR Institute Health Behavioural Research
IHSR Institute for Health Systems Research
IHC Immunohistochemistry
IHM Institute Health Management
IIT Investigator initiated Trials
IKN Institut Kanser Negara (National Cancer Institute)
IMR Institute for Medical Research
IMU International Medical University
IPHKL Institut Paediatrik Hospital Kuala Lumpur
IPTA Institut Pengajian Tingga Awam (Public Higher
Educational Institutions)
IPTS Institut Pengajian Tinggi Swasta (Private Higher
Educational Institutions)
IR Interventional Radiology
ISH In situ hybridization
ISR Industry Standard Research
JKN Jabatan Kesihatan Negeri (State Health Department)

155
 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

ABBREVIATION EXPLANATION

JKPPOG Jawatankuasa Pengurusan dan Perkembangan O&G

JKR Jabatan Kerja Raya (Public Works Department)
JPA Jabatan Perkhidmatan Awam (Public Services
Department)
KOSPEN Komuniti Sihat Pembina Negara
KPI Key Performance Index
KSM Kementerian Sumber Manusia (Ministry of Human
Resources)
KSKB Kolej Sains Kesihatan Bersekutu (College of Allied Health
Sciences)
LBC Liquid Based Cytology
LDCT Low-dose Computed Tomography
LDP Latihan Dalam Perkhidmatan (paid study leave)
LINAC Linear Accelerator
LIS Laboratory Information System
Lu-177 Lutetium-177
MAOMS Malaysian Association of Oral and Maxillofacial Surgeons
MDA Malaysian Dental Association
MDT Multi-disciplinary Team
MGCS Malaysian Gynaecological Cancer Society
MHTC Malaysia Healthcare Travel Council
MIBG meta-iodobenzylguanidine
MLT Medical Laboratory Assistant
MMA Malaysian Medical Association
NSR National Specialist Registry
MNCR Malaysia National Cancer Registry
MO Medical Officer
MOF Ministry of Finance
MOH Ministry of Health
MOHE Ministry of Higher Education
MOS Malaysia Oncology Society
MPDPA Malaysian Private Dental Practitioners Association
mpMRI multiparametric Magnetic Resonance Imaging
MRD Minimal Residual Disease
mRECIST modified Response Evaluation Criteria in Solid Tumours
MRI Magnetic Resonance Imaging
MyHDW Malaysian Health Data Warehouse
MYPAP Malaysia Patient Assistance Program

156
 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

ABBREVIATION EXPLANATION

NCCB National Cancer Control Blueprint

NCD Non-Communicable Disease
NGO Non-government Organisation
NHMS National Health and Morbidity Survey
NIH National Institute of Health
NPANM III National Plan of Action for Nutrition Malaysia III
NPC Nasopharyngeal cancer
NSPCCP National Strategic Plan of Cancer Control Programme
NSR National Specialists Registry
O&G Obstetrics and Gynaecology
OCRCC Oral Cancer Research & Coordinating Centre
OGSM Obstetrical and Gynaecological Society of Malaysia
OHP Oral Health Programme
OSCC One Stop Crisis Centre
PACS Picture Archiving and Communication System
PAP Papanicolaou test
PCR Polymerase Chain Reaction
PERCIST PET Response Criteria in Solid Tumours
PET Positron Emission Tomography
PHW Pictorial Health Warnings
PIK Pusat Informatik Kesihatan (Health Informatic Centre)
PIVKA2 Protein induced by Vitamin K absence-II
PKD Pejabat Kesihatan Daerah (District Health Office)
PNP Patient Navigation Programme
PPP Public-Private-Partnership
PRC Pink Ribbon Centre
PRIS Patient Registry Information System
PROGRP Progastrin-releasing peptide
PRRT Peptide Receptor Radionuclide Therapy
PSA Prostate Specific Antigen
PSH Pekerja Sambilan Harian (daily part-time staff)
PSMA Prostate-specific Membrane Antigen
PSMA-RLT Prostatic-specific membrane antigen directed radioligand
therapy
QALY Quality Adjusted Life Years
QUAADRIL Quality Assurance Audit for Diagnostic Radiology
Improvement and Learning

157
 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

ABBREVIATION EXPLANATION

RCPA Royal College of Pathologists Australasia

RCPath Royal College of Pathologists UK
RECIST Response Evaluation Criteria in Solid Tumours
RFA Radiofrequency Ablation
RIS Radiology Information System
RIT Radioimmunotherapy
RM Ringgit Malaysia
RMK-10 Rancangan Malaysia ke-10
RMK-12 Rancangan Malaysia ke-12
SBRT Stereotactic Body Radiotherapy
SIRT Selective Internal Radiation Therapy
SMDC Small Molecule Discovery Centre
SME Subject Matter Expert
SPA Suruhanjaya Perkhidmatan Awam (Public Services
Commission)
SPECT Single Photon Emission Computed Tomography
SST Somatostatin
STR Short Tandem Repeat
T&CM Traditional and Complementary Medicine
TACE Transarterial chemo-embolisation
TKI Tyrosine Kinase Inhibitor
TNM Tumour, Nodes, Metastases
UKM Universiti Kebangsaan Malaysia (National University of
Malaysia)
UM Universiti Malaya (University of Malaya)
UMMC University of Malaya Medical Centre
UPM Universiti Putra Malaysia
USM Universiti Sains Malaysia
WHO World Health Organisation
YLD Years lived with disability
YLL Years of live lost

158
 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

EDITORS AND CONTRIBUTORS

MAIN EDITORS

1. Dr Nor Saleha Ibrahim Tamin 3. Dr Feisul Idzwan Mustapha

Public Health Physician Public Health Consultant
Cancer Unit, NCD Section Deputy Director (NCD)
Disease Control Division, MOH Disease Control Division, MOH

2. Dr Siti Norain Binti Sallahuddin

Principle Assistant Director
Cancer Unit, NCD Section,
Disease Control Division, MOH

LIST OF CONTRIBUTORS (in no specific order)

1. Dr Rosnah Ramly 6. Dr Cheng Lai Choo
Sector Head, Deputy Director
CVD-Diabetes-Cancer (NCD) Oral Health Program, MOH
Disease Control Division,MOH

2. Datuk Dr Muhammad Radzi bin 7. Dr Gerald Lim Chin Chye

Abu Hassan National Head Radiotherapy &
National Head Gastroenterology & Oncology (until June 2020)
Hepatology National Cancer Institute
Hospital Sultanah Bahiyah, Alor
Setar

3. Dato’ Dr Mohd Rushdan Mohd 8. Dr Ros Suzana binti Ahmad

Noor Bustaman
National Head of Obstretric & National Head Radiotherapy &
Gynaecology Oncology (present)
Hospital Sultanah Bahiyah Hospital Kuala Lumpur

4. YBhg. Dato’ Dr Goh Ai Sim 9. Dr Yun Sii Ing

National Head of Haematology National Head Radiology
Hospital Pulau Pinang Hospital Sungai Buloh

5. Dato’ Dr. Fitjerald Henry 10. Dr Arni Talib

National Head of Colorectal National Head Pathology
Surgery Hospital Kuala Lumpur
Hospital Selayang

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

11. Dr Ng Chen Siew 20. Dr Ong Gek Bee

National Head Nuclear Medicine Paediatric Oncologist
National Cancer Institute Hospital Umum Sarawak

12. Dr Yusniza Mohd Yusof 21. Dr Toh See Guan

National Head Rehabilitation Haematologist
Hospital Kuala Lumpur Hospital Tuanku Jaafar
Seremban

13. Miss Jasiah Binti Zakaria 22. Dr Prathepamalar a/p

Head of Surgical Department Yehgambaran
Hospital Tuanku Jaafar, Oncologist
Seremban Hospital Kuala Lumpur

14. Dr Alan Khoo Soo Beng 23. Dr Norhayati Omar

Head of Cancer Research Centre Pathologist
(CaRC) (until September 2020) Hospital Kuala Lumpur
Institute for Medical Research

15. Dr Ezalia binti Esa 24. Dr Siti Shahrom

Head of Cancer Research Centre Pathologist
(CaRC) (Present) Hospital Tunku Azizah
Institute Medical Research

16. Miss Nor Aina binti Emran 25. Dr Chai Koh Meow
Consultant Surgeon (Breast and Senior Principal Assistant
Endocrine) Director
Hospital Kuala Lumpur Traditional & Complementary
Medicine Division, MOH

17. Dr Zulaiha binti Muda Senior 26. Dr Badiuzzaman bin Abd Kadir
Consultant Paediatric Haemato- Senior Assistant Director
Oncologist Traditional and Complementary
Hospital Tunku Azizah Kuala Medicine Division, MOH
Lumpur

18. Dr Ida Shahnaz Othman 27. Dr Siti Norbayah Yusof

Paediatric Haemato-Oncologist Head of Cancer Registry
Hospital Tunku Azizah Kuala Department
Lumpur National Cancer Institute

19. Dr Teo Chiah Shean 28. Datuk Dr Nor Asiah Muhamad

Head of Traditional and Head of Sector for Evidence
Complementary Medicine Unit Based in Healthcare (EBH)
National Cancer Institute National Institute of Health,
MOH

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29. Datin Dr Zuhanis Abdul Rahim 37. Dr Hans Prakash a/l

General Radiologist Sathasivam
National Cancer Institute Head of Biobank Unit
Institute for Medical Research
30. Dr Tan Chih Kiang 38. Dr Adiratna Mat Ripen
Oncologist Head of Immunodeficiency and
National Cancer Institute Immunogenetics Unit
Institute for Clinical Research,
MOH

31. Dr Jamil Omar 39. Dr Mohammad Zabri Johari

Head of Oncology Surgery Senior Assistant Director
Department Institute for Health Behavioural
National Cancer Institute Research (IHBR), MOH

32. Dr Noraini Ab Rahim 40. Dr Woon Yuan Liang

Head of Radiology Department Head of Centre for Clinical
National Cancer Institute Epidemiology
Institute for Clinical Research,
MOH
33. Dr Nik Mazlina Mohammad 41. Dr Siti Fazira Edzua Jamaluddin
Family Medicine Specialist Centre for Health Quality
Klinik Kesihatan Kelana Jaya Research
Institute for Health Systems
Research (IHSR), MOH

34. Dr Muhammad Fadhli bin Mohd 42. Dr Nur Hidayati Abd Halim
Yusoff Centre for Health Policy
Head of Centre for Non- Research
communicable Diseases Research Institute for Health Systems
Institute for Public Health, MOH Research (IHSR), MOH

35. Dr Rozita Halina binti Tun 43. Dr Norma Sabtu

Hussein Senior Principal Assistant
Senior Deputy Director Director
Planning Division, MOH State of Health Office, Melaka

36. Dr Zakiah binti Mohd Said 44. Dr Noor Hashimah binti

Sector Head Abdullah
Adult Health Senior Principal Assistant
Family Health Development Director
Division MOH State of Health Office, Kelantan

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45. Dr Fatanah binti Ismail 53. Dr Sivarajan Ramasamy

Public Health Physician Senior Principal Assistant
Family Health Development Director
Division MOH State of Health Office, Negeri
Sembilan

46. Dr Shazimah binti Abdul Samad 54. Dr Noryati binti Abu Amin
Public Health Physician Director
Family Health Development National Blood Center, MOH
Division MOH

47. Dr Nasrul Muhaimin bin Mohd 55. Dr Nor Sheereen binti Adzaludin
Mokhtar Medical Officer
Senior Principal Assistant National Blood Center, MOH
Director
Family Health Development
Division MOH

48. Dr Zurina Asiah binti Musa 56. Dr Hamdan bin Mohamad

Senior Principal Assistant Dietician,NCD Section
Director Disease Control Division, MOH
Oral Health Program, MOH

49. Dr Siti Nur Fatihah 57. Puan Azlina binti Abdul Aziz
Senior Assistant Director Head of Health Education Unit
Oral Health Program National Cancer Institute
MOH

50. Puan Hidayatun Fadillah Mohd 58. Dr Cecilia Loo Shi Ni

Nor Research Assistant
Senior Assistant Director National Institute of Health
Health Education Division, MOH

51. Puan Rosne Rafidah binti Abd 59. Dr Umawathy a/p Sundrajoo
Rani Senior Principal Assistant
Assistant Director Director
Health Education Division Medical Development Division
MOH MOH

52. Norfarhainy binti Yahya 60. Dr Olivia Tan

Assistant Director Senior Principal Assistant
Health Education Division Director
MOH Medical Development Division
MOH

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61. Dr Noor Haslinda binti Ismail 64. Dr Suriani Aishah bt Zainal

Senior Assistant Director Senior Principal Assistant
National Health Financing Section Director
Planning Division MOH Medical Development Division
MOH

62. Dr. Mohd Wan Shariffudin bin 65. Dr. Muhammad Al-Amin Safri
Zainudin Senior Assistant Director
Principle Assisstant Director Medical Development Division
Family Health Development MOH
Division MOH

63. Dr Siti Munira Abd Jalil

Medical Officer
National Institute of Health

Academicians, Non-Government Organisations (NGOs) and Phar-

maceutical Companies

1. Prof. Dr Nur Aishah binti Mohd 5. Prof. Datin Paduka Dr Teo

Taib Soo-Hwang
University of Malaya Cancer Chief Scientific Officer
Research Institute (UMCRI) Cancer Research Malaysia
Universiti Malaya (CRM)

2. Prof. Dr Jennifer Geraldine Doss 6. Assoc. Prof. Dr Nirmala a/p

Department of Community Oral Bhoo Pathy
Heath & Clinical Prevention Department of Social and
Faculty of Dentistry Preventative Medicine
Universiti Malaya Universiti Malaya

3. Prof. Dr. Raja Affendi Raja Ali 7. Dato’ Dr Meheshinder Singh

Consultant Physician & President
Gastroenterologist Colorectal Cancer Survivorship
Dean of Faculty of Medicine Society Malaysia (CORUM)
Universiti Kebangsaan Malaysia
(UKM)

4. Dr Saunthari Somasundaram 8. Puan Ong Mei Ching

President Max Family Society Foundation
National Cancer Society of Malaysia
Malaysia

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 NATIONAL STRATEGIC PLAN FOR CANCER CONTROL PROGRAMME 2021-2025

9. Ms. Shamie Zainal 17. Associate Prof Dr Mazanah

Corporate Affairs & Government Muhamad
Relations Lead Chairperson,
Pfizer (Malaysia) Sdn Bhd Persatuan Kanser Network
Selangor & WP (KANWORK)

10. Dr Murallitharan Munisamy 18. Associate Prof. Dr Bahariah

Director binti Khalid
National Cancer Society Malaysia War on Cancer Malaysia

11. Puan Farawahida Mohd Farid 19. Puan Wendy Thoo

General Manager National Cancer Society
Majlis Kanser Nasional (MAKNA) Malaysia (NCSM)

12. Matron Salimah Saleh 20. Dr Sri Ganesh Muthiah

Community Outreach Services Founder
Manager, Cancerfly Networks
Breast Cancer Welfare
Asosciation (BCWA)

13. Mr. Wong Kuan Sing 21. Dr Sharon Tay Hui Wen
President Malaysian Dental Association
Together Against Cancer Malaysia (MDA)

14. En Azrul Mohd Khalib 22. Mr. Ronnie Teo

Chief Executive Officer Public Affairs Lead
GALEN Centre for Health and ROCHE (Malaysia) Sdn Bhd
Social Policy

15. Mr. Rohan Talalla 23. Ms. Wong Sit Yin

Government Affairs & Corporate Healthcare Access Corporate
Business Developments Affairs Lead
MERCK Biopharma Sdn Bhd ROCHE (Malaysia) Sdn Bhd

16. Dr Muhammad Azrif, 24. Dr Matin Mellor

President Malaysian Oncological Society
Malaysian Oncological Society (MOS)

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 Disease Control Division (NCD)
Level 2, Block E3, Complex E, Precint 1, Federal Government Administration Centre
62590 Putrajaya, MALAYSIA.