Biomarkers for cancer risk among people attending a community event: an observational cohort study in Johor, Malaysia

Introduction: Cancer is the second most common cause of death in Malaysia. Early detection and treatment may help to optimise outcomes, but most cancer patients in Malaysia present with late-stage disease. The aim of this community health project was to improve community awareness of the risks of cancer (among other non-communicable diseases), and the benefits of screening for disease prevention and early detection. Methods: Community health screening was conducted during the 2016 Kembara Mahkotacommunity event in Johor, Malaysia. Blood-based biomarkers were used to screen for risk of cardiovascular disease, diabetes, cancer and thyroid disease in the population attending the event. Cancer screening involved measurement of carcinoembryonic antigen (CEA), a marker of colorectal cancer risk, cancer antigen 125 (CA125) for assessment of ovarian cancer risk, prothrombin induced by vitamin K absence II (PIVKA II) levels for hepatocellular carcinoma (HCC) risk, and pepsinogen I/II (PG I/II) ratio for assessment of gastric cancer risk. Individuals identified as high risk were referred for specialist follow-up. Results: A total of 2744 individuals participated in biomarker screening.CEA and CA 125 levels indicated that 4–7% of the population had high cancer risk. HCC risk was high in 17% of individuals, based on PIVKA II levels, and 3% were at risk of gastric cancer based on the PG I/II ratio. Conclusion: Community health projects such as ours are required to raise awareness of the risks of common preventable diseases, and to encourage individuals to participate in health checks and disease screening programmes.