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BackgroundColorectal cancer (CRC) is a major cause of cancer-related mortality worldwide. It is the second leading cause of cancer death in men and women in Malaysia and poses a major burden on society.AimsTo determine the overall survival rate of patients diagnosed with CRC and factors contributing to survival.MethodsData were obtained from the Malaysia National Cancer Registry. All patients with CRC were identified, and a total of 15,515 patients were screened. A total of 5,675 CRC patients were included from January 1, 2012, to December 31, 2016. Sex, age groups, ethnic groups, stage at diagnosis, cancer sites, and status of treatment received were analysed. The Kaplan–Meier analysis was performed to estimate the 1-, 3-, and 5-year survival of CRC. The log-rank test was conducted to compare the survival between sex, age groups, ethnic groups, stage at diagnosis, cancer sites, and status of treatment received. Multiple Cox regression was conducted to determine the risk of CRC death.ResultsOf 5,675, a total of 2,055 had died, 3,534 were censored, and another 86 were still alive within 5 years of CRC diagnosis. The 1-, 3-, and 5-year survival rates were 68.5%, 34.7%, and 18.4%, respectively with a median survival time of 24 months. Significant differences in survival rates of CRC were observed between age groups (p < 0.001), ethnic groups (p < 0.001), stages at diagnosis (p < 0.001), treatment status (p = 0.003), and treatment modalities (p < 0.001). No significant difference was observed in survival rates of CRC between sex (p = 0.235) and cancer sites (p = 0.410). Those who were 80 years old and above were found to be at higher risk of CRC death compared to those below 80 years old (adjusted hazard ratio (HR): 1.24, 95% CI 1.14–1.36). The risk of CRC death was also found four times higher among those with stage IV compared to those with stage 0 (adjusted HR: 4.28, 95% CI 3.26–5.62).ConclusionIn general, Malaysian patients with CRC had low survival rates. National health policies should focus on enhancing awareness of CRC, encouraging early screening, and developing strategies for early detection and management to reduce CRC-associated mortality.

Reliable information on causes of death is essential for an evidence-based health policy. There is a challenge in ascertaining the cause for deaths occurring without medical attention. This has been a persistent problem for Malaysia, where 50% of deaths are registered as “nonmedically certified” deaths mostly with ill-defined causes. During 2014–2016, a research study was conducted in a nationally representative sample of 15,000 deaths in Malaysia, to verify their registered causes and develop cause-specific mortality estimates. Standard Verbal Autopsy (VA) methods were used to ascertain causes for the nonmedically certified deaths in the sample. VA methods were successful in assigning specific causes for most cases with ill-defined causes of death, resulting in plausible mortality patterns. The Malaysian government issued official instructions for routine implementation of VA methods for nonmedically certified deaths. Nationwide capacity development was implemented to improve data quality. These activities provide several lessons for strengthening the national mortality statistics programs.