I refer to Dr Jacob George's letter stating that Malaysia has only 39 oncologists and that we actually need 100 based on the recommended ratio of one oncologist per 250,000 population. I have to say that I doubt this figure as recommended ratios are usually based on Western country models.

Those countries have very different age profiles from Malaysia. I suggest the Malaysian authorities consider the local age profile and cancer incidence in estimating the need of oncologists, if this has not been done yet.

Until such official figures are made available, I have taken the liberty to do some preliminary calculations which suggest that the number of oncologists needed in Malaysia is between 40 and 45.

Assuming Jacob's recommended ratio reflects a western country such as the UK, then we also assume that the proportion of older people in the UK is higher than in Malaysia. For example 33 percent of the UK population (2001 UK Census) is above the age of 50, but the corresponding figure for Malaysia is only 13.2% (2000 Malaysian Census).

As most cancer cases affect those above 50, Malaysia can expect fewer cancer cases per population than the UK. Hence, we don't need to employ the UK's recommended ratio.

Dividing the ratio between the over-50s in Malaysia and the UK (13.2%/33% = 40%), I estimate that we only need 40% of the total figure needed in the West. This means we need only 40 instead of 100 oncologists.

Using a different approach which takes into account all age groups (instead of only those above 50) and the fact that Malaysians have higher liver cancer rate, I estimate that Malaysia's current need is between 42 to 45 oncologists.

With the current 39 oncologists, we will only need a further six of these cancer specialists rather than the 61 if the recommended ratio is used.

For the time being, the shortage of oncologists in the country is perhaps not as desperate as some would suggest. However, the situation may change with an ageing population exerting more pressure on the healthcare system.