- Volume 17 Issue 7
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Pioneering Annual Colorectal Cancer Screening and Treatment Targeting Low Income Communities in Malaysia (2010-2015)
- Tze, Christina Ng Van (EMPOWERED - The Cancer Advocacy Society of Malaysia) ;
- Fitzgerald, Henry (Hospital Selayang) ;
- Qureshi, Akhtar (Sunway Medical Centre) ;
- Tan, Huck Joo (Sunway Medical Centre) ;
- Low, May Lee (International Medical University)
- Published : 2016.07.01
The aim of this study was to assess the rate of uptake of a customised annual Colorectal Cancer Awareness, Screening and Treatment Project (CCASTP) using faecal immunohistochemical test (FIT) kits in low income communities in Malaysia. The immediate objectives were (1) to evaluate the level of adherence of CRC screening among low-income groups, (2) to assess the knowledge and awareness of the screened population and (3) to assess the accuracy of FIT kits. A total of 1,581 FIT kits were distributed between years 2010 to 2015 to healthy asymptomatic participants of the annual CCASTP organized by Empowered - the Cancer Advocacy Society of Malaysia. Data for socio-demographic characteristics, critical health and lifestyle information of the registered subjects were collected. Findings for use of the FIT kits were collected when they were returned for stool analyses. Those testingd positive were invited to undergo a colonoscopy examination. A total of 1,436 (90.8%) of the subjects retuned the FIT-kits, showing high compliance. Among the 129 subjects with positive FIT results, 92 (71.3%) underwent colonoscopy. Six cases (6.5%) of CRC were found. Based on the data collected, the level of awareness of stool examination and knowledge about CRC was poor amongst the participants. Gender, age group, ethnicity and risk factors (i.e. smoking, lack of exercise and low consumption of fresh fruits) were associated with positive FIT-kit results. In conclusion, CRC screening can be performed in the community with a single FIT-kit. Although CRC knowledge and awareness is poor in low-income communities, the average return rate of the FIT kits and rate of colonoscopy examination were 91.2% and 70.3%, respectively.
Colorectal cancer screening;cancer awareness;low-income communities;Malaysia
- Aizat AAA, Nurfatimah MSS, Aminudin MM, Ankathil, R. (2013). XPC Lys939Gln polymorphism, smoking and risk of sporadic colorectal cancer among Malaysians. World J Gastroenterol: WJG, 19, 3623-8. https://doi.org/10.3748/wjg.v19.i23.3623
- Azeem S, Gillani SW, Siddiqui A, et al (2015). Diet and colorectal cancer risk in Asia-a systematic review. Asian Pac J Cancer Prev, 16, 5389-5396. https://doi.org/10.7314/APJCP.2015.16.13.5389
- Chiu HM, Chang LC, Hsu WF, et al (2015). Non-invasive screening for colorectal cancer in Asia. Best Pract Res Clin Gastroenterol, 29, 953-965. https://doi.org/10.1016/j.bpg.2015.09.015
- Frederiksen BL, Jorgensen T, Brasso K, et al (2010). Socioeconomic position and participation in colorectal cancer screening. Br J Cancer, 103, 1496-1501. https://doi.org/10.1038/sj.bjc.6605962
- Giacosa A, Franceschi S, La Vecchia C, et al (1999). Energy intake, overweight, physical exercise and colorectal cancer risk. Eur J Cancer Prev, 8, 53-60. https://doi.org/10.1097/00008469-199912001-00008
- Haggar FA, Boushey RP (2009). Colorectal cancer epidemiology: incidence, mortality, survival, and risk factors. Clin Colon Rectal Surg, 22, 191-197. https://doi.org/10.1055/s-0029-1242458
- Hilmi I, Hartono JL, Goh KL (2010). Negative perception in those at highest risk-potential challenges in colorectal cancer screening in an urban Asian population. Asian Pac J of Cancer Prev, 11, 815-822
- Kong CK, Roslani AC, Law CW, et al (2010). Impact of socioeconomic class on colorectal cancer patient outcomes in Kuala Lumpur and Kuching, Malaysia. Asian Pac J Cancer Prev, 11, 969-74.
- Koo JH, Leong RW, Ching J, et al (2012). Knowledge of, attitudes toward, and barriers to participation of colorectal cancer screening tests in the Asia-Pacific region: a multicenter study. Gastrointest Endosc, 76, 126-135. https://doi.org/10.1016/j.gie.2012.03.168
- Lim KG (2014). A review of colorectal cancer research in Malaysia. Med J Malaysia, 69, 23-32.
- McCaffery K, Wardle J, Nadel M, et al. (2002). Socioeconomic variation in participation in colorectal cancer screening. J Med Screen, 9, 104-108. https://doi.org/10.1136/jms.9.3.104
- Ministry of Health of Malaysia (2006). National Cancer Registry, Malaysia Cancer Statistics Report; Data and Figure Peninsular Malaysia.
- Petty MT, Deacon MC, Alexeyeff MA, et al (1992). Readability and sensitivity of a new faecal occult blood test in a hospital ward environment. Comparison with an established test. Med J Aust, 156, 420-3.
- Pourhoseingholi MA (2014). Epidemiology and burden of colorectal cancer in Asia-Pacific region: what shall we do now? Transl Gastrointest Cancer, 3, 169-173.
- Schreuders EH, Ruco A, Rabeneck L, et al (2015). Colorectal cancer screening: a global overview of existing programmes. Gut, 64, 1637-49. https://doi.org/10.1136/gutjnl-2014-309086
- Smith A, Young GP, Cole SR, Bampton P (2006). Comparison of a brush-sampling fecal immunochemical test for hemoglobin with a sensitive guaiac-based fecal occult blood test in detection of colorectal neoplasia. Cancer, 107, 2152-9. https://doi.org/10.1002/cncr.22230
- Su TT, Goh JY, Tan J, et al (2013). Level of colorectal cancer awareness: a cross sectional exploratory study among multiethnic rural population in Malaysia. BMC Cancer, 13, 1-8. https://doi.org/10.1186/1471-2407-13-1
- Syful AM, Hassan MR, Junainah S, Rugayah B (2015). Immunochemical faecal occult blood test for colorectal cancer screening: a systematic review. Med J Malaysia, 70, 24-30.
- Yusoff HM, Daud N, Noor NM, Rahim AA (2012). Participation and barriers to colorectal cancer screening in Malaysia. Asian Pac J Cancer Prev, 13, 3983-7. https://doi.org/10.7314/APJCP.2012.13.8.3983