• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.237-241
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• 2012

Objective: Screening for colorectal cancer using guaiac-based fecal occult blood tests (gFOBT) is well established in Western populations, but is hampered by poor patient compliance due to the imposed dietary restrictions. Fecal immunochemical tests (FIT) do not require dietary restriction, but are more expensive than gFOBT and therefore restrict its use in developing countries in Asia. However, Asian diets being low in meat content may not require diet restriction for gFOBT to achieve equivalent results. The objective of this study was to evaluate and compare the validity and suitability of gFOBT and FIT or a combination of the two in screening for colorectal neoplasias without prior dietary restriction in an Asian population. Methods: Patients referred to the Endoscopic Unit for colonoscopy were recruited for the study. Stool samples were collected prior to bowel preparation, and tested for occult blood with both gFOBT and FIT. Dietary restriction was not imposed. To assess the validity of either tests or in combination to detect a neoplasm or cancer in the colon, their false positive rates, their sensitivity (true positive rate) and the specificity (true negative rate) were analyzed and compared. Results: One hundred and three patients were analysed. The sensitivity for picking up any neoplasia was 53% for FIT, 40% for gFOBT and 23.3% for the combination. The sensitivities for picking up only carcinoma were 77.8%, 66.7% and 55.5%, respectively. The specificity for excluding any neoplasia was 91.7% for FIT, 74% for gFOBT and 94.5% for a combination, whereas for excluding only carcinomas they were 84%, 73.4% and 93.6%. Of the 69 with normal colonoscopic findings, FOBT was positive in 4.3%, 23.2 %and 2.9% for FIT, gFOBT, or combination of tests respectively. Conclusion: FIT is the recommended method if we are to dispense with dietary restriction in our patients because of its relatively low-false positivity and better sensitivity and specificity rates.

• Research in Community and Public Health Nursing
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• v.33 no.2
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• pp.237-246
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• 2022

Purpose: The aim of this study was to investigate the relationship between the 5-year survival rate, socioeconomic status, and SEER (Surveillance Epidemiology and End Results) stage of stomach, colorectal, breast and cervical cancer patients. Methods: A total of 11,770 cases of four target cancers, which were diagnosed during 2005-2007, were extracted from the database of Gwangju-Jeonnam Regional Cancer Registry. The subjects of the study were 11,770 including stomach (n=5,479), colorectal (n=3,565), breast (n=1,516) and cervical cancers (n=710). Cox's proportional hazards model was used to obtain the hazards ratio (HR) according to the SEER stage and socioeconomic status. Results: Stomach cancer had a significantly higher HR in the medical aid recipients (HR=1.39), and the group below 20% (HR=1.20) compared to the group with the highest income level. Colorectal cancer had a significantly higher HR in the medical aid recipients (HR=1.26) than in the group with the highest income level. In addition, stomach, colorectal, breast and cervical cancers had a significantly higher HR according to the SEER stage in regional direct (stomach=4.10, colorectal=1.76, breast=12.90, cervical=3.10), regional lymph only(stomach=2.58, colorectal=2.33, breast=4.32, cervical=4.43), regional both (stomach=6.74 colorectal=3.04, breast=15.57 cervical=6.50), and regional NOS (Not Otherwise Specified)/distant (stomach=17.53, colorectal=11.53, breast=25.34, cervical=26.51) than in situ and localized only. Conclusion: In order to increase the cancer survival rate, a support system for early detection and early treatment of cancer should be established for groups with low individual income levels, and regular health checkups and management measures should be actively implemented through the National Cancer Screening Program.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6487-6491
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• 2013

To investigate the cognition of medical professionals when following screening guidelines for colorectal cancer (CRC) and barriers to CRC screening. Between February 2012 and December 2012, an anonymous survey with 19-questions based on several CRC screening guidelines was randomly administered to gastroenterologists, oncologists, general surgeons, and general practitioners in Jiangsu, a developed area in China where the incidence of CRC is relatively high. The average cognitive score was 26.4% among 924 respondents. Gastroenterologists and oncologists had higher scores compared with others (p<0.01 and p<0.01, respectively); doctor of medicine (M.D.) with or without doctor of philosophy (Ph.D.) or holders with bachelor of medical science (BMS) achieved higher scores than other lower degree holders (P<0.05). More importantly, doctors who finished CRC related education in the past year achieved higher scores than the others (p<0.001). The most commonly listed barriers to referring high-risk patients for CRC screening were "anxiety about colonoscopy without anesthesia", "lack of awareness of the current guidelines" and "lack of insurance reimbursement". Lack of cognition was detected among doctors when following CRC screening guidelines for high-risk populations. Educational programs should be recommended to improve their cognition and reduce barriers to CRC screening.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3179-3183
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• 2016

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.

• Journal of Digestive Cancer Research
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• v.1 no.1
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• pp.1-5
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• 2013

Incidence of colorectal cancer has been increasing in Korea probably due to the westernized life style. Although the technical development of colonoscopy and introduction of screening examination has led to the detection of early colorectal cancer, considerable patients still have clinical symptoms of colorectal obstruction. Most of these patients are old and they have advances stage of cancer or severe co-morbidities. In addition, the emergency operation under poor preparation state of colon can lead to serious mortality or complications. Since the introduction of colorectal stent, there have been a large number of studies for recent 10 years. It seems that the role of colorectal stent in the palliative indication or bridge to surgery has been recognized. A well designed, randomized prospective study with long term data is necessary to support the role of colorectal stent in the malignant colorectal obstruction.

• Journal of Digestive Cancer Research
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• v.11 no.3
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• pp.175-176
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• 2023

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.9801-9804
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• 2014

Background: Colorectal cancer is currently the third most common cancer in Indonesia, yet colonoscopy - the most accepted mode of screening to date - is not done routinely and national data are still lacking. Objective: To determine the detection rate of colorectal cancers and adenomas in unselected patients undergoing colonoscopy for various large bowel symptoms at the Digestive Disease and GI Oncology Centre, Medistra Hospital in Jakarta, Indonesia. Materials and Methods: Colonoscopy data from January 2009 to December 2012 were reviewed. New patients referred for colonoscopy were included. Data collected were patient demographic and significant colonoscopy findings such as the presence of hemorrhoids, colonic polyps, colonic diverticula, inflammation, and tumor mass. Histopathological data were obtained for specimens taken by biopsy. Associations between categorical variables were analyzed using chi-square test, while mean differences were tested using the t-test. Results: A total of, 1659 cases were included in this study, 889 (53.6%) of them being men. Polyps or masses were found in 495 (29.8%) patients while malignancy was confirmed in 74 (4.5%). Patients with a polyp or mass were significantly older (60.2 vs 50.8 years; p<0.001; t-test) and their presence was significantly associated with male gender (35.0% vs 23.9%; prevalent ratio [PR] 1.71; 95% confidence interval [CI] 1.38-2.12; p<0.001) and age >50 years (39.6% vs 16.6%; PR 3.29; 95% CI 2.59-4.12; p<0.001). Neoplastic lesions was found in 257 (16.1%), comprising 180 (11.3%) adenomas, 10 (0.6%) in situ carcinomas, and 67 (4.2%) carcinomas. Conclusions: Polyps or masses were found in 30% of colonoscopy patients and malignancies in 16.1%. These figures do not represent the nation-wide demographic status of colorectal cancer, but may reflect a potentially increasing major health problem with colorectal cancer in Indonesia.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3809-3813
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• 2012

Background and Objectives: Colorectal cancer (CRC) is a major health problem in the Kingdom of Saudi Arabia (KSA). Our aim was to characterize the epidemiology of CRC in the Saudi population. Design and Setting: Retrospective analysis of all cases of CRC recorded in the Saudi Cancer Registry (SCR) between January 2001 and December 2006 amongst Saudi citizens in KSA. Patients and Methods: Data were retrieved from the database of the SCR. Descriptive statistics was performed using SPSS. Results: A total of 4,201 cases of CRC were registered in the SCR. The incidence of CRC increased between 2001 and 2006. The mean age of patients at the time of diagnosis was 58 years; most patients were above 45 years of age (n=3322; 79.1%). At the time of diagnosis, 977 patients (23.0%) presented with localized disease and 1,018 (24.0%) had distant metastasis. The most frequent pathological variant was adenocarcinoma (73%), with grade 2 (moderately differentiated) being the most common grade among all variants (61%). For all cancer grades, the frequency of CRC was significantly higher among patients >45 years (P=0.004), who presented with more advanced disease (stages III and IV) (P=0.012). Based on logistic regression, age >45 years was associated with advanced regional presentation (P=0.001). Tumor grade was associated with advanced regional presentation and metastasis. Conclusions: There was an increase in the incidence of CRC between 2001 and 2006. The age at the time of diagnosis was low when compared with reports from developed countries. A nationwide approach is needed to encourage and illustrate the importance of screening programs.

• Journal of Korean Academy of Nursing
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• v.45 no.1
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• pp.129-138
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• 2015

Purpose: The purpose of this study was to report the instrument modification and validation processes to make existing health belief model scales culturally appropriate for Korean Americans (KAs) regarding colorectal cancer (CRC) screening utilization. Methods: Instrument translation, individual interviews using cognitive interviewing, and expert reviews were conducted during the instrument modification phase, and a pilot test and a cross-sectional survey were conducted during the instrument validation phase. Data analyses of the cross-sectional survey included internal consistency and construct validity using exploratory and confirmatory factor analysis. Results: The main issues identified during the instrument modification phase were (a) cultural and linguistic translation issues and (b) newly developed items reflecting Korean cultural barriers. Cross-sectional survey analyses during the instrument validation phase revealed that all scales demonstrate good internal consistency reliability (Cronbach's alpha=.72~.88). Exploratory factor analysis showed that susceptibility and severity loaded on the same factor, which may indicate a threat variable. Items with low factor loadings in the confirmatory factor analysis may relate to (a) lack of knowledge about fecal occult blood testing and (b) multiple dimensions of the subscales. Conclusion: Methodological, sequential processes of instrument modification and validation, including translation, individual interviews, expert reviews, pilot testing and a cross-sectional survey, were provided in this study. The findings indicate that existing instruments need to be examined for CRC screening research involving KAs.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.195-198
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• 2012

To date, there was no controlled-study regarding awareness and knowledge of colorectal cancer in the Turkish population. We therefore designed a questionnaire consisting of items related to socio-demographic parameters, medical and family history and questions of awareness and knowledge about colorectal cancer for use in a descriptive cross-sectional study. An interviewer-administered technique was applied and 450 subjects were interviewed in the outpatient clinics at Near East University Hospital. Among all subjects, 337 were found to be eligible for the study group. Exclusion criteria were age below 18 years, any cancer history, family history of colorectal cancer, current colorectal problems, history of any diagnostic or therapeutic interventions for colorectal diseases. All participants stated that they heard about colorectal cancer. When asked about the lifetime risk of colorectal carcinoma, only 25.4% of women and 37.9% of men estimated correctly. Univariate analysis revealed that the total awareness score was significantly correlated with age, marital status, parenthood and fecal occult blood testing history. On multivariate analysis of independent predictors for awareness of colorectal cancer were found to be history of fecal occult blood testing, age and marital status were found to be the most important determinants. As a conclusion, opportunistic screening with fecal occult blood test by physicians from non-gastrointestinal specialties not only helps to reduce the mortality but also increases the awareness of colorectal cancer.