Implementation of a home-based colorectal cancer screening intervention in Malaysia (CRC-SIM)

BMC Cancer

Research

Christopher R Cardwell¹  Ciaran O’Neill¹  Désirée Schliemann¹  Michael Donnelly¹  Frank Kee¹  Tin Tin Su²  Kogila Ramanathan³  Roshidi Ismail³  Nor Saleha Binti Ibrahim Tamin⁴  Zaid Kassim⁵ 

[1] Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, UK;Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, UK;Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia;South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Petaling Jaya, Malaysia;Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia;South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Petaling Jaya, Malaysia;Ministry of Health Malaysia, Putrajaya, Malaysia;Segamat District Health Office, Johor, Malaysia;

关键词: Colorectal neoplasms;    Early detection;    Screening;    Fecal occult blood test;    Implementation Science;    LMIC;   

DOI  :  10.1186/s12885-022-10487-6

 received in 2022-07-26, accepted in 2022-12-26,  发布年份 2022

来源: Springer

【 摘 要 】

IntroductionThe Colorectal Cancer Screening Intervention for Malaysia (CRC-SIM) was a CRC study of home-based testing designed to improve low screening uptake using the immunochemical fecal occult blood test (iFOBT) in Malaysia.MethodsThis quasi-experimental study was informed by the Implementation Research Logic Model and evaluated with the RE-AIM framework. Trained data collectors recruited by phone, randomly selected, asymptomatic adults aged 50-75 years from Segamat District, who previously completed a health census form for the South East Asia Community Observatory (SEACO). Participants were posted an iFOBT kit and asked to return a photo of the completed test for screening by health care professionals. A regression analysis of evaluation data was conducted to identify which variables were associated with the outcome indicators of ‘study participation’ and ‘iFOBT completion’ and the CRC-SIM was evaluated in terms of its appropriateness, feasibility and acceptability.ResultsSeven hundred forty-seven eligible adults (52%) agreed to participate in this study and received an iFOBT kit. Participation was significantly lower amongst Chinese Malaysians (adjusted OR 0.45, 95% CI 0.35 - 0.59, p<0.001) compared to Malays and amongst participants from the rural sub-district (Gemereh) (adjusted OR 0.71, 95% CI 0.54 - 0.92, p=0.011) compared to the urban sub-district (Sungai Segamat). Less than half of participants (42%, n=311/747) completed the iFOBT. Test-kit completion was significantly higher amongst Chinese Malaysians (adjusted OR 3.15, 95% CI 2.11 - 4.69, p<0.001) and lower amongst participants with a monthly household income ≥RM 4,850 (adjusted OR 0.58, 95% CI 0.39 - 0.87, p=0.009) compared to participants with a lower household income. The main reported reason for non-participation was ‘not interested’ (58.6%) and main implementation challenges related to invalid photographs from participants and engaging iFOBT positive participants in further clinic consultations and procedures.ConclusionHome-testing for CRC (test completion) appeared to be acceptable to only around one-fifth of the target population in Malaysia. However, mindful of the challenging circumstances surrounding the pandemic, the CRC-SIM merits consideration by public health planners as a method of increasing screening in Malaysia, and other low- and middle-income countries.

【 授权许可】

CC BY   
© The Author(s) 2023

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