Assessment Of A Colorectal Cancer Screening Project Using Faecal Occult Blood Test (FOBT) Kit In Penang State, Malaysia
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Date
2014-12
Authors
Alaydrus, Lely Lubna
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Abstract
Incidence of colorectal cancer (CRC) has been increasing in many countries due to
changes in life style. In Malaysia, CRC is the second most common cancer with the
highest incidence among the Chinese ethnic group. Periodic screening for CRC with
faecal occult blood test kit (FOBT) has been shown to reduce the mortality and
morbidity from this disease. The objective of this study was to assess a CRC
screening project using FOBT kit in Penang, Malaysia. A total of 970 FOBT kits
were distributed between June and November 2009 during CRC public health talks.
Data was collected using self-administered questionnaires and telephone interviews.
Statistical analyses were carried out using PASW version 18 for descriptive statistics
as well as for the binary logistic regression analyses to determine associated factors
for CRC knowledge and return of FOBT. A total of 617 participants completed the
first questionnaire with a response rate of 63.6 %. Few (3.8 %) reported
encountering difficulties in doing the FOBT. The level of awareness of stool
examination and knowledge of CRC were poor among participants. The factors
associated with poor knowledge of CRC were low education (OR=3.07; 95%CI:
2.01-4.70) and not having family history of cancer (OR=1.71; 95%CI: 1.16-2.52).
Older age (OR =3.31; 95%CI: 2.09-5.23), Chinese ethnicity (OR=2.35; 95%CI: 1.32-
4.19) and higher education (OR=2.26; 95%CI:1.49- 3.42) were factors associated
with the return of FOBT kit. Thirty-one participants had positive FOBT result and some reported feeling anxious (30%) and frightened (25%) after knowing the result.
Eight participants underwent colonoscopy. One case of CRC was found in a 61 year
old Chinese female; two participants had polyps; one participant with ulcerative
colitis and another with haemorrhoids. From the 9 participants who did not undergo
colonoscopy, 6 reported seeing doctors for follow-up but were not advised
colonoscopy and 3 did not seek any medical advice for the positive FOBT. In
conclusion, this study found a return rate for FOBT of 56.7% and only a quarter of
the positive FOBT cases underwent colonoscopy. Although the CRC screening
project identified one case of CRC, it is recommended that steps be taken to increase
the compliance in FOBT return and colonoscopy following a positive FOBT.
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Keywords
Colorectal Neoplasms