Factors Associated with Participation in Colorectal Cancer Screening Using a Fecal Immunochemical Test (FIT) in Thai Population Aged 45 to 74 years in Namphong District, Khon Kaen Province

2021 ◽  
Vol 104 (7) ◽  
pp. 1067-1072

Background: Presently, the level of participation in screening programs for colorectal cancer (CRC) with Fecal Immunochemical Test (FIT) is considerably low. Objective: To investigate factors associated with participation in CRC screening using a FIT in the Thai population age 45 to 74 years in the Namphong District of Khon Kaen Province. Materials and Methods: In the present study, the unmatched case-control study design was applied. Three hundred ten participants were equally divided into two groups with 155 participants in the study group and the other 155 in the control group. The data were collected by conducting interviews. Moreover, to explain the association between the factors, multiple logistic regressions were used with adjusted odds ratio (ORadj), a confidence level at 95%, and with p<0.05. Results: It was found that ages were equal to or higher than 60 years (ORadj 2.08; 95%CI 1.19 to 3.63), the lower education level (ORadj 3.70; 95% CI 1.86 to 7.33), a family history of cancer (ORadj 5.25; 95% CI 2.14 to 12.86), receiving advice from public health officials regarding CRC screening (ORadj 3.09; 95% CI 1.81 to 5.27), and high level of knowledge about CRC (ORadj 4.01; 95% CI 2.09 to 7.69) had all been related to participation in the CRC screening program with a statistical significance (p<0.05). Conclusion: The results revealed that receiving advice from public health officials regarding CRC screening and that proper knowledge had been related to participation in screening programs for CRC with the FIT. Thus, to raise awareness and create a greater understanding, public health officers should disseminate knowledge about CRC. Information about the colorectal screening with the FIT should especially be spread to those people who are younger than 60 years of age, have educational levels higher than the primary level, and to those, who have no family history of CRC. Keywords: Colorectal Cancer Screening; Fecal Immunochemical Test (FIT); Thai population

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243158
Author(s):  
Marta Malagón ◽  
Sara Ramió-Pujol ◽  
Marta Serrano ◽  
Joan Amoedo ◽  
Lia Oliver ◽  
...  

Guidelines recommend routine screening for colorectal cancer (CRC) in asymptomatic adults starting at age 50. The most extensively used noninvasive test for CRC screening is the fecal immunochemical test (FIT), which has an overall sensitivity for CRC of approximately 61.0%-91.0%, which drops to 27.0%-67.0% for advanced adenomas. These figures contain a high false-positive rate and a low positive predictive value. This work aimed to develop a new, noninvasive CRC screening tool based on fecal bacterial markers capable of decreasing FIT false-positive rates in a FIT-positive population. We defined a fecal bacterial signature (RAID-CRC Screen) in a proof-of-concept with 172 FIT-positive individuals and validated the obtained results on an external cohort of 327 FIT-positive subjects. All study participants had joined the national CRC screening program. In the clinical validation of RAID-CRC Screen, a sensitivity of 83.9% and a specificity of 16.3% were obtained for the detection of advanced neoplasm lesions (advanced adenomas and/or CRC). FIT 20 μg/g produced 184 false-positive results. Using RAID-CRC Screen, this value was reduced to 154, thus reducing the false-positive rate by 16.3%. The RAID-CRC Screen test could be implemented in CRC screening programs to allow a significant reduction in the number of colonoscopies performed unnecessarily for FIT-positive participants of CRC screening programs.


Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1520
Author(s):  
Cristina Regueiro ◽  
Raquel Almazán ◽  
Isabel Portillo ◽  
María Besó ◽  
Carlos Tourne-Garcia ◽  
...  

Colorectal cancer (CRC) screening programs have been implemented to reduce the burden of the disease. When an advanced colonic lesion is detected, clinical practice guidelines recommend endoscopic surveillance with different intervals between explorations. Endoscopic surveillance is producing a considerable increase in the number of colonoscopies, with a limited effect on the CRC incidence. Instead, participation in CRC screening programs based on the fecal immunochemical test (FIT) could be a non-inferior alternative to endoscopic surveillance to reduce 10-year CRC incidence. Based on this hypothesis, we have designed a multicenter and randomized clinical trial within the Spanish population CRC screening programs to compare FIT surveillance with endoscopic surveillance. We will include individuals aged from 50 to 65 years with complete colonoscopy and advanced lesions resected within the CRC screening programs. Patients will be randomly allocated to perform an annual FIT and colonoscopy if fecal hemoglobin concentration is ≥10 µg/g, or to perform endoscopic surveillance. On the basis of the non-superior CRC incidence, we will recruit 1894 patients in each arm. The main endpoint is 10-year CRC incidence and the secondary endpoints are diagnostic yield, participation, adverse effects, mortality and cost-effectiveness. Our results may modify the clinical practice after advanced colonic resection in CRC screening programs.


2021 ◽  
pp. 096914132199748
Author(s):  
Andrew Wang ◽  
Briton Lee ◽  
Shreya Patel ◽  
Evans Whitaker ◽  
Rachel B Issaka ◽  
...  

Objective Digital health care offers an opportunity to scale and personalize cancer screening programs, such as mailed outreach for colorectal cancer (CRC) screening. However, studies that describe the patient selection strategy and process for CRC screening are limited. Our objective was to evaluate implementation strategies for selecting patients for CRC screening programs in large health care systems. Methods We conducted a systematic review of 30 studies along with key informant surveys and interviews to describe programmatic implementation strategies for selecting patients for CRC screening. PubMed and Embase were searched since inception through December 2018, and hand searches were performed of the retrieved reference lists but none were incorporated ( n = 0). No language exclusions were applied. Results Common criteria for outreach exclusion included: being up-to-date with routine CRC screening ( n = 22), comorbidities ( n = 20), and personal history ( n = 22) or family history of cancer ( n = 9). Key informant surveys and interviews were performed ( n = 28) to understand data sources and practices for patient outreach selection, and found that 13 studies leveraged electronic medical care records, 10 studies leveraged a population registry (national, municipal, community, health), 4 studies required patient opt-in, and 1 study required primary care provider referral. Broad ranges in fecal immunochemical test completion were observed in community clinic ( n = 8, 31.0–59.6%), integrated health system ( n = 5, 21.2–82.7%), and national regional CRC screening programs ( n = 17, 23.0–64.7%). Six studies used technical codes, and four studies required patient self-reporting from a questionnaire to participate. Conclusion This systematic review provides health systems with the diverse outreach practices and technical tools to support efforts to automate patient selection for CRC screening outreach.


2014 ◽  
Vol 28 (4) ◽  
pp. 191-197 ◽  
Author(s):  
Mahmoud Torabi ◽  
Christopher Green ◽  
Zoann Nugent ◽  
Salaheddin M Mahmud ◽  
Alain A Demers ◽  
...  

OBJECTIVE: To investigate the geographical variation and small geographical area level factors associated with colorectal cancer (CRC) mortality.METHODS: Information regarding CRC mortality was obtained from the population-based Manitoba Cancer Registry, population counts were obtained from Manitoba’s universal health care plan Registry and characteristics of the area of residence were obtained from the 2001 Canadian census. Bayesian spatial Poisson mixed models were used to evaluate the geographical variation of CRC mortality and Poisson regression models for determining associations with CRC mortality. Time trends of CRC mortality according to income group were plotted using joinpoint regression.RESULTS: The southeast (mortality rate ratio [MRR] 1.31 [95% CI 1.12 to 1.54) and southcentral (MRR 1.62 [95% CI 1.35 to 1.92]) regions of Manitoba had higher CRC mortality rates than suburban Winnipeg (Manitoba’s capital city). Between 1985 and 1996, CRC mortality did not vary according to household income; however, between 1997 and 2009, individuals residing in the highest-income areas were less likely to die from CRC (MRR 0.77 [95% CI 0.65 to 0.89]). Divergence in CRC mortality among individuals residing in different income areas increased over time, with rising CRC mortality observed in the lowest income areas and declining CRC mortality observed in the higher income areas.CONCLUSIONS: Individuals residing in lower income neighbourhoods experienced rising CRC mortality despite residing in a jurisdiction with universal health care and should receive increased efforts to reduce CRC mortality. These findings should be of particular interest to the provincial CRC screening programs, which may be able to reduce the disparities in CRC mortality by reducing the disparities in CRC screening participation.


2020 ◽  
Vol 158 (6) ◽  
pp. S-1180-S-1181
Author(s):  
Temitayo Gboluaje ◽  
Martha Gwengi ◽  
Titi Olanipekun ◽  
Taiwo A. Ajose ◽  
Krystal Mills ◽  
...  

2020 ◽  
Vol 9 (10) ◽  
pp. 3302
Author(s):  
Yoon Suk Jung ◽  
Jinhee Lee ◽  
Hye Ah Lee ◽  
Chang Mo Moon

Background: The potential role of the fecal immunochemical test (FIT) in individuals with a family history of colorectal cancer (CRC) remains unclear. We assessed interval cancer rate (ICR) after the FIT and FIT diagnostic performance according to family history of CRC. Methods: Using the Korean National Cancer Screening Program Database, we collected data on subjects who underwent the FIT between 2009 and 2011. The interval cancer rate (ICR) was defined as the number of subjects diagnosed with CRC within 1 year after the FIT per 1000 subjects with negative FIT results. Results: Of 5,643,438 subjects, 224,178 (3.97%) had a family history of CRC. FIT positivity rate (6.4% vs. 5.9%; adjusted relative risk (aRR) 1.11; 95% confidence interval (CI) 1.09–1.13) and ICR (1.4 vs. 1.1; aRR 1.43 (95% CI 1.27–1.60)) were higher in these subjects than in those with no such history. These results were the same regardless of whether subjects had undergone colonoscopy within the last 5 years before the FIT. However, the diagnostic performance of the FIT for CRC, as measured using the area under the operating characteristic curve, was similar between subjects without a family history and those with one (85.5% and 84.6%, respectively; p = 0.259). Conclusion: the FIT was 1.4 times more likely to miss CRC in subjects with a family history than in those without (aRR 1.43 for ICR), although its diagnostic performance was similar between the two groups. Our results suggest that for individuals with a family history of CRC, colonoscopy should be preferred over FIT for both screening and surveillance.


Cancer ◽  
2015 ◽  
Vol 121 (22) ◽  
pp. 3982-3989 ◽  
Author(s):  
Ugo Fedeli ◽  
Manuel Zorzi ◽  
Emanuele D.L. Urso ◽  
Nicola Gennaro ◽  
Angelo P. Dei Tos ◽  
...  

2021 ◽  
Vol 8 ◽  
Author(s):  
Ru-chen Zhou ◽  
Pei-zhu Wang ◽  
Yue-yue Li ◽  
Yan Zhang ◽  
Ming-jun Ma ◽  
...  

Objective: The diagnostic efficiency of the quantitative fecal immunochemical test (qFIT) has large variations in colorectal cancer (CRC) screening. We aimed to explore whether the practical sample collection operant training could improve the diagnostic accuracy of the qFIT in CRC screening.Methods: Moderate-/high-risk individuals aged 50–75 years old were invited to participate in a prospective observational study between July 2020 and March 2021. Participants took a qFIT sample without fecal sample collection operant training in advance and then completed another qFIT sample after the operant training. The primary outcome was the sensitivity and specificity of the qFITs for CRC and advanced colorectal neoplasia (ACRN). The secondary outcome was the difference in the area under the curves (AUCs) and the concentrations of the fecal hemoglobin (Hb) between the qFIT without and after the operant training.Results: Out of 913 patients, 81 (8.9%) patients had ACRN, including 25 (2.7%) patients with CRC. For CRC, the sensitivities of the qFIT without and after the operant training at 10 μg/g were 80.4 and 100.0%, respectively, and the specificities were 90.1 and 88.4%, respectively. For ACRN, the sensitivities were 49.4 and 69.1% and the specificities were 91.7 and 91.3%, respectively. The AUC of the qFIT after the operant training was significantly higher than that without the operant training for CRC (p = 0.027) and ACRN (p = 0.001). After the operant training, the concentration of the fecal Hb was significantly higher than that without the operant training (p = 0.009) for ACRN, but there was no significant difference for CRC (p = 0.367).Conclusion: Practical sample collection operant training improves the diagnostic accuracy of the qFIT, which increases the detection of the low concentrations of fecal Hb. Improving the quality of the sample collection could contribute to the diagnostic efficiency of the qFIT in CRC screening.


2020 ◽  
pp. 525-531
Author(s):  
Elizabeth O. Labaeka ◽  
Achiaka E. Irabor ◽  
David O. Irabor

PURPOSE Colorectal cancer (CRC) is a disease of public health importance because of the increasing incidence of the disease and presentation in advanced stage of the disease in Western Africa. CRC is amenable to screening because of the long course of premalignant lesions before final development of the disease. Despite this, the practice of CRC screening is inadequate at the sites in this study. The fecal immunochemical test (FIT) is one of the recommended noninvasive methods for CRC screening. It has a sensitivity of 96%, specificity of 90%, and an overall accuracy of 95%. We aimed to determine the practicability of FIT for CRC screening in patients aged 40 to 75 years who attended primary care clinics in the University College Hospital, Ibadan, Nigeria. PATIENTS AND METHODS A total of 422 patients selected by systematic random sampling were recruited and offered free FIT screening. Participants with a positive finding had additional GI examination, including a digital rectal examination, proctoscopy, and colonoscopy, if no lesion was biopsied during proctoscopy. RESULTS The mean (± standard deviation) age of the respondents was 62 ± 9.61 years. The prevalence of a positive FIT in the study was 10.1%. The FIT was not completed by 3.8% of patients, and the rate of completion of additional evaluation after a positive FIT reduced as the investigations became invasive, with 36.8% and 71.1% noncompletion rates for proctoscopy and colonoscopy, respectively. CONCLUSION A FIT-based screening for age and risk-appropriate patients is practical in this environment, where the capacity and acceptability of colonoscopy are limited.


2017 ◽  
Vol 6 (3) ◽  
pp. 471-479 ◽  
Author(s):  
Clasine M de Klerk ◽  
Manon van der Vlugt ◽  
Patrick M Bossuyt ◽  
Evelien Dekker

Background Symptomatic invitees are advised not to participate in colorectal cancer (CRC) screening but to directly consult their general practitioner (GP), because fecal immunochemical test (FIT) sensitivity for cancer is not optimal. This recommendation may not always be followed in daily practice. We evaluated how many FIT-positive participants had CRC-related symptoms and whether the presence of symptoms was associated with the presence and location of CRC/advanced neoplasia. Methods We prospectively collected data on CRC-related symptoms in all FIT-positive participants in the Dutch CRC screening program, referred to our endoscopy centers between 2014 and 2016, and evaluated whether symptoms were associated with detected CRC/advanced neoplasia at colonoscopy. Results Of 527 FIT-positive participants, 314 had advanced neoplasia, of which 41 had CRC. Overall, 246 (47%; 95% confidence interval (CI) 0.42–0.51) reported CRC-related symptoms. A change in bowel habits (odds ratio (OR) 2.86, CI 1.23–6.62) and visible blood in stool (OR 8.65, CI 2.34–32.0) were associated with the detection of CRC at colonoscopy. We did not observe significant associations between evaluated symptoms and advanced neoplasia. Conclusions A large proportion of FIT-positive screening participants have CRC-related symptoms. This suggests that current instructions do not retain symptomatic screening invitees from participation and awareness of CRC-related symptoms is inadequate.


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