Implementation of a home-based colorectal cancer screening intervention in Malaysia (CRC-SIM)
Abstract Introduction The 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. Methods This quasi-experimental study was informed by the Imp...
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-022-10487-6 |
| _version_ | 1797958636665831424 |
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| author | Désirée Schliemann Kogila Ramanathan Nor Saleha Binti Ibrahim Tamin Ciaran O’Neill Christopher R Cardwell Roshidi Ismail Zaid Kassim Frank Kee Tin Tin Su Michael Donnelly |
| author_facet | Désirée Schliemann Kogila Ramanathan Nor Saleha Binti Ibrahim Tamin Ciaran O’Neill Christopher R Cardwell Roshidi Ismail Zaid Kassim Frank Kee Tin Tin Su Michael Donnelly |
| author_sort | Désirée Schliemann |
| collection | DOAJ |
| description | Abstract Introduction The 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. Methods This 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. Results Seven 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. Conclusion Home-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. |
| first_indexed | 2024-04-11T00:21:45Z |
| format | Article |
| id | doaj.art-546286cf93a14f40bed5a1ca9312a4bb |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-11T00:21:45Z |
| publishDate | 2023-01-01 |
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| series | BMC Cancer |
| spelling | doaj.art-546286cf93a14f40bed5a1ca9312a4bb2023-01-08T12:14:30ZengBMCBMC Cancer1471-24072023-01-0123111210.1186/s12885-022-10487-6Implementation of a home-based colorectal cancer screening intervention in Malaysia (CRC-SIM)Désirée Schliemann0Kogila Ramanathan1Nor Saleha Binti Ibrahim Tamin2Ciaran O’Neill3Christopher R Cardwell4Roshidi Ismail5Zaid Kassim6Frank Kee7Tin Tin Su8Michael Donnelly9Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University BelfastGlobal Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University MalaysiaMinistry of Health MalaysiaCentre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University BelfastCentre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University BelfastGlobal Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University MalaysiaSegamat District Health OfficeCentre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University BelfastCentre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University BelfastCentre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University BelfastAbstract Introduction The 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. Methods This 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. Results Seven 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. Conclusion Home-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.https://doi.org/10.1186/s12885-022-10487-6Colorectal neoplasmsEarly detectionScreeningFecal occult blood testImplementation ScienceLMIC |
| spellingShingle | Désirée Schliemann Kogila Ramanathan Nor Saleha Binti Ibrahim Tamin Ciaran O’Neill Christopher R Cardwell Roshidi Ismail Zaid Kassim Frank Kee Tin Tin Su Michael Donnelly Implementation of a home-based colorectal cancer screening intervention in Malaysia (CRC-SIM) BMC Cancer Colorectal neoplasms Early detection Screening Fecal occult blood test Implementation Science LMIC |
| title | Implementation of a home-based colorectal cancer screening intervention in Malaysia (CRC-SIM) |
| title_full | Implementation of a home-based colorectal cancer screening intervention in Malaysia (CRC-SIM) |
| title_fullStr | Implementation of a home-based colorectal cancer screening intervention in Malaysia (CRC-SIM) |
| title_full_unstemmed | Implementation of a home-based colorectal cancer screening intervention in Malaysia (CRC-SIM) |
| title_short | Implementation of a home-based colorectal cancer screening intervention in Malaysia (CRC-SIM) |
| title_sort | implementation of a home based colorectal cancer screening intervention in malaysia crc sim |
| topic | Colorectal neoplasms Early detection Screening Fecal occult blood test Implementation Science LMIC |
| url | https://doi.org/10.1186/s12885-022-10487-6 |
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