A 5-year evaluation of using stool-based test for opportunistic colorectal cancer screening in primary health institutions across Malaysia

Nor Saleha Ibrahim Tamin; Khursiah Ahmad Razalli; Siti Norain Sallahuddin; Huan-Keat Chan; Muhammad Radzi Abu Hassan

doi:10.1016/j.canep.2020.101829

A 5-year evaluation of using stool-based test for opportunistic colorectal cancer screening in primary health institutions across Malaysia

Cancer Epidemiol. 2020 Dec:69:101829. doi: 10.1016/j.canep.2020.101829. Epub 2020 Sep 28.

Authors

Nor Saleha Ibrahim Tamin¹, Khursiah Ahmad Razalli², Siti Norain Sallahuddin³, Huan-Keat Chan⁴, Muhammad Radzi Abu Hassan⁵

Affiliations

¹ Cancer Unit, Disease Control Division, Ministry of Health, 62590 Putrajaya, Malaysia. Electronic address: norsaleha@gmail.com.
² Cancer Unit, Disease Control Division, Ministry of Health, 62590 Putrajaya, Malaysia. Electronic address: khursiah@moh.gov.my.
³ Cancer Unit, Disease Control Division, Ministry of Health, 62590 Putrajaya, Malaysia. Electronic address: ppctnor@moh.gov.my.
⁴ Clinical Research Center, Sultanah Bahiyah Hospital, 05460 Alor Setar, Kedah, Malaysia. Electronic address: huankeat123@yahoo.com.
⁵ Department of Medicine, Sultanah Bahiyah Hospital, 05460 Alor Setar, Kedah, Malaysia. Electronic address: drradzi91@yahoo.co.uk.

PMID: 32998070
DOI: 10.1016/j.canep.2020.101829

Abstract

Introduction: The immunochemical fecal occult blood test (iFOBT) has been widely used for opportunistic colorectal cancer (CRC) screening in average-risk individuals seeking care from public health clinics in Malaysia. This study provides a 5-year outcome evaluation of such a practice.

Methods: The findings for a few outcome indicators, ranging from the iFOBT uptake to the CRC and polyp detection rates, were generated from the data contributed by 583 public health clinics between 2014 and 2018. The trends in their changes were also evaluated.

Results: The iFOBT uptake constantly increased over the years (p < 0.001), totaling 2.29 % (n = 127,957) as at 2018. Nearly 10 % (n = 11,872) of the individuals screened had a positive test result. Of those who underwent colonoscopy (n = 6,491), 4.04 % (n = 262) and 13.93 % (n = 904) were found to have CRC and polyps, respectively.

Conclusion: An uptrend in the CRC screening uptake was witnessed following the introduction of the iFOBT in public health clinics.

Keywords: Cancer early diagnosis; Cancer screening test; Colonoscopy; Colorectal neoplasms; Malaysia.

MeSH terms

Aged
Colorectal Neoplasms / diagnosis*
Early Detection of Cancer
Feces
Female
Humans
Malaysia
Male
Middle Aged
Occult Blood
Time Factors