Colorectal Cancer Screening

Abstract

To assess the awareness and acceptability of colorectal cancer (CRC) screening in noncompliant Singaporeans and to determine if their barriers can be overcome by education. A questionnaire developed from thematic analysis of open-ended interviews with 72 subjects was administered to 580 residents in a local high-rise housing estate. Participants aware of CRC screening were assessed for barriers and acceptability of CRC screening. All participants were subsequently educated about CRC screening and reassessed for barriers and acceptance. Those keen for fecal occult blood testing (FOBT) were offered FOBT kits and followed up. CRC screening awareness was poor. Having no symptoms was the most common barrier. More barriers to FOBT than to colonoscopy were reduced with education. After education, acceptability toward FOBT increased but rejection rates rose even higher. FOBT is probably Singapore's most acceptable screening modality. Education is limited by barriers, which need to be overcome by alternative measures.

Barriers to colorectal cancer screening in Asia: A systematic review

“…While there are few effective methods to tackle the psychological barriers, Sung et al [6] has recommended the use of lay health advisors who have previously recovered from CRC, as this gives the population a more relatable person. As for defeatist beliefs, some studies have reported success in the usage of interventions that are culturally orientated and faith based [14].…”

“…Sung et al [6], Farooqui et al [7], Loh et al [10], Yusoff et al [11], Harmy et al [12], Foo et al [14], Javadzade et al [16], Wong et al [23], Khayyat et al [17], Tastan et al [18], Wong et al [24], Abdullah et al [21], Ahmad [22] 13 'Ostrich strategy'-aversion to facing test results Sung et al [16], Loh et al [10], Yusoff et al [11], Harmy et al [12], Foo et al [14], Javadzade et al [16], Wong et al [23], Bae et al [25], Tastan et al [18], Wong et al [24], Ahmad [22] 11 Financial constraints, lack of insurance coverage Sung et al [6], Farooqui et al [7], Yusoff et al [11], Koo et al [5], Harmy et al [12], Foo et al [14], Deng et al [15], Wong et al [23], Tastan et al [18], Wong et al [24], Abdullah et al [21], Ahmad [23] study subjects, who comprised of Chinese people, were partly attributable to the cultural aversion towards topics regarding the bowel, displaying fecal aversion behavior. This is particularly eminent among the elderly folk.…”

“…Latest guidelines need to be available for them so that they can give the best advice and recommendations to respective patients. It has been suggested for primary care physicians to be recruited for active dissemination of CRC screening information [14]. While there are few effective methods to tackle the psychological barriers, Sung et al [6] has recommended the use of lay health advisors who have previously recovered from CRC, as this gives the population a more relatable person.…”

“…This is of extreme importance as many people are highly influenced by physicians in health decision making [14,18]. Interestingly, Leung et al [13] discovered that the poor dissemination of CRC information among the [6], Farooqui et al [7], Hilmi et al [8], Kong et al [9], Loh et al [10], Yusoff et al [11], Koo et al [5], Harmy et al [12], Leung et al [13], Foo et al [14], Deng et al [15], Javadzade et al [16], Khayyat et al [17], Tastan et al [18], Salimzadeh et al [19], Salimzadeh et al [20] Abdullah et al [21], Ahmad et al [22] 18 Negative perspective towards screening methods (fear, pain, embarrassment, health damage, lack of confidence in test efficacy, inconvenient)…”

Using peer review to distribute group work marks equitably between medical students

“…In the Yong Loo Lin School of Medicine, National University of Singapore, medical students in the fourth year of a 5 year bachelor of medicine and bachelor of surgery degree embark on a research project over a year in a module called the Community Health Project (CHP), supervised by faculty members from the Saw Swee Hock School of Public Health in the same university. The CHP is a capstone research project in which groups of medical students (of 25–40 students each) work on a clinical, public health, epidemiologic or health services research project with the ultimate goal of better understanding and improving the health status of their target population, and which is often published (for examples see Wee et al [ 9 ], Foo et al [ 10 ], Lee et al [ 11 ] or Koo et al [ 12 ]). Medical students are expected to integrate and apply what they have learned from basic sciences, clinical sciences, epidemiology, public health and biostatistics since the start of medical school in their CHP.…”