Exploration of Malaysian Stakeholders View on Barriers to and Facilitators of Colorectal Cancer Screening Among Older Population

Abstract

According to the Malaysian National Cancer Registry (MNCR), more than 70% of colorectal cancer (CRC) cases in Malaysia are presented in the advanced stages of the disease, leading to poor survival rates while taxing the health care system. This study aims to explore the barriers to and facilitators of CRC screening uptake in the perspectives of the general population, health care providers, and policymakers. In-depth, semi-structured interviews were conducted with 25 purposively sampled respondents comprising general population above the age of 40, health care providers, and policymakers. Commonly reported barriers to CRC screening included psychological, poor knowledge and awareness, lack of physicians’ recommendation, and inadequate implementation of CRC-related campaigns at systemic level. Facilitating factors for CRC screening included family support and family history of CRC. A comprehensive understanding of barriers and facilitators is relevant for designing an effective intervention and policy to increase CRC screening rates in Malaysia.

Study protocol for a mixed methods approach to optimize colorectal cancer screening in Malaysia: Integrating stakeholders insights and knowledge-to-action framework

“…Efficient and streamlined workflows are essential for a successful screening program [18]. However, variations may occur at various levels in the implementation of the screening program, which includes multiple components and phases, such as promotion of the iFOBT, screening test administration, and subsequent referral for colonoscopy [19][20][21]. The screening process in healthcare systems becomes complex due to a lack of integration, causing coordination and continuity of care issues.…”

“…screening services across clinics and hospitals. This includes addressing potential inconsistencies in service delivery and the impact of healthcare systems' structure and processes [11,[19][20][21]. A comprehensive analysis is needed to identify the systemic and operational challenges healthcare providers face in implementing a colorectal cancer screening program.…”

“…The role of healthcare providers in the effectiveness of colorectal cancer screening programs is critical, and there is a need to address the challenges they face in distributing and delivering screening services across clinics and hospitals. This includes addressing potential inconsistencies in service delivery and the impact of healthcare systems’ structure and processes [ 11 , 19 – 21 ]. A comprehensive analysis is needed to identify the systemic and operational challenges healthcare providers face in implementing a colorectal cancer screening program.…”