Saengow Udomsak, Chongsuwiwatvong Virasakdi, Geater Alan, Birch Stephen
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand E-mail :
Asian Pac J Cancer Prev. 2015;16(6):2269-76. doi: 10.7314/apjcp.2015.16.6.2269.
Colorectal cancer (CRC) is now common in Thailand with an increase in incidence over time. Health authorities are planning to implement a nationwide CRC screening program using fecal immunochemical test (FIT) as a primary screening tool. This study aimed to estimate preferences and acceptance of FIT and colonoscopy, explore factors influencing the acceptance, and investigate reasons behind choosing and rejecting to screen before the program was implemented. Patients aged 50-69, visiting the primary care unit during the study period, were invited to join this study. Patients with a history of cancer or past CRC screening were excluded. Face-to-face interviews were conducted. Subjects were informed about CRC and the screening tests: FIT and colonoscopy. Then, they were asked for their opinions regarding the screening. The total number of subjects was 437 (86.7% response rate). Fifty-eight percent were females. The median age was 58 years. FIT was accepted by 74.1% of subjects compared to 55.6% for colonoscopy. The acceptance of colonoscopy was associated with perceived susceptibility to CRC and family history of cancer. No symptoms, unwilling to screen, healthy, too busy and anxious about diagnosis were reasons for refusing to screen. FIT was preferred for its simplicity and non-invasiveness compared with colonoscopy. Those rejecting FIT expressed a strong preference for colonoscopy. Subjects chose colonoscopy because of its accuracy; it was refused for the process and complications. If the screening program is implemented for the entire target population in Thailand, we estimate that 106,546 will have a positive FIT, between 8,618 and 12,749 identified with advanced adenoma and between 2,645 and 3,912 identified with CRC in the first round of the program.
结直肠癌（CRC）目前在泰国很常见，且发病率随时间呈上升趋势。卫生当局计划实施一项全国性的CRC筛查计划，使用粪便免疫化学检测（FIT）作为主要筛查工具。本研究旨在评估对FIT和结肠镜检查的偏好与接受程度，探讨影响接受程度的因素，并调查在该计划实施前选择和拒绝筛查的原因。邀请了在研究期间前往初级保健单位就诊的50 - 69岁患者参与本研究。排除有癌症病史或既往CRC筛查史的患者。进行了面对面访谈。向受试者介绍了CRC以及筛查检测方法：FIT和结肠镜检查。然后，询问他们对筛查的看法。受试者总数为437人（应答率为86.7%）。58%为女性。中位年龄为58岁。74.1%的受试者接受FIT，而接受结肠镜检查的为55.6%。对结肠镜检查的接受与感知到的CRC易感性和癌症家族史有关。没有症状、不愿筛查、健康、太忙以及对诊断感到焦虑是拒绝筛查的原因。与结肠镜检查相比，FIT因其简单性和非侵入性而更受青睐。那些拒绝FIT的人强烈倾向于结肠镜检查。受试者选择结肠镜检查是因为其准确性；而拒绝是因为检查过程和并发症。如果在泰国对整个目标人群实施筛查计划，我们估计在该计划的第一轮中，将有106,546人的FIT呈阳性，8,618至12,749人被诊断为高级别腺瘤，2,645至3,912人被诊断为CRC。
