Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Family Medicine, Kuala lumpur, Malaysia.
Ministry of Health, Malaysia.
Med J Malaysia. 2021 May;76(3):346-352.
Colorectal cancer (CRC) is one of the major causes of cancer-related mortality in Malaysia. Early screening has proven to be effective in reducing mortality due to CRC. The Malaysian CRC Clinical Practice Guidelines (2017) recommends that immunochemical faecal occult blood test (iFOBT) as the best non-invasive method for screening CRC in asymptomatic or average risk population. Outcome data on CRC screening program in the community is scarce. This study was to evaluate the prevalence and determinants of CRC among patients attending a public primary care health centre who underwent the screening program.
Reviews of CRC Screening Registry and medical case record were conducted on patients who underwent CRC screening program at Klinik Kesihatan Mahmoodiah, Johor Bahru (KKMJB) from 2016 to 2018 period. Sociodemographic data, clinical profile of patients, iFOBT results and colonoscopy outcomes were extracted for analysis. Descriptive and inferential statistics were performed using IBM SPSS version 25.
Out of 591 registered patients, 584 were included for analysis. Majority of the screened individuals were males (2016-2017) compared to females (2018). Chinese were most screened individuals in 2016 [94 (46.8%)] and 2017[87 (61.7%)]. Percentage of patients with appropriate indicators for screening and underwent colonoscopy for positive iFOBT were highest recorded in 2018 (74.7%, 58.8% respectively). Prevalence of CRC among those screened with iFOBT was 1 per cent for 2017 and 2018. Adherence to annual screening with iFOBT ranged between 1.1% (2016)- 2.2% (2018). Significant association observed between gender and iFOBT results, χ2(df)= 4.747, p=0.029 (2018). Median age and ethnicity were not significantly associated with iFOBT results (p>0.05) CONCLUSION: Screening for CRC among average risk groups in primary care should focus on recruiting female patients/clients as an organised activity. Prevalence of CRC detected from screening with iFOBT was 1 per cent. CRC screening programs should focus on proportion of iFOBT positive patients progressing to receive definitive colonoscopy and complying to annual surveillance screening.
结直肠癌（CRC）是导致马来西亚癌症相关死亡的主要原因之一。早期筛查已被证明可有效降低 CRC 死亡率。马来西亚 CRC 临床实践指南（2017 年）建议，免疫化学粪便潜血试验（iFOBT）是无症状或平均风险人群筛查 CRC 的最佳非侵入性方法。社区 CRC 筛查计划的结果数据很少。本研究旨在评估在接受筛查计划的 Mahmoodiah 综合健康中心就诊的患者中 CRC 的患病率和决定因素。
对 2016 年至 2018 年期间在柔佛州 Mahmoodiah 综合健康中心接受 CRC 筛查计划的患者的 CRC 筛查登记处和病历进行了回顾。提取社会人口统计学数据、患者临床特征、iFOBT 结果和结肠镜检查结果进行分析。使用 IBM SPSS 版本 25 进行描述性和推断性统计。
在 591 名登记患者中，有 584 名患者纳入分析。筛查的个体中男性（2016-2017 年）多于女性（2018 年）。2016 年和 2017 年，筛查的个体中以华人最多[94（46.8%）和 87（61.7%）]。2018 年，记录到适当筛查指标的患者比例和阳性 iFOBT 患者进行结肠镜检查的比例最高（分别为 74.7%和 58.8%）。在接受 iFOBT 筛查的患者中，2017 年和 2018 年 CRC 的患病率为 1%。2016 年（1.1%）至 2018 年（2.2%），iFOBT 的年度筛查依从率呈上升趋势。在 2018 年，性别与 iFOBT 结果之间存在显著关联，χ2(df)=4.747，p=0.029。年龄中位数和种族与 iFOBT 结果无显著关联（p>0.05）。
初级保健中对平均风险人群进行 CRC 筛查应侧重于招募女性患者/客户作为一项有组织的活动。通过 iFOBT 筛查发现的 CRC 患病率为 1%。CRC 筛查计划应侧重于 iFOBT 阳性患者接受明确结肠镜检查的比例，并遵守年度监测筛查。
