Department of Family Medicine, RCSI&UCD Malaysia Campus, Georgetown, Penang, Malaysia.
Department of Public Health, RCSI&UCD Malaysia Campus, Georgetown, Penang, Malaysia.
Asian Pac J Cancer Prev. 2021 Nov 1;22(11):3475-3482. doi: 10.31557/APJCP.2021.22.11.3475.
Colorectal cancer (CRC) is the most common cancer in men and the second most common cancer in women in Malaysia. A major challenge for CRC screening programs is to improve the screening participation rates. In Malaysia, the most critical barrier to the uptake of CRC screening is the lack of patient awareness. This study aimed to determine the intention and the uptake of CRC screening, and to explore the related motivators and barriers after raising awareness with a brief health education.
An analytical cross-sectional study was conducted in a government health clinic of Penang from March to August 2019. Asymptomatic clinic attendees aged 50-75 years who had no prior awareness of CRC screening were recruited by systematic random sampling technique. Participants first received a standardised one to one health education, followed by an interview using a standardised questionnaire to assess their CRC screening intention and the relevant motivators and barriers. A submission of a sample for immunochemical faecal occult blood test (iFOBT) was considered as an uptake of the CRC screening.
A total of 546 participants participated in this study. The mean age of the participants was 62.8 (SD=6.36). Majority of them were females (57.3%), Chinese (78.6%), who had attained primary or higher education (92.0%) and had comorbidities (87.0%). After a brief health education, 231 participants (42.3%) agreed to undergo iFOBT. The actual screening uptake rate in this study was 28%. Perceived benefit of the test (84.4%) was the most common motivators, while self-perceived non-vulnerability was the biggest impediment to CRC screening intention. Physicians' recommendation was the perceived most effective way in raising CRC awareness.
Participants prefer physicians to provide health education. Standardised brief health education is inadequate to stimulate CRC screening adherence. Future interventions will require in-depth understanding of patients' beliefs, risk perception, and affective responses.
结直肠癌（CRC）是马来西亚男性中最常见的癌症，也是女性中第二常见的癌症。CRC 筛查计划面临的主要挑战是提高筛查参与率。在马来西亚，阻碍 CRC 筛查的最关键因素是缺乏患者意识。本研究旨在确定接受 CRC 筛查的意愿和接受程度，并探讨提高认识后进行简短健康教育对 CRC 筛查的接受程度的相关动机和障碍。
本研究为 2019 年 3 月至 8 月在槟城一家政府诊所进行的分析性横断面研究。采用系统随机抽样技术招募年龄在 50-75 岁之间、无 CRC 筛查意识的无症状诊所就诊者。参与者首先接受标准化的一对一健康教育，然后使用标准化问卷进行访谈，评估他们的 CRC 筛查意愿以及相关动机和障碍。提交免疫化学粪便潜血试验（iFOBT）样本被视为接受 CRC 筛查。
共有 546 名参与者参加了这项研究。参与者的平均年龄为 62.8（SD=6.36）。他们大多数是女性（57.3%）、华人（78.6%）、具有小学或更高学历（92.0%）且患有合并症（87.0%）。在进行简短的健康教育后，有 231 名参与者（42.3%）同意进行 iFOBT。本研究的实际筛查参与率为 28%。对测试的益处感知（84.4%）是最常见的动机，而自我感知的不易感是 CRC 筛查意愿的最大障碍。医生的建议被认为是提高 CRC 意识的最有效方法。
参与者希望医生提供健康教育。标准化的简短健康教育不足以激发 CRC 筛查的依从性。未来的干预措施需要深入了解患者的信念、风险感知和情感反应。
