Abdul Jalal Muhammad Irfan, Mohd Azhar Ahmad Termidzi, Kamaruddin Mohd Arman, Alias Mohd Raziff, Abd Jalal Nazihah, Ismail Norliza, Chin Siok-Fong, Goh Ying-Xian, Abdullah Noraidatulakma, Sagap Ismail, Mohd Azman Zairul Azwan, Aizuddin Azimatun Noor, Mohamed Nawi Azmawati, Ismail Nor Halizam, Jamal Rahman, Abdul Murad Nor Azian
UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.
Hospital Tunku Ampuan Besar Tuanku Aishah Rohani, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.
Malays J Med Sci. 2025 Feb;32(1):154-168. doi: 10.21315/mjms-09-2024-726. Epub 2025 Feb 28.
Colorectal cancer (CRC) is one of the most common cancers globally, with the immunochemical faecal occult blood test (iFOBT) frequently used for population level screening. This study evaluated CRC screening uptake among urban-poor individuals aged 40-65, assessed their knowledge of CRC risk factors and symptoms before and after an educational programme, and identified determinants of polyps and CRC within this group.
A cross-sectional study recruited 577 individuals from seven People's Residential Project (PPR) areas in Cheras, Kuala Lumpur and Malaysia Madani Carnival between March 2022 and July 2023. Inclusion criteria were age 40-65 and smartphone ownership, excluding those with CRC history, acute gastritis, inflammatory bowel disease, or recent CRC screening. The iFOBT was administered, followed by questionnaires and educational talks. A follow-up questionnaire was conducted via phone two weeks post-programme.
Overall, 321 participants fulfilled the eligibility criteria. Most iFOBT-positive participants were in their 50s (median [interquartile range, IQR]: 56 [16]), female (65%), 86.3% non-smokers, and 62.5% with moderate CRC risk based on the Asia Pacific Colorectal Screening (APCS) Score, showing no significant differences from iFOBT-negative participants. Among the 267 who returned iFOBT kits, 30.0% tested positive, with 28.8% undergoing colonoscopy. Polyps and CRC were detected in 21.74% and 4.35% of the participants, respectively. The mean knowledge score on CRC symptoms was significantly lower post-programme, with no significant change in awareness of CRC risk factors.
Detection rates for polyps and CRC are low. Awareness of CRC symptoms is higher pre-screening than post-screening, highlighting challenges in conducting CRC education in urban-poor communities.
结直肠癌（CRC）是全球最常见的癌症之一，免疫化学粪便潜血试验（iFOBT）常用于人群水平的筛查。本研究评估了40 - 65岁城市贫困个体的CRC筛查接受情况，在一项教育计划前后评估了他们对CRC危险因素和症状的了解，并确定了该群体中息肉和CRC的决定因素。
一项横断面研究于2022年3月至2023年7月从吉隆坡蕉赖的七个人民住宅项目（PPR）地区和马来西亚马纳尼嘉年华招募了577名个体。纳入标准为年龄40 - 65岁且拥有智能手机，排除有CRC病史、急性胃炎、炎症性肠病或近期进行过CRC筛查的个体。进行了iFOBT检测，随后进行问卷调查和教育讲座。在计划结束两周后通过电话进行了随访问卷调查。
总体而言，321名参与者符合资格标准。大多数iFOBT阳性参与者为50多岁（中位数[四分位间距，IQR]：56 [16]），女性（65%），86.3%不吸烟，根据亚太结直肠癌筛查（APCS）评分，62.5%具有中度CRC风险，与iFOBT阴性参与者无显著差异。在归还iFOBT试剂盒的267人中，30.0%检测呈阳性，其中28.8%接受了结肠镜检查。分别在21.74%和4.35%的参与者中检测到息肉和CRC。关于CRC症状的平均知识得分在计划后显著降低，对CRC危险因素的认识没有显著变化。
息肉和CRC的检出率较低。CRC症状的知晓率在筛查前高于筛查后，凸显了在城市贫困社区开展CRC教育的挑战。
