Colorectal Cancer Screening Knowledge Research Articles

Effect of a Theory-Based Narrative Video on Colorectal Cancer Screening Intention, Knowledge, and Psychosocial Variables Among a Predominantly Hispanic Population.

Colorectal cancer (CRC) remains the third leading cause of cancer death in the USA. Latinx adults are overrepresented in late-stage CRC diagnosis as CRC screening utilization remains low among Latinx-identifying individuals. This study aims to evaluate the effect of a theory-based narrative video following a culturally appropriate storyline on CRC screening intention, knowledge, and psychosocial variables along the U.S.-Mexico border. We designed and analyzed a non-randomized pre-posttest evaluation of a narrative, culturally tailored video embedded within a community program. The study is set in the U.S.-Mexico border community. Outreach provided a link or QR code to access the survey. In all, 458 participants started the survey, and 304 completed the survey. Participants were recruited through flyers distributed throughout various community events by the program's community health workers and via social media. The intervention evaluated changes in participant's knowledge, perceived barriers, perceived susceptibility, self-efficacy, and perceived benefits and intention to screen. Participants were a mean age of 39 and identified mainly as female (72.7%) and Hispanic/Latinx (88.49%). After viewing the narrative video, participants had significantly improved perceived susceptibility, self-efficacy, and benefits, while perceived barriers and sense of fatalism significantly decreased. Paradoxically, this was associated with a significant decrease in knowledge scores. Results from this intervention suggest that a theory-based narrative video following a culturally appropriate storyline effectively improves psychosocial variables and intention to carry out CRC screening in a predominantly Hispanic border population.

Colorectal cancer screening knowledge among community pharmacists: A national survey

BackgroundColorectal cancer (CRC) screening can reduce CRC morbidity and mortality. Community pharmacies could be a viable option for delivering home-based CRC screening tests such as fecal immunochemical tests (FITs). However, little is known about community pharmacists' knowledge about CRC screening guidelines. ObjectiveWe assessed community pharmacists' knowledge about CRC screening to identify education and training needs for a pharmacy-based CRC screening program. MethodsBetween September 2022 and January 2023, we conducted an online national survey of community pharmacists practicing in the United States. Responders were eligible if they were currently-licensed community pharmacists and currently practiced in the United States. The survey assessed knowledge of national CRC screening guidelines, including recommended starting age, frequency of screening, different screening modalities, and follow-up care. Using multiple linear regression, we evaluated correlates of community pharmacists' level of CRC screening knowledge, defined as the total number of knowledge questions answered correctly from "0" (no questions correct) to "5" (all questions correct). ResultsA total of 578 eligible community pharmacists completed the survey, with a response rate of 59%. Most community pharmacists correctly answered the question about the next steps following a positive FIT (87%) and the question about where a FIT can be done (84%). A minority of community pharmacists responded correctly to questions about the age to start screening with FIT (34%) and how often a FIT should be repeated (28%). Only 5% of pharmacists answered all knowledge questions correctly. Community pharmacists answered more CRC screening knowledge questions correctly as their years in practice increased. Board-certified community pharmacists answered more CRC screening knowledge questions correctly compared to those who were not board-certified. ConclusionTo ensure the successful implementation of a pharmacy-based CRC screening program, community pharmacists need to be educated about CRC screening and trained to ensure comprehensive patient counseling and preventive service delivery.

Abstract 4803: Cancer screening, knowledge, and fatalism among Chinese, Korean, and South Asian residents of New York City

Abstract Background: Asian New York City (NYC) residents have the lowest screening rates by race across cancer type. Past studies indicate heterogeneity within the Asian American population, yet few have examined differences in screening uptake and related factors among Asian ethnic subgroups in NYC. Further, cancer screening knowledge and cancer fatalism have been found to impact cancer screening uptake, and effects vary by race, ethnicity, immigration status, and cancer type. Objective: Our study aimed to examine differences in cancer screening uptake, knowledge, and fatalism among Chinese, Korean, and South Asian NYC adults and to examine the effects of cancer screening knowledge and cancer fatalism on cancer screening uptake. Methods: We used data from NYU Langone Perlmutter Cancer Center’s Cancer Community Health Resources and Needs Assessment survey. The survey was developed and distributed in 10 languages in collaboration with 23 community partners. Data were collected from NYC adults with recruitment strategies focused on immigrant and non-English language preference communities from Oct. 2021 - Dec. 2022. Multivariable logistic and multinomial regression analyses were used to examine differences in breast, cervical, and colorectal cancer (CRC) screening uptake; breast and CRC screening knowledge; and cancer fatalism between Chinese, Korean, and South Asian (Bangladeshi, Pakistani, Asian Indian, and Nepali) adults; and to examine the effects of breast and CRC screening knowledge on breast and CRC screening uptake and cancer fatalism on breast, cervical, and CRC screening uptake (n=1,045). Analyses were restricted by age and sex using United States (U.S.) Preventive Services Task Force guidelines. Results: The sample was 60.0% female with a mean age of 45.7 years; 83.1% of participants were born outside of the U.S., 49.9% of participants were Chinese, 22.8% were Korean, and 27.3% were South Asian. Korean women had 0.52 (95%CI: 0.31, 0.88) times lower odds of Pap test uptake than Chinese women; South Asian adults had 0.44 (95%CI: 0.24, 0.80) times lower odds of CRC screening uptake than Chinese adults. Korean adults had 1.68 (95%CI: 1.17, 2.41) times higher odds of knowing the correct age to begin having mammograms compared to Chinese adults; South Asian adults had 0.66 (95%CI: 0.46, 0.94) times lower odds of knowing the correct age to begin CRC screening compared to Chinese adults. Korean adults had a 0.39 (95%CI: 0.25, 0.63) and 0.22 (95%CI: 0.13, 0.37) times lower odds of some and high cancer fatalism, respectively, compared to Chinese adults. No associations were found between cancer screening knowledge or cancer fatalism and cancer screening uptake. Conclusions: Our study adds to the current literature on the diversity of cancer needs, beliefs, and behaviors among Asian Americans. The findings indicate the need for ethnic-specific cultural tailoring for future cancer screening interventions. Citation Format: Isabel I. Curro, Chloe A. Teasdale, Laura Wyatt, Yousra Yusuf, Victoria Foster, Sonia Sifuentes, Perla Chebli, Julie A. Kranick, Simona C. Kwon, Chau Trinh-Shevrin, Madison N. LeCroy. Cancer screening, knowledge, and fatalism among Chinese, Korean, and South Asian residents of New York City [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4803.

Knowledge, Attitude, Practice, and Perceived Barriers Regarding Colorectal Cancer Screening Practices Among Healthcare Practitioners: A Systematic Review.

The recommendations of medical professionals play a significant role in colorectal cancer (CRC) screening. This study aims to systematically review knowledge, attitude, practice, and perceived barriers regarding CRC screening practices among healthcare practitioners (HCPs). From January 2023 to December 2023, a comprehensive literature search was conducted using online databases, including Web of Science, PubMed, Scopus, and Research Gate, by using the following keywords in combination: "knowledge," "attitude," "practice," "perceived barriers," "colorectal cancer," and "health practitioners." The researchers screened and examined the retrieved literature. A total of 21 studies were considered relevant for the current review. Among these studies, eight assessed the level of knowledge, attitude, practices, and perceived barriers toward CRC screening among various health practitioners. Three studies assessed knowledge and attitudes toward CRC screening among health practitioners. The remaining ten studies assessed awareness, perceived barriers, or only knowledge of CRC screening among HCPs. In addition, all the included studies employed a cross-sectional design. The review shows that many healthcare providers need more fundamental knowledge of CRC screening. Healthcare procedures must be improved to enhance the knowledge, attitudes, and practices of healthcare professionals regarding CRC screening and their understanding of the associated barriers.

Knowledge, Attitude and Obstacles of Colorectal Cancer Screening in Primary Health Care in Bali, Indonesia

Background: The knowledge of CRC and its screening methods of healthcare workers is the bedrock of CRC early detection particularly in countries lacking national screening programs. Unknown factors influencing colorectal cancer early detection program implementation. We aimed to evaluate the knowledge and attitudes of primary health care (PHC) provider regarding CRC screening and identify the barriers associated with the screening plan.Methods: A cross-sectional study was conducted among PHC physicians and nurses in public primary health care centers in Bali, Indonesia. A 44-item self-administered questionnaire was used to assess the knowledge, attitude and practice of CRC screening. The questionnaire was spread using google form. Results: Two hundred and five respondents have participated in this study. The average duration of doing practice in PHC is 6.6 years. In knowledge of CRC, 50.2% of them have good knowledge, and there is no difference between PCPs vs nurses (51.9% vs 47.3%; p=0.53). In attitude toward CRC screening, 58.5% out of the have good attitude, and there is no difference between PCPs vs nurses (60.3% vs 55.4%; p=0.50). The barriers of the screening was divided into two areas, a barrier from the health care system and patients. There was no association between knowledge and attitude towards CRC screening (p=0.63).Conclusion: The majority of health workers' knowledge and attitudes toward CRC screening were in the "good" category. The patient's fear of being diagnosed with cancer, as well as the patient's fear and anxiety of screening tests, is the most significant barrier to colorectal cancer screening.

Knowledge, Attitude and Obstacles of Colorectal Cancer Screening in Primary Health Care in Bali, Indonesia

Background: The knowledge of CRC and its screening methods of healthcare workers is the bedrock of CRC early detection particularly in countries lacking national screening programs. Unknown factors influencing colorectal cancer early detection program implementation. We aimed to evaluate the knowledge and attitudes of primary health care (PHC) provider regarding CRC screening and identify the barriers associated with the screening plan.Methods: A cross-sectional study was conducted among PHC physicians and nurses in public primary health care centers in Bali, Indonesia. A 44-item self-administered questionnaire was used to assess the knowledge, attitude and practice of CRC screening. The questionnaire was spread using google form. Results: Two hundred and five respondents have participated in this study. The average duration of doing practice in PHC is 6.6 years. In knowledge of CRC, 50.2% of them have good knowledge, and there is no difference between PCPs vs nurses (51.9% vs 47.3%; p=0.53). In attitude toward CRC screening, 58.5% out of the have good attitude, and there is no difference between PCPs vs nurses (60.3% vs 55.4%; p=0.50). The barriers of the screening was divided into two areas, a barrier from the health care system and patients. There was no association between knowledge and attitude towards CRC screening (p=0.63).Conclusion: The majority of health workers' knowledge and attitudes toward CRC screening were in the "good" category. The patient's fear of being diagnosed with cancer, as well as the patient's fear and anxiety of screening tests, is the most significant barrier to colorectal cancer screening.

Knowledge and barriers to screening for colorectal cancer among individuals aged 40 years or older visiting primary healthcare clinics in Al-Khobar, Eastern Province.

Colorectal cancer (CRC) ranks third as the most common cancer in the world and the 4th most common cause of deaths from cancer. In Saudi Arabia, CRC is the most common cancer in males and the third most common in females. Early screening reduces the risk of CRC and death. However, there is a lack of awareness of CRC screening in Saudi Arabia. The objective of this study was to determine the knowledge, practices, and barriers to CRC screening using the Health Belief Model (HBM). This study enrolled Saudis aged 40 years or older visiting PHCCs in Al-Khobar. Data were collected using a self-administered questionnaire or a direct interview of the selected participants. Information sought included sociodemographics, past CRC screening, CRC knowledge, and HBM items. Data analysis was done using SPSS; the Chi-squared test and ANOVA were used to determine statistical significance. A total of 206 of the individuals approached completed the questionnaire. The average age was 51.1 years, and 51% were males. Only 10% reported that a physician had provided information on CRC prevention or discussed/recommended screening for CRC, and 10% had undergone screening for CRC. Seventy-five percent of respondents had heard of CRC, and 74% said that CRC was preventable. Regarding the HBM, no significant difference in the mean scores for perceived susceptibility, perceived severity, self-efficacy, and benefits of CRC screening was found by age groups. The mean score for perceived severity was higher for females than males. About 60% of participants were extremely likely to have a screening test for CRC done on the day if recommended by the doctor. The knowledge and awareness of CRC screening of the targeted sample is inadequate. Individuals with higher perceived susceptibility, severity of CRC, and perceived benefit of the screening tests were more willing to undergo the test. The highest perceived barrier was having no symptoms, and the lowest was "getting a stool test is too much of a hassle." These findings underline the importance of having a national screening program and campaigns to deal with the concerns of people and raise awareness of CRC.

Factors associated with prior completion of colorectal cancer and hepatitis C virus screenings among community health center patients: a cross-sectional study to inform a multi-behavioral educational intervention.

Colorectal cancer (CRC) and liver cancer are two of the leading causes of cancer death in the United States and persistent disparities in CRC and liver cancer incidence and outcomes exist. Chronic hepatitis C virus (HCV) infection is one of the main contributors to liver cancer. Effective screening for both CRC and HCV exist and are recommended for individuals based upon age, regardless of gender or sex assigned at birth. Recommendations for both screening behaviors have been recently updated. However, screening rates for both CRC and HCV are suboptimal. Targeting adoption of multiple screening behaviors has the potential to reduce cancer mortality and disparities. To examine psychosocial factors associated with completion of CRC and HCV screenings in order to inform a multi-behavioral educational intervention that pairs CRC and HCV screening information. A cross-sectional survey was conducted with participants (N = 50) recruited at two community health centers in Florida (United States). Kruskal-Wallis and Fisher's exact tests were used to examine associations between completion of both CRC and HCV screening, CRC and HCV knowledge, Preventive Health Model constructs (e.g., salience and coherence, response efficacy, social influence), and sociodemographic variables. Most participants were White (84%), female (56%), insured (80%), and reported a household income of $25,000 or less (53%). 30% reported ever previously completing both CRC and HCV screenings. Prior completion of both screening behaviors was associated with higher educational attainment (p = .014), having health insurance (p = .022), being U.S.-born (p = .043), and higher salience and coherence scores for CRC (p = .040) and HCV (p = .004). Findings demonstrate limited uptake of both CRC and HCV screenings among adults born between 1945 and 1965. Uptake was associated with multiple sociodemographic factors and health beliefs related to salience and coherence. Salience and coherence are modifiable factors associated with completion of both screening tests, suggesting the importance of incorporating these health beliefs in a multi-behavioral cancer education intervention. Additionally, health providers could simultaneously recommend and order CRC and HCV screening to improve uptake among this age cohort.

Colorectal Cancer (CRC) Screening Literacy and Facilitators Related to a Free Screening Program in Thailand.

This study aimed to evaluate CRC screening literacy and to determine the association between demographic characteristics and levels of CRC screening literacy and facilitators motivating participation. This cross-sectional study was carried out with 1,272 Thai citizens aged 50-70 years consenting to complete the screening protocol. Data were collected at the final visit by a self-reported questionnaire which was developed and validated using I-CVI=1. Difficulty of CRC screening knowledge dimension was tested by KR20, Cronbach's alpha 0.49. The majority of participants, 834 (65.6%) had sufficient CRC screening literacy and association between characteristics and levels of CRC screening literacy was not different. Comparing between characteristics and facilitators showed significant differences in trusting healthcare providers, perceiving harmless procedures, having constipation and time available. By married and own income participants exhibited lower trust in healthcare providers, 68% (OR 0.32, 95%CI 0.14 - 0.73) and 59% (OR 0.41, 95%CI 0.19 - 0.95), respectively. Married individuals perceived the procedures of screening involved higher harm, 32% (OR 0.68, 95%CI 0.45 - 0.99). Female and age over 60 with constipation constituted higher screening, 1.9 fold (OR 1.93, 95%CI 1.44 - 2.60) and 1.4 fold (OR 1.44, 95%CI 1.09 - 1.90). Though time available, age over 60 was lower screening 56% (OR 0.44, 95%CI 0.24 - 0.80), while own income and income more than 30,000 THB/month participants constituted higher screening 15 fold (OR 15.14, 95%CI 4.72 - 48.56) and 2.5 fold (OR 2.50, 95%CI 1.50 - 4.18), respectively. CRC screening literacy of participants was high. The association between characteristics and CRC screening literacy levels did not differ while characteristics and facilitators differed in some aspects. The free program promoted CRC screening equity; however, multilevel facilitators must be concerned, prioritized and intervened to motivate participation.

Implementation studio: implementation support program to build the capacity of rural community health educators serving immigrant communities to implement evidence-based cancer prevention and control interventions

PurposeRural community-based organizations (CBOs) serving immigrant communities are critical settings for implementing evidence-based interventions (EBIs). The Implementation Studio is a training and consultation program focused on facilitating the selection, adaptation, and implementation of cancer prevention and control EBIs. This paper describes implementation and evaluation of the Implementation Studio on CBO’s capacity to implement EBIs and their clients’ knowledge of colorectal cancer (CRC) screening and intention to screen.MethodsThirteen community health educators (CHEs) from two CBOs participated in the Implementation Studio. Both CBOs selected CRC EBIs during the Studio. The evaluation included two steps. The first step assessed the CHEs’ capacity to select, adapt, and implement an EBI. The second step assessed the effect of the CHEs-delivered EBIs on clients’ knowledge of CRC and intention to screen (n = 44).ResultsAll CHEs were Hispanic and women. Pre/post-evaluation of the Studio showed an increase on CHEs knowledge about EBIs (pre: 23% to post: 75%; p < 0.001). CHEs’ ability to select, adapt, and implement EBIs also increased, respectively: select EBI (pre: 21% to post: 92%; p < 0.001), adapt EBI (pre: 21% to post: 92%; p < 0.001), and implement EBI (pre: 29% to post: 75%; p = 0.003). Pre/post-evaluation of the CHE-delivered EBI showed an increase on CRC screening knowledge (p < 0.5) and intention to screen for CRC by their clients.ConclusionImplementation Studio can address unique needs of low resource rural CBOs. An implementation support program with training and consultation has potential to build the capacity of rural CBOs serving immigrant communities to implementation of cancer prevention and control EBIs. Clinical Trials Registration Number: NCT04208724 registered.

Changes in knowledge and awareness for a community-based cancer screening educational program

BackgroundCervical cancer (CC), colorectal cancer (CRC), and breast cancer (BC) are diseases that can be prevented/detected through early test. Through educational programs, individuals can become better informed about these cancers and understand the importance of screening and early detection. However, many people, especially low-income, low-educated, uninsured minority population groups, do not have their cancer screenings at the recommended intervals and do not receive appropriate and timely follow-up of abnormal screening results or timely treatment after diagnosis. A community-based educational program was developed to improve knowledge and awareness toward the screening of the three cancer types in a South Texas underserved population.MethodsResidents living in Laredo, Texas were invited to participate in the present educational program. From January 2020 to April 2021, participants were recruited using social media and flyer distributions in the general community. Participants received a free live web cancer education presentation delivered by bilingual community health educators, and online pre- and post-education surveys for CC, CRC, and BC separately. Pre-post changes in knowledge for individual items were compared using McNemar’s chi-squared tests.ResultsOverall, the participants showed increases in CC (n = 237), CRC (n = 59), and BC (n = 56) screening knowledge and awareness after receiving the cancer screening education (Ps < 0.05). After receiving the cancer screening education, 85–97% of participants had an intent to talk to a healthcare provider about CC/CRC/BC screening, 88–97% had an intent to get a CC/CRC/BC screening test in the next 12 months or at the next routine appointment, and 90–97% had an intent to talk about CC/CRC/BC with their family members or friends.ConclusionsA community-based educational program culturally and linguistically tailored help increase knowledge and awareness about cervical, colorectal, and breast cancer screening, and promote positive changes in population’s knowledge and awareness about the benefits of cancer screening. Future cancer screening educational programs in similar populations are warranted to reduce the risk of cervical, colorectal, and breast cancer.

Colorectal Cancer (CRC) Awareness among Primary Healthcare Providers

Background: According to the Ministry of Health data, cancer prevalence is growing internationally and in Saudi Arabia, particularly colorectal cancer (CRC). We also noticed several individuals with a spectrum of different clinical presentations of gastro intestinal symptoms among adults in our routine primary health care (PHC) practice. Methodology: A 379 person cross-sectional research was undertaken among PHC participants from June 2021 to December 2022. SPSS was used to enter and evaluate data. Statistical tests such as basic proportions, chi square test for categorical data, risk variables relationship with CRC, and logistic regression analysis were used. The current study found that nearly half of the individuals (50.9%) had strong CRC knowledge of common symptoms. Dietary variables, fast meals, and greasy foods were cited by nearly two-thirds of the study group (69.5%) as potential causes of CRC. Furthermore, two-thirds (68.6%) were aware of the CRC screening test. Regression analysis was used, and a significant correlation was found between risk variables of fast-food intake, daily red meat consumption, and physical inactivity with CRC knowledge (P - 0.026, 0.012, and 0.004, respectively). Conclusions: According to the findings, primary health care attendants have a low level of CRC awareness. Almost one-third (35.6%) of persons will have a FOBE test for CRC. There is a need to raise knowledge of risk factors and CRC screening, as well as to strengthen current awareness programs. More research is needed to back up the current study findings in our population

A Review of Community Awareness for Colorectal Cancer Screening and Prevention in North and Central Asian Countries.

Colorectal cancer (CRC) incidence and mortality rates are increasing in low- and middle-income countries (LMIC), including North and Central Asian countries (NCAC). Screening and risk factor reduction can aid in the prevention of colorectal cancer, but communities lack awareness of these screening programs. The review assessed community awareness about CRC screening and prevention in NCAC to facilitate cancer control policies. Study type and methods: For this scoping review, we searched PubMed/Medline, Embase, and the Cochrane Library for articles on community awareness about CRC screening and prevention in NCAC according to inclusion and exclusion criteria. Eight of 677 articles from five of the 15 NCAC countries met the criteria. Most of the studies utilized a survey design. The results indicated low awareness of the availability of CRC screening and poor knowledge of CRC symptoms. Knowledge of CRC screening modalities was also inadequate. Some countries also lack CRC screening programs. Community unawareness is a significant barrier to screening program utilization and sustenance. Community health awareness programs (CHAP) are needed to improve the uptake of CRC screening in NCAC. The NCAC should include CHAP as an integral component of the CRC control plan. Long-term cancer control in LMICcould be adapted using the step-ladder pyramidal approach.

Developing Faith-Based Messaging and Materials for Colorectal Cancer Screening: Application of Boot Camp Translation Within the African Methodist Episcopal Church

Purpose of the study: Colorectal cancer (CRC) is the 2nd leading cause of cancer-related death in Black and African American people in the United States. We created culturally appropriate and locally relevant faith-based CRC screening messages and materials for African Methodist Episcopal (AME) church communities in Atlanta, Georgia. Methods: We used boot camp translation (BCT), a validated community based participatory strategy, to elicit input from AME congregants to 1) develop faith-based CRC screening messages that resonate with the AME community and 2) identify the role of the church in bringing CRC information to the AME community. Eligible participants were members of the AME Atlanta East District churches, ages 45 to 75 years, and willing to participate in one 5-hour in-person meeting and two follow-up video-conferencing calls. The in-person session, conducted in the church sanctuary and fellowship hall, consisted of expert presentations by a national leader on colorectal cancer and screening, a local leader well-versed in barriers to screening and community resources, and a prominent figure within the church clergy. Additionally, we held interactive small group sessions to create messages and identify dissemination methods. Results: A total of 27 adults participated in the in-person session (17 women and 10 men). Participants preferred CRC screening messages that incorporated faith-based concepts including “honoring God by taking care of one's body”_ and “choosing faith over fear of screening.”_ Other key themes focused on increasing awareness and knowledge of CRC screening, taking control of one's own health, and sharing personal stories with one's community to reduce stigma and inspire action. Favored dissemination channels within the church were Sunday service, print (e.g., flyers, pamphlets, message cards) distributed at church, and digital materials (e.g., videos) shown during service. Desired community channels included cancer awareness events and social media platforms. Conclusions: Churches serve as key partners in delivering health information as they are among the most trusted institutions within the Black and African American community. Using BCT, we successfully incorporated participant feedback to create faith-based CRC screening messages and identified appropriate channels for sharing information within the AME community.

The Ohio State University Guardant Shield Colorectal Cancer Screening Project.

TPS3626 Background: Asymptomatic screening is an effective method for detecting early cancers when prognosis strongly depends on stage at time of diagnosis. Unscreened individuals often have a basic understanding of the importance and availability of colorectal cancer (CRC) screening but have concerns regarding the collection method of the currently available stool-based options or the invasiveness of direct visualization options that deter test completion. We hypothesize that offering a blood-based CRC screening test during a routine healthcare visit can increase screening adherence, especially within hard-to-reach populations and those hesitant about completing CRC screening. Methods: The Ohio State University Guardant Shield Colorectal Cancer Screening Project (NCT05716477) is a prospective study in the United States designed to recruit individuals who are currently engaging with mobile health clinics and are not up to date with CRC screening, with the aim of improving health in hard-to-reach populations. The study’s primary objective is to evaluate the acceptance of a commercially available blood-based CRC screening test (Shield, Guardant Health, USA) in individuals aged 45-84, who have existing appointments with a mobile health clinic, and are not up to date with guideline recommended CRC screening. The study team screens for eligibility criteria before the appointment and reaches out to the individual to begin the informed consent process. Positive blood-based test results will be triaged to colonoscopy for further evaluation. A post-study survey will be administered to consented individuals aimed to collect data on CRC screening knowledge which will be correlated to patient demographics and uptake. Acceptance will be defined as those approached and with completed specimen collection. Progress: The study initiated on October 25, 2022, with the first patient enrolled on December 20, 2022. Enrollment is expected to continue with a target enrollment of 300 individuals. Clinical trial information: NCT05716477 .

Colorectal Cancer Screening in the Middle East: What, Why, Who, When, and How?

The incidence of colorectal cancer (CRC) in the Middle East is increasing, especially among those younger than 50 years. Risk factors including obesity, sedentary lifestyle, and dietary changes are associated with the epidemiologic shift and are a result of socioeconomic changes happening in the region. Worldwide, CRC screening is associated with decreased incidence and mortality of CRC, but screening uptake is still low in the Middle East because of cultural barriers and lack of awareness; in addition, most countries do not have national screening programs. Knowledge of CRC screening and participation rates vary among different countries, but overall they are low. Both primary and secondary prevention approaches are needed in the Middle East, and cost-effectiveness is important in choosing screening modalities. Although colonoscopy is considered the most robust screening method, stool-based testing may be an acceptable screening strategy in resource-limited settings, and focusing on high-risk individuals such as those with hereditary CRC might be the most cost-effective strategy. In addition to financial limitations in many countries in the Middle East, human displacement places an extra toll on cancer control strategies in the region.

Colorectal cancer screening: understanding the needs of the pre-screening group.

For the last three decades, although colorectal cancer incidence has been decreasing in those over 50 years of age, it has been increasing in those under 50 included in the pre-screening group (PSG). The present study aims to explain the screening-related factors and compliance of individuals in PSG who are not included in the colorectal cancer screening programme. This cross-sectional study was conducted with a total of 323 participants, 143 of whom were from the pre-screening group (40-49 years), and 180 from the screening included group (SIG) (50-70 years). Individuals included in PSG were more likely to have accepted that both faecal occult blood test (FOBT) (2.23 ± 1.22 vs. 1.89 ± 1.33, p = 0.018) and colonoscopy (2.37 ± 0.97 vs. 2.02 ± 1.14, p = 0.003) were useful and suitable screening tests in colorectal cancer. Adequate health literacy (OR = 4.3, 95% CI: 1.8-10.0, p = 0.001) and better education level (OR = 3.3, 95% CI: 1.3-8.4, p = 0.010) were factors of increased knowledge of colorectal cancer screening. The findings show that PSG has different characteristics than SIG and may be more fitting in the colorectal cancer screening programme if included.

Knowledge Attitude and Practices of Health Care Workers towards Colorectal Cancer Screening in Primary Care Settings in Durban, South Africa: A Cross-Sectional Survey

BACKGROUND: South Africa has the highest number of colorectal cancer (CRC) patients in sub-Saharan Africa, with the CRC projected new cases at 8 000 per 100&amp;nbsp;000 population by 2030. Screening assists with the early detection and control of cancer. This study determined knowledge, attitude, and practices (KAP) related to CRC among Health Care Workers (HCWs).&#x0D; &#x0D; METHODS: A cross-sectional descriptive study was conducted between April and November 2021 using a self-administered close-ended questionnaire. Data was collected from 109 HCWs in public primary health care facilities in Durban, South Africa. Summary descriptive and association analysis were conducted using IBM SPSS vs. 28.&#x0D; &#x0D; RESULTS: Overall CRC screening knowledge score was 12% (mean 13) with 39% that were familiar with the National Department of Health Cancer Control framework. Only 15% of participants perceived the Perceived the National Cancer Control Guidelines to be influential for the implementation of colorectal cancer screening. 70% of participants would recommend CRC screening to patients. Over one-fifth, (22%) of participants felt that fecal occult blood, flexible sigmoidoscopy, and colonoscopy were effective for CRC screening. Over a third (44%) preferred a structured CRC screening programme. Most participants (81%) were willing to recommend CRC screening to their patients. Only 10% of participants had ever conducted colorectal screening before. The vast majority were unfamiliar with the types of CRC screening tests. Lack of CRC screening guidelines, training, equipment and CRC low burden were identified as barriers to screening.&#x0D; &#x0D; CONCLUSION: The vast majority of HCWs lacked knowledge of the CRC screening programme and its procedures. However, the vast majority of HCWs were willing to conduct screening once trained. This study also highlighted perceived health systems barriers affecting CRC screening. Currently, South Africa does not have national guidelines for CRC screening in South Africa, hence, a national risk differentiation CRC screening guideline is needed to guide implementation at the PHC level. Health systems strengthening interventions, including training of HCWs, availability of screening tests and materials to facilitate the integration of CRC screening noting that PH already implements screening programmes for other cancer types.&amp;nbsp;

Colorectal Cancer Screening Among Adults in Zuni Pueblo: Factors Associated with FOBT and Colonoscopy Utilization.

Although strategies to mitigate barriers to colorectal cancer (CRC) screening have proven successful in some parts of the US, few of these strategies have been studied in rural, American Indian communities that may exhibit unique culturally driven attitudes toward and knowledge of colorectal cancer and experience increased barriers to healthcare access. In this study, we describe the results of a survey among CRC screen-eligible members of Zuni Pueblo (N = 218) on an array of questions regarding CRC screening behaviors, knowledge, satisfaction with and access to healthcare services, social support for CRC screening, perceptions toward FOBT, and preference for evidence-based interventions or strategies for improving CRC screening rates. Results from the multivariable model suggest age, having a regular healthcare provider, and harboring fewer negative perceptions toward FOBT are key drivers of ever completing CRC screening. Respondents reported strong support for Community Guide-recommended interventions and strategies for increasing CRC screening for nearly all proposed interventions. Results confirm the need for multilevel, multicomponent interventions, with a particular focus on improving Zuni Pueblo community members' access to a regular source of care, improving knowledge of CRC risk factor, and addressing negative perceptions toward CRC screening. These results provide critical, community-specific insight into better understanding the drivers of low guideline-adherent screening rates and inform local healthcare providers and community leaders of context-specific strategies to improve CRC screening in Zuni Pueblo.

Knowledge and awareness of colorectal cancer among a predominantly Indigenous Caribbean community

ObjectiveTo assess awareness levels and knowledge of colorectal cancer (CRC) and CRC screening among an Indigenous Caribbean community.MethodsA community-based participatory research project was developed to perform a needs assessment of cancer prevention and education in an Indigenous non-metropolitan community in Dominica. Purposive sampling occurred at a local health clinic. Data was collected from 58 eligible patients via a 57-item structured interview. Descriptive statistics were calculated, and demographic correlates of CRC knowledge and awareness were assessed using chi-square and Fisher Exact tests.ResultsOf 58 participants, 72.4% identified as Indigenous, and 36.5% had heard of CRC. Most respondents (96.1%) believed CRC screening to be “important,” yet only 3.0% of those who were age eligible had received screening in the prior 10 years, and 12.5% knew how to get screened. More respondents with incomes over $5,000 ECD had heard of CRC (72.2%) compared to those who had not (21.7%), and those who were unsure (16.7%, p < 0.01). Among those with a family cancer history, 14.3% knew how to get tested for CRC, 60.0% did not, and 25.0% were unsure (p < 0.03).ConclusionDespite limited familiarity with CRC screening, participants broadly believed CRC screening to be important. Health education research is needed to develop patient-centered, culturally appropriate materials about CRC screening and prevention. Future work facilitating productive community partnerships and incorporating prevailing community traditions may align cancer prevention and education initiatives with community priorities.