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Participation in colorectal cancer screening among asymptomatic average-risk Chinese aged 50 to 75: A population-based survey

ABSTRACT: Background and study aims Colorectal cancer is the first and second most common cancer among male and female respectively in Hong Kong. In September 2016, the Department of Health launched a three-year voluntary colorectal cancer screening pilot programme in Hong Kong and subsidised eligible Hong Kong Chinese to undergo fecal immunochemical tests (FIT). Despite the success of the programme in the detection of adenoma and adenocarcinoma (cancer), the overall screening participation rate in the programme was only 8.3%. The decision on whether to go for a test or not could be related to a few reasons or factors that influence individuals’ behaviours. In 2019, the implementation of Government-subsidised colorectal cancer screening programme to Hong Kong Chinese has been regularized and whether such subsidies will change people’s intention and their final decision on whether to participate in the screening or not still remain unknown. In order to inform further health-promoting intervention and enhance the screening uptake, it is necessary to understand the participation of colorectal cancer screening among asymptomatic Chinese and the associated factors. Aim of the study: To assess the colorectal cancer screening participation among the asymptomatic average-risk population of HK Chinese aged 50 to 75 and to identify the association between predisposing, enabling and need factors, personal health practice and colorectal cancer screening participation. Who can participate? Hong Kong Chinese aged 50 to 75 years with no history of colorectal cancer What does the study involve? Participants will take part in a telephone survey regarding their general health

DISEASE(S): Colorectal Cancer

PROVIDER: 2413464 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Background and study aims Colorectal cancer is one of the most common cancers worldwide, and the risk of its development increases with age. It is therefore of great importance to undertake preventive measures against colorectal cancer in order to reduce its increasing prevalence. Undergoing cancer screening is one of the most effective ways of preventing the development of colorectal cancer through early detection, leading to increased chances of successful treatment and survival. Despite the proven benefits of cancer screening, studies showed that South Asian ethnic minorities, both in Hong Kong and worldwide, do not tend to use the publicly available cancer screening services, resulting in a higher chance of these individuals developing colorectal cancer, particularly among older adults. It was shown that their reduced tendency to undergo cancer screening is partly contributed by their low level of health knowledge and barriers to accessing health and cancer preventive services. In view of this, educational programmes are required to educate older South Asians ethnic minorities on the importance of cancer screening. With studies showing that younger family members educated on the importance of cancer screening are more able to recommend their older family members to undergo cancer screening, such an education programme should be targeted for families rather than older adults alone. This study aims to develop a multimedia health promotion programme for families of South Asian ethnic minorities in Hong Kong, to increase their awareness of the importance of undergoing cancer screening in colorectal cancer prevention. Who can participate? Pairs of healthy South Asian (Indian, Pakistani and Nepali) adults living in Hong Kong, comprising a younger family member aged between 18 and 61 and an older family member aged between 62 and 71 What does the study involve? Each pair of participants is randomly allocated into either group A or group B. Participants in group A receive the educational programme. It is delivered in one session using multiple means including a health talk on colorectal cancer and cancer screening, presentation of a video clip depicting the benefits of family support in motivating an older family member to undergo cancer screening, and a health information booklet. Participants in group B receive this programme after those in group A have completed the programme. For participants in both groups, before and after group A participants have received the programme, the researchers assess the following: whether the younger family members of each participant pair are willing to encourage their older family members to consult a family doctor for undertaking colorectal cancer screening, and are prepared to assist older family members in collecting samples for colorectal cancer screening; whether the older family members of each participant pair have seen a family doctor for an appointment in colorectal cancer screening. The researchers also assess whether participants in both groups are satisfied with the programme after they have attended it.

Project description:Introduction: Colorectal cancer (CRC) is the second most common cancer among Chinese in Hong Kong and the second leading cause of cancer death in this population. Several screening strategies has been associated with improved survival and may affect patients’ health-related quality of life (HRQOL). HRQOL impact should be used to adjust for survival in terms of quality adjusted life years (QALY) in the evaluation of cost-effectiveness of any intervention including screening. Objectives: to determine the HRQOL and health preference of patients with different stages of colorectal neoplasm, and to determine the most cost-effective CRC screening strategy for increasing QALYs. Design and Subjects: A longitudinal survey to collect data on HRQOL associated with colorectal neoplasm for Markov modeling on cost-effectiveness of CRC screening. A stratified sample of 420 patients with colorectal polyps and different stages of CRC will be recruited from colorectal clinics of Queen Mary Hospital for health preference and HRQOL assessment. The HRQOL over time will be measured at baseline, 6 and 12 months later. Health preference data will be integrated with cost and effectiveness data obtained from the literature to determine the cost-effectiveness of currently recommended CRC screening strategies by Markov modeling. Main outcome measures: The primary outcome measure is the SF-6D health preference value and QALYs. Secondary outcomes are the SF-12v2 and FACT-C scores. The outcomes will be compared between patients with different stages of colorectal neoplasm. Markov modeling study will estimate the expected QALYs gained and incremental cost-effectiveness ratio for each CRC screening strategy. Results: The study will provide information on HRQOL of patients with colorectal neoplasm to guide health services. The Markov Model will identify the most cost-effective CRC screening strategy for Hong Kong Chinese, which can inform policy makers and the public for the prevention of CRC of the population.

Dataset Information

Participation in colorectal cancer screening among asymptomatic average-risk Chinese aged 50 to 75: A population-based survey

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