Change in public awareness of colorectal cancer symptoms following the Be Cancer Alert Campaign in the multi-ethnic population of Malaysia

Abstract

Background: Colorectal cancer (CRC) cases are detected late in Malaysia similar to most Asian countries. The Be Cancer Alert Campaign (BCAC) was a culturally adapted mass media campaign designed to improve CRC awareness and reduce late detection in Malaysia. The evaluation of the BCAC-CRC aimed to assess campaign reach, campaign impact and health service use. Methods: Participants aged ≥40 years (n = 730) from randomly selected households in Selangor State Malaysia, completed interview-based assessments. Campaign reach was assessed in terms of responses to an adapted questionnaire that was used in evaluations in other countries. The impact of the campaign was assessed in terms of awareness, confidence to detect symptoms and self-efficacy to discuss symptoms with a doctor as captured by the Cancer Awareness Measure (CAM). CAM was administered before-and-after campaign implementation and responses by BCAC recognisers (i.e. participants who recognised one or more of the BCAC television, radio or print advertisements when prompted) and non-recognisers (i.e. participants who did not recognise any of the BCAC advertisements) were compared analytically. Logistic regression analysed comparative differences in cancer awareness by socio-demographic characteristics and recognition of the BCAC materials. Results: Over 65% of participants (n = 484) recognised the BCAC-CRC. Campaign-recognisers were significantly more likely to be aware of each CRC symptom at follow-up and were more confident about noticing symptoms (46.9% vs 34.9%, p = 0.018) compared to non-recognisers. There was no difference between groups in terms of selfefficacy to see a doctor about symptoms. Improved symptoms awareness at follow-up was lower for Indians compared to Malays (adjusted odds ratio (OR) 0.53, 95% Confidence Interval (CI): 0.34, 0.83, p = 0.005). Health service use data did not indicate an increase in screening activity during or immediately after the campaign months.

Changes in Anxiety, Depression, and Stress in 1 Week and 1 Month Later After the Wuhan Shutdown Against the COVID-19 Epidemic

“…Our study also showed that the greater the level of attention to COVID-19, the greater the negative emotions, which is in agreement with previous research 30 . As a result of strict prevention and control measures, the general awareness and vigilance of residents have increased 31,32 . Since respondents were those who had mobile phones with access to WeChat and decide to participate in the survey, which means that most people get information about COVID-19 mainly through the mass media.…”

Impact of a mass media campaign on breast cancer symptoms awareness and screening uptake in Malaysia: findings from a quasi-experimental study

“…Although the BCAC-BC had greater reach compared with the BCAC-CRC, the BCAC-CRC appeared to be more successful in terms of improving symptoms awareness 25 , perhaps, because of the higher precampaign symptom knowledge/awareness (prompted and unprompted) among the BCAC-BC sample compared with BCAC-CRC participants. Awareness improved significantly at follow-up for three prompted BC symptoms, whereas awareness about all prompted CRC symptoms was improved.…”

“…The differential reach that was experienced by ethnic groups was similar to the findings from the BCAC for colorectal cancer (BCAC-CRC) in Malaysia. 25 Different attitudes and behaviours across ethnic groups regarding help seeking may help to explain the apparent discrepancy. For example, US health survey participants who did not seek health information in the media and preferred to trust their health service provider tended to be older and have a lower socioeconomic status.…”

“… 28 29 Findings from the BCAC social media campaigns demonstrated higher reach and engagement for the BC social media posts compared with the CRC posts (ie, highest reach of CRC-related post: 92 678 users vs BC-related post: 202 430 users; highest engagement with CRC-related post: 2065 users vs BC-related post: 4498 users). 25 CRC campaign material about symptoms may be perceived to be less pleasant to share compared with BC symptoms. Overall, it may not be surprising that BC awareness levels are higher than other cancer sites such as CRC and that the gains from a mass media campaign directed towards BC would be smaller given this elevated baseline awareness.…”

Conceptual Framework to Guide Early Diagnosis Programs for Symptomatic Cancer as Part of Global Cancer Control

“… 27 Recently published findings indicate improvements in symptom awareness at follow-up across ethnic and social strata although, in common with the English experience, evidence of improvements in downstream outcomes was less clear. 28 …”