Colon cancer in Africa: Primetime for screening?

May, Folasade P.; Anandasabapathy, Sharmila

doi:10.1016/j.gie.2019.04.206

Cited by 23 publications

(21 citation statements)

References 15 publications

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“…Inadequate financial resources [67,73,74,80,81] Lack of funding to improve infrastructure and access to screening programmes, staff, centres, treatment, etc.…”

Section: Discussionmentioning

confidence: 99%

“…Improve reporting of CRC screening efforts and evaluation [67,72,73] Establish timely, reliable and efficient health information system for the design, management and evaluation of CRC prevention activities. Implement electronic medical records to allow for ICD-10 coding.…”

Section: Opportunitiesmentioning

confidence: 99%

“…Cost-effective CRC screening methods [67,74,80,81] Identify cost-effective, culturally-acceptable CRC screening methods and conduct cost-effectiveness evaluation of services to understand impact of services and improve existing practice.…”

Section: Opportunitiesmentioning

confidence: 99%

“…Improve health care infrastructure [67,69,76,80] Improve and align infrastructure, improve equitable distribution of screening technology throughout regions Increase number of trained endoscopists and provide specialised training to health care staff [67,70,80] Train specialised staff to conduct screening. Options are to train individuals from other specialities and non-physicians to deliver services and to provide e-training.…”

Section: Opportunitiesmentioning

confidence: 99%

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The implementation of colorectal cancer screening interventions in low-and middle-income countries: a scoping review

et al. 2021

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Background Low- and middle-income countries (LMICs) experienced increasing rates of colorectal cancer (CRC) incidence in the last decade and lower 5-year survival rates compared to high-income countries (HICs) where the implementation of screening and treatment services have advanced. This review scoped and mapped the literature regarding the content, implementation and uptake of CRC screening interventions as well as opportunities and challenges for the implementation of CRC screening interventions in LMICs. Methods We systematically followed a five-step scoping review framework to identify and review relevant literature about CRC screening in LMICs, written in the English language before February 2020. We searched Medline, Embase, Web of Science and Google Scholar for studies targeting the general, asymptomatic, at-risk adult population. The TIDieR tool and an implementation checklist were used to extract data from empirical studies; and we extracted data-informed insights from policy reviews and commentaries. Results CRC screening interventions (n = 24 studies) were implemented in nine middle-income countries. Population-based screening programmes (n = 11) as well as small-scale screening interventions (n = 13) utilised various recruitment strategies. Interventions that recruited participants face-to-face (alone or in combination with other recruitment strategies) (10/15), opportunistic clinic-based screening interventions (5/6) and educational interventions combined with screening (3/4), seemed to be the strategies that consistently achieved an uptake of > 65% in LMICs. FOBT/FIT and colonoscopy uptake ranged between 14 and 100%. The most commonly reported implementation indicator was ‘uptake/reach’. There was an absence of detail regarding implementation indicators and there is a need to improve reporting practice in order to disseminate learning about how to implement programmes. Conclusion Opportunities and challenges for the implementation of CRC screening programmes were related to the reporting of CRC cases and screening, cost-effective screening methods, knowledge about CRC and screening, staff resources and training, infrastructure of the health care system, financial resources, public health campaigns, policy commitment from governments, patient navigation, planning of screening programmes and quality assurance.

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“…Inadequate financial resources [67,73,74,80,81] Lack of funding to improve infrastructure and access to screening programmes, staff, centres, treatment, etc.…”

Section: Discussionmentioning

confidence: 99%

Section: Opportunitiesmentioning

confidence: 99%

Section: Opportunitiesmentioning

confidence: 99%

Section: Opportunitiesmentioning

confidence: 99%

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The implementation of colorectal cancer screening interventions in low-and middle-income countries: a scoping review

et al. 2021

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“…From this, the most commonly diagnosed cancers worldwide are colorectal cancer, lung, and breast cancers [7][8][9]. Cancer in sub-Saharan Africa (SSA) is on the rise caused by rapid population growth, higher life expectancy, and the adoption of unhealthy lifestyles, and a lack of awareness about cancer [4,10,11].…”

Section: Introductionmentioning

confidence: 99%

Awareness of Colorectal Cancer and Associated Factors Among Adult Patients in Jimma, South-West Ethiopia.

Hamza

Argaw

Gela

2020

Preprint

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Background: Colorectal cancer (CRC) is the first commonest diagnosed cancer in men and the fourth commonest in women in Ethiopia. The most significant factors that may increase the risk of having CRC were modifiable. However, little is known about the awareness of CRC and associated factors among adult patients in study area. Therefore, the study aimed to assess the awareness of CRC and associated factors among adult patients in Jimma, South-West Ethiopia, 2020. Methods: The institution-based quantitative cross-sectional study design was conducted among 422 patients from March 8 to April 30, 2020. The study participants were recruited by a systematic random sampling method and data was collected semi-structured interviewer-administered questionnaires. Descriptive, bivariate, and multivariate logistic regression was implemented. The statistical level of significance was stated at p-value < 0.05. Result: A 100% response rate in this study was recorded. More than half (57.6%) of the study participants had low awareness of colorectal cancer. Smoking (78.2%) and bloody stool (49.3%) were the most known risk factors and symptoms. There is a significant association between awareness of colorectal cancer with gender, residency, monthly income, level of education, information sources, and heard about CRC. Conclusion: Overall awareness of patients towards CRC was inadequate. Participants with high levels of education and females had better awareness, however; the overall awareness of them was insufficient. Therefore, there is a need for awareness campaigns and health education for promoting colorectal cancer awareness.

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Delivering colorectal cancer screening integrated with primary health care services in Morocco: Lessons learned from a demonstration project

Selmouni

Amrani

Sauvaget

et al. 2022

Cancer

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BACKGROUND: Colorectal cancer (CRC) incidence and mortality rates are increasing rapidly in many low-income and middle-income countries. A demonstration project was implemented in Morocco in collaboration with the Ministry of Health to assess the feasibility, acceptability, and challenges of implementing CRC screening through routine primary care facilities. METHODS: The objective of the project was to screen 10,000 men and women aged 50 to 75 years through 10 primary health centers (PHCs) in 2 provinces. All eligible men and women attending the selected PHCs were offered the fecal immunochemical test (FIT). Stool specimens brought to the PHCs were tested immediately by trained nurses. FIT-positive individuals were referred to the National Oncology Institute for colonoscopy. RESULTS: In total, 9763 eligible men and women were screened by FIT between June 2017 and May 2019; most (73.3%) were women. The test was positive in 460 participants (4.7%). Among the individuals who had positive FIT results, 62.6% underwent colonoscopy. The main reasons for noncompliance to colonoscopy were competing life priorities (15.4%), other health problems (13%), and fear of getting a cancer diagnosis (12.3%). As the number of referrals to colonoscopy increased, the waiting time for the procedure increased, resulting in a drop in compliance. The detection rates of advanced adenomas and CRC were 4.0 in 1000 and 0.5 in 1000 individuals screened, respectively. CONCLUSIONS: An effective strategy to reach the target populations (especially men), a pragmatic assessment of the health system's capacity to deal with large numbers of referrals, and a formal cost-effectiveness analysis are essential before making any decision to introduce CRC screening in Morocco.

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Colon cancer in Africa: Primetime for screening?

Cited by 23 publications

References 15 publications

The implementation of colorectal cancer screening interventions in low-and middle-income countries: a scoping review

The implementation of colorectal cancer screening interventions in low-and middle-income countries: a scoping review

Awareness of Colorectal Cancer and Associated Factors Among Adult Patients in Jimma, South-West Ethiopia.

Delivering colorectal cancer screening integrated with primary health care services in Morocco: Lessons learned from a demonstration project

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