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

Abstract

IntroductionColorectal cancer (CRC) imposes a significant global burden of disease. CRC survival rates are much lower in low-income and middle-income countries (LMICs). Screening tends to lead to an improvement in cancer detection and the uptake of available treatments and, in turn, to better chances of cancer survival. Most evidence on CRC screening interventions comes from high-income countries. The objective of this scoping review is to map the available literature on the implementation of CRC screening interventions in LMICs.Methods and analysisWe will conduct a scoping review according to the framework proposed by Arksey and O’Malley (2005). We will search MEDLINE, EMBASE, Web of Science and Google Scholar using a combination of terms such as “colorectal cancer”, “screening” and “low-middle-income countries”. Studies of CRC screening interventions/programmes conducted in the general adult population in LMICs as well as policy reviews (of interventions in LMICs) and commentaries on challenges and opportunities of delivering CRC screening in LMICs, published in the English language before February 2020 will be included in this review. The title and abstract screen will be conducted by one reviewer and two reviewers will screen full-texts and extract data from included papers, independently, into a data charting template that will include criteria from an adapted template for intervention description and replication checklist and implementation considerations. The presentation of the scoping review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews guidance.Ethics and disseminationThere are no ethical concerns. The results will be used to inform colorectal screening interventions in LMICs. We will publish the findings in a peer-reviewed journal and present them at relevant conferences.

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

“…identifying the research question; identifying relevant studies; study selection; charting the data; collating and reporting the results) [13]. The review protocol was developed and published prior to the search [14]. A scoping review was deemed the most appropriate method to ensure that we captured and analysed the full range and breadth of studies about CRC screening in LMICs.…”

Global colorectal cancer burden in 2020 and projections to 2040

“…These treatments have effectively inhibited cancer progression and prolonged overall survival. The implementation of population-based screen of CRC such as fecal occult blood test and endoscopy, also greatly enhances the overall survival and leads to good prospects of a cure for CRC [3] , [4] , [5] , [6] . In the United States, the mortality rates of CRC have been in a long-term decline through 2017, even as the reduction among women has slowed down recently [7] .…”

Economic evaluations of colorectal cancer screening: A systematic review and quality assessment

“…There are many variables to be considered, for example, previous preparation needed, risk of adverse events, cost, and frequency. In addition, the screening strategies will also impact health services differently, as some strategies require previous preparation, specialized personnel, and the use of physical space inside health institutions, such as colonoscopy and computed tomography [26] , [27] . Therefore, economic evaluations are essential to draw each country's scenario and to support local decision-makers.…”