Predictive factors by multivariate analysis for colorectal cancer in Malaysian patients undergoing colonoscopy

The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics.

Section: Discussionmentioning

confidence: 99%

“…About 93% were done for investigation of symptoms and surveillance of previous cancer. This shows that the use of colonoscopy as a screening tool in asymptomatic patients is underutilised (Tan et al, 2002). Among Malaysian patients, local study shows that anaemia is the most common presentation (Rashid et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Colorectal Cancer Screening Practices of Primary Care Providers: Results of a National Survey in Malaysia

Daud

Harmy²,

Norhayati³

et al. 2014

“…Based on the above results, the authors suggest that colonoscopy should be prioritized to the high risk group population, especially those with positive family history and older age group. Tan et al also suggested that priority given to patient presented with rectal bleeding and iron deficiency anemia (Tan et al, 2002). Simultaneously, concerted effort is needed to increase numbers of skill operators and availability of the procedure throughout the country.…”

Section: Discussionmentioning

confidence: 99%

Colorectal Cancer Awareness and Screening Preference: A Survey during the Malaysian World Digestive Day Campaign

Suan

Mohammed²,

Hassan³

2016

Background: Although the incidence of colorectal cancer in Malaysia is increasing, awareness of this cancer, including its symptoms, risk factors and screening methods, remains low among Malaysian populations. This survey was conducted with the aim of (i) ascertaining the awareness level regarding colorectal cancer symptoms, risk factors and its screening among the general populations and (ii) assessing the public preference and willingness to pay for colorectal cancer screening. Materials and Methods: The questionnaire was distributed in eight major cities in West Malaysia during the World Health Digestive Day (WDHD) campaign. Two thousand four hundred and eight respondents participated in this survey. Results: Generally, awareness of colorectal cancer was found to be relatively good. Symptoms such as change in bowel habit, blood in the stool, weight loss and abdominal pain were well recognized by 86.6%, 86.9%, 83.4% and 85.6% of the respondents, respectively. However, common risk factors such as positive family history, obesity and old age were acknowledged only by less than 70% of the respondents. Almost 80% of the respondents are willing to take the screening test even without any apparent symptoms. Colonoscopy is the preferred screening method, but only 37.5% were willing to pay from their own pocket to get early colonoscopy. Conclusions: Continous cancer education should be promoted with more involvement from healthcare providers in order to make future colorectal cancer screening programs successful.

“…Rectal bleeding is the most common and important symptom of CRC (Majumdar et al, 1999;Tan et al, 2002) with the highest positive predictive value for CRC than other symptoms (Ferraris et al, 2004). Hence, awareness on this symptom will be crucial to promote early identification of the disease.…”

Section: Discussionmentioning

confidence: 99%

Sociodemographic Predictors of Recall and Recognition of Colorectal Cancer Symptoms and Anticipated Delay in Help-Seeking in a Multiethnic Asian Population

Loh¹,

Majid²,

Dahlui³

et al. 2013

Background: Colorectal cancer is the second most common cancer in Malaysia. The prognosis of the disease is excellent if detected at an early stage, but the majority of Malaysian patients present at late stages. We aimed to assess the awareness of cancer warning signs and anticipated delay in help-seeking as possible contributors to this phenomenon. Materials and Methods: A population-based cross-sectional survey using the Colorectal Cancer Awareness Measure was initiated in Perak, Malaysia. A total of 2,379 respondents aged 18 years and above were recruited using a multi-stage sampling in five locations. Analysis of covariance was used to examine independent sociodemographic predictors of scores for symptom awareness. Results: Younger age, being female, a higher education, and higher income were significantly associated with better scores for both recall and recognition of warning symptoms. Among the ethnic groups, Malays had better recognition of symptoms whereas Chinese recalled the most symptoms. Passing bloody stool was associated with the least anticipated delay and unexplained anal pain had the highest anticipated delay. Conclusions: The level of awareness across all ethnicities in Malaysia is generally low, especially among minorities. Targeted public education, which is culturally and linguistically appropriate, should be developed to encourage early help-seeking and improve clinical outcomes.