A Colorectal Cancer Screening Programs in Middle-Income Countries: A Scoping Review
Main Article Content
Abstract
Background: Colorectal cancer (CRC) is the 3rd most common cancer worldwide, and a major contributor to cancer-related mortality. In contrast to declining CRC incidence and mortality rates across high-income countries, the CRC burden is increasing in low- and middle-income countries. Although CRC screening has been shown to be a cost-effective intervention that decreases CRC incidence and mortality, screening programs remain an unmet need in most low- and middle-income countries. This article reviews evidence on existing CRC screening efforts in middle income countries, where the majority of new CRC cases and deaths are projected to occur over the next decade.
Aims: The aim of this study was to identify and describe opportunistic and organized CRC screening programs in middle income countries and to identify barriers and facilitators of such programs.
Methods: We identified countries defined as middle income countries by the World Bank and conducted a scoping literature review using PubMed, Google Scholar, and ScienceDirect. For each country, we identified whether CRC screening guidelines or programs exist on the national, regional, or local levels, and summarized data on screening methods and uptake, when this information was available. We also summarized published literature describing barriers and facilitators to CRC screening in middle income countries.
Results: Of the 108 countries defined as middle income countries by the World Bank, we identified CRC screening programs in six lower-middle income countries and 23 upper-middle income countries. Most countries have opportunistic CRC screening guidelines/programs. Countries with organized CRC screening programs had higher screening uptake rates, although very few have achieved CRC screening coverage rates of >50% of the eligible population. Most programs were initiated less than 10 years ago, limiting ability to evaluate effect on CRC incidence and mortality. Several barriers to CRC screening were identified, including lack of physician buy in, participant knowledge and resources, and participant fear of screening.
Conclusions: While there has been growth of CRC screening programs in the last decade with the initiation of both opportunistic and organized screening programs in middle income countries, there remain significant barriers to the uptake and implementation of such programs.
Article Details
How to Cite
MICHEL, Alissa; PUMPALOVA, Yoanna S.
A Colorectal Cancer Screening Programs in Middle-Income Countries: A Scoping Review.
Medical Research Archives, [S.l.], v. 11, n. 7.2, july 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4192>. Date accessed: 15 may 2024.
doi: https://doi.org/10.18103/mra.v11i7.2.4192.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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4. Nigeria National Cancer Control Plan (2018-2022). Ministry for Health, Nigeria; 2018. Accessed June 10, 2023. https://www.iccp-portal.org/system/files/plans/NCCP_Final%20%5B1%5D.pdf
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6. Alatise OI, Dare AJ, Akinyemi PA, et al. Colorectal cancer screening with fecal immunochemical testing: a community-based, cross-sectional study in average-risk individuals in Nigeria. Lancet Global Health. 2022;10:e1012-22.
7. Koo JH, Leong RWL, Ching J, et al. Knowledge of, attitudes toward, and barriers to participation of colorectal cancer screening tests in the Asia-Pacific region: a multicenter study. Gastrointest Endosc. 2012;76(1):126-135. doi:10.1016/j.gie.2012.03.168
8. Ngelangel CA, Wang EHM. Cancer and the Philippine Cancer Control Program. Jpn J Clin Oncol. 2002;32 Suppl:S52-61. doi:10.1093/jjco/hye126
9. Purnomo HD, Permatadewi CO, Prasetyo A, et al. Colorectal cancer screening in Semarang, Indonesia: A multicenter primary health care based study. PLoS One. 2023;18(1):e0279570. doi:10.1371/journal.pone.0279570
10. Abdullah M, Nufus H, Syam AF, Makmun D, Simadibrata M, Rani AA. The Use of Immunochemical Fecal Occult Blood Test as Colorectal Cancer Screening Tool in Asymptomatic Population in Indonesia. The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy. 2014;15(1):15-19. doi:10.24871/151201415-9
11. Rahimi F, Rezayatmand R, Shojaeenejad J, Tabesh E, Ravankhah Z, Adibi P. Costs and outcomes of colorectal cancer screening program in Isfahan, Iran. BMC Health Serv Res. 2023;23(1):13. doi:10.1186/s12913-022-09010-1
12. Salimzadeh H, Bishehsari F, Sauvaget C, et al. Feasibility of Colon Cancer Screening by Fecal Immunochemical Test in Iran. Arch Iran Med. 2017;20(12):726-733.
13. Hassanlouei B, Ostovar A, Motevalian SA, et al. Colorectal Cancer Screening Program Results in Iran. Med J Islam Repub Iran. 2022;36:118. doi:10.47176/mjiri.36.118
14. Chen H, Lu B, Dai M. Colorectal Cancer Screening in China: Status, Challenges, and Prospects — China, 2022. CCDCW. 2022;4(15):322-328. doi:10.46234/ccdcw2022.077
15. Zheng S, Chen K, Liu X, et al. Cluster Randomization Trial of Sequence Mass Screening for Colorectal Cancer. Diseases of the Colon & Rectum. 2003;46(1):51. doi:10.1007/s10350-004-6496-2
16. Li S, Wang H, Hu J, et al. New immunochemical fecal occult blood test with two-consecutive stool sample testing is a cost-effective approach for colon cancer screening: results of a prospective multicenter study in Chinese patients. Int J Cancer. 2006;118(12):3078-3083. doi:10.1002/ijc.21774
17. Meng W, Cai SR, Zhou L, Dong Q, Zheng S, Zhang SZ. Performance value of high risk factors in colorectal cancer screening in China. World J Gastroenterol. 2009;15(48):6111-6116. doi:10.3748/wjg.15.6111
18. Chen H, Li N, Ren J, et al. Participation and yield of a population-based colorectal cancer screening programme in China. Gut. 2019;68(8):1450-1457. doi:10.1136/gutjnl-2018-317124
19. Zhang J, Xu H, Zheng L, et al. Determinants of Participation and Detection Rate of Colorectal Cancer From a Population-Based Screening Program in China. Frontiers in Oncology. 2020;10. Accessed June 9, 2023. https://www.frontiersin.org/articles/10.3389/fonc.2020.01173
20. Cai SR, Zhang SZ, Zhu HH, Zheng S. Barriers to colorectal cancer screening: A case-control study. World J Gastroenterol. 2009;15(20):2531-2536. doi:10.3748/wjg.15.2531
21. Wang L, Chen H, Zhu Y, et al. One-sample quantitative and two-sample qualitative faecal immunochemical tests for colorectal cancer screening: a cross-sectional study in China. BMJ Open. 2022;12(5):e059754. doi:10.1136/bmjopen-2021-059754
22. Arunah C, Feisul IM, Nor Saleha IT, Muhammad Radzi AH. Overview of colorectal cancer screening programme in Malaysia. Med J Malaysia. 2020;75(3):235-239.
23. Chandran A. Overview of colorectal cancer screening programme in Malaysia. 2020;75(3).
24. Non-Communicable Disease: Risk Factors and Other Health Problems. National Institutes of Health (NIH) Ministry of Health Malaysia; 2019. Accessed June 10, 2023. https://iku.moh.gov.my/images/IKU/Document/REPORT/NHMS2019/Report_NHMS2019-NCD_v2.pdf
25. National Comprehensive Cancer Control Plan (2017-2022). Ministry of Health & Human Services Republic of the Marshall Islands; 2022. ftp://ftp.cdc.gov/pub/Publications/Cancer/ccc/marshall_islands_ccc_plan-508.pdf
26. Republic of Palau: Comprehensive Cancer Control Plan (2018-2023). Bureau of Public Health Services; 2018. https://ftp.cdc.gov/pub/publications/cancer/ccc/republic_of_palau_ccc_plan-508.pdf
27. American Samoa Comprehensive Cancer Control Plan 2007-2012. American Samoa Community Cancer Coalition; 2007.
28. Ruidas L, Adaoag A, Tofaeono Willams V, Sesepasara M. Cancer in American Samoa. Pacific Health Dialog. 2004;11(2):17-22.
29. Lohsiriwat V, Chaisomboon N, Pattana-Arun J. Current Colorectal Cancer in Thailand. Ann Coloproctol. 2020;36(2):78-82. doi:10.3393/ac.2020.01.07
30. Khuhaprema T, Sangrajrang S, Lalitwongsa S, et al. Organised colorectal cancer screening in Lampang Province, Thailand: preliminary results from a pilot implementation programme. BMJ Open. 2014;4(1):3671. doi:10.1136/BMJOPEN-2013-003671
31. Magwaza S. Colorectal Cancer Screening in South Africa: Consideration for National Risk Differentiated Colorectal Cancer Screening Programme. OAJBS. 2022;4(1). doi:10.38125/OAJBS.000372
32. Jadallah K, Khatatbeh M, Mazahreh T, et al. Colorectal cancer screening barriers and facilitators among Jordanians: A cross-sectional study. Prev Med Rep. 2023;32:102149. doi:10.1016/j.pmedr.2023.102149
33. Giordano L, Bisanti L, Salamina G, et al. The EUROMED CANCER network: state-of-art of cancer screening programmes in non-EU Mediterranean countries. Eur J Public Health. 2016;26(1):83-89. doi:10.1093/eurpub/ckv107
34. Buturovic S. Colonoscopy as a Method of Choice in the Diagnosis of Colorectal Cancer. Acta Inform Med. 2014;22(3):164-166. doi:10.5455/aim.2014.22.164-166
35. Nonikashvili M, Kereselidze M, Toidze O, Beruchashvili T. The incidence of colorectal cancer (CRC) in Georgia continues to increase: A population-based registry study. Cancer Treat Res Commun. 2023;35:100693. doi:10.1016/j.ctarc.2023.100693
36. Cancer in Georgia (2015-2019). National Center for Disease Control and Public Health; 2019. Accessed June 10, 2023. https://test.ncdc.ge/Handlers/GetFile.ashx?ID=61a5547b-8e8b-482b-8425-12f8bdfbb7bb
37. Strengthening Cancer Screening in Montenegro. Institute of Health Metrics and Evaluation; 2015. Accessed June 10, 2023. https://www.integratedcare4people.org/media/files/Montenegro.pdf
38. WP7 - Implementation of colorectal cancer screening. EU-TOPIA-EAST. Accessed June 10, 2023. https://eu-topia-east.org/workpackages/wp7-road-maps/
39. Jovanka T, Nevenka V. The Importance of Molecular Diagnostics and Screening Programs in Monitoring and Evaluation of Colorectal Cancer in the Republic of North Macedonia. Sestrinski glasnik. 2020;25(2):152-154. doi:10.11608/sgnj.25.2.10
40. Goss PE, Strasser-Weippl K, Lee-Bychkovsky BL, et al. Challenges to effective cancer control in China, India, and Russia. Lancet Oncol. 2014;15(5):489-538. doi:10.1016/S1470-2045(14)70029-4
41. Avksentyeva M. Colorectal cancer in Russia. European Journal of Health Economics. 2009;10 (Suppl 1):S91-S98. doi:10.1007/s10198-009-0195-9
42. Barchuk A, Raskina Y, Tursun-Zade R, Craig H, Chandrakanth A, Gushchin V. Cancer on the Global Stage Incidence and Cancer-Related Mortality in the Russian Federation. The ASCO Post. Published online February 10, 2022. Accessed June 10, 2023. https://ascopost.com/issues/february-10-2022/cancer-on-the-global-stage-incidence-and-cancer-related-mortality-in-the-russian-federation/
43. Banković Lazarević D, Krivokapić Z, Barišić G, Jovanović V, Ilić D, Veljković M. Organized colorectal cancer screening in Serbia - the first round within 2013-2014. Vojnosanit Pregl. 2016;73(4):360-367. doi:10.2298/VSP150421113B
44. Gultekin M. Turkey Cancer Control Programme. Republic of Turkey Ministry of Health Cancer Control Department; 2016. Accessed June 10, 2023. https://www.iccp-portal.org/system/files/plans/Turkiye_Kanser_Kontrol_Program_English.pdf
45. Mauyenova D, Zhadykova Y, Khozhayev A, et al. Trends of Colorectal Cancer Incidence in Kazakhstan. Asian Pac J Cancer Prev. 2021;22(10):3405-3414. doi:10.31557/APJCP.2021.22.10.3405
46. Zhylkaidarova A, Kaidarova D, Batyrbekov K, Shatkovskaya O, Begimbetova D. Trends of Colorectal Cancer Prevalence in Kazakhstan Related to Screening. Clin Endosc. 2021;54(1):32-37. doi:10.5946/ce.2019.198
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