Factors associated with participation in stool based colorectal screening in Brunei Darussalam

Abstract

Colorectal cancers (CRC) continues to increase worldwide and is associated with significant morbidity and mortality. CRC can be prevented through early detection using several modalities. However, like any screening program participation remains suboptimal. This study assessed the factors associated with participation in a stool based CRC screening that was carried out as part of an Integrated Health Screening Survey for civil servants. Materials and Methods: Civil servants who participated in a health survey (N=10,756, mean age 48.08 ± 5.26 years old) were studied. Demographic factors (gender, age groups, marital status, employment status, body mass index [BMI] categories, smoking status, personal and family history of cancers) were analyzed to assess for features associated with willingness to participate in this fecal immunohistochemistry test (FIT) screening for CRC. Comorbid conditions studied were cardiac disease, diabetes mellitus, dyslipidemia, hypertension and stroke. Multivariate analysis was performed to evaluate variables associated with participation in CRC screening programme. Results: Of the invited 10,756 participants, 7,360 returned a stool specimen giving a participation rate of 68.4%. Those who participated were significantly older (<40 [41.3%], 40-44 [64.6%], 45-49 [68.8%], 50-54 years [70.6%], 55-59 years [72.4%] and >60 years [77.8%], p<0.001 for trend), being of professional employment (p=0.010) and presence of comorbid conditions (p=0.003). There were no significant differences between gender, race, marital status, BMI categories, personal history of cancer, family history of cancer, and smoking status (all p values >0.05). Multivariate analyses showed that older age (45-49, 50-54, 55-59 and >60) and employment status (professional) remained significant factors associated with participation in a stool based CRC screening. Conclusions: Our study showed that older age and professional employment status were significantly associated with willingness to participate in a stool based CRC screening.