Colorectal cancer screening in Semarang, Indonesia: A multicenter primary health care based study

• Published in: PloS one Vol. 18; no. 1; p. e0279570
• Main Authors: Purnomo, Hery Djagat, Permatadewi, Cecilia Oktaria, Prasetyo, Agung, Indiarso, Didik, Hutami, Hesti Triwahyu, Puspasari, Dik, Listiana, Devia Eka, Suhartono, Armatussolikha, Herna Rizkia, Priyadi, Suryanto Setyo, Sadono, Sri, Silvina, Nurhayati, Samsudin, Ahnaf, Hidayanto, Muhammad, Nugroho, Puriyanto Wahyu, Rakhmawati, Nur Dian, Susanto, Agus, Setiawan, Mukti, Sonny, Mochamad
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 03-01-2023; Public Library of Science (PLoS)
• Subjects: Adenoma; Adenoma - diagnosis; Adenoma - epidemiology; Age groups; Aged; Body weight; Cancer; Cancer screening; Citizen participation; Colitis; Colonoscopy; Colonoscopy - methods; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - epidemiology; Colorectal Neoplasms - pathology; Cross-Sectional Studies; Data analysis; Diabetes; Diagnosis; Early Detection of Cancer - methods; Family medical history; Female; Genetics; Health care; Health risks; Histology; Humans; Indonesia - epidemiology; Inflammatory bowel disease; Male; Malignancy; Mass Screening - methods; Medical prognosis; Medical screening; Medicine and Health Sciences; Middle Aged; Morbidity; Mortality; National health insurance; Occult Blood; Overweight; Patients; People and Places; Polyps; Primary care; Primary Health Care; Public awareness; Public health; Tumors; Womens health; Indonesia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0279570

Colorectal cancer (CRC) is a major public health problem in Indonesia. It ranks among the top four cancers with high mortality rates. CRC screening is expected to improve early diagnosis that can reduce mortality and morbidity rate. Primary health care-based CRC screening in Indonesia has not yet been performed. This study was conducted to obtain information about prevalence, adenoma detection rate and public compliance for CRC screening in Semarang, Indonesia. This cross-sectional study was done across 10 primary health care centers in Semarang during April-October 2021. The screening method used Immunochromatography Faecal Occult Blood Tests (I-FOBT) as the primary test. Patients with positive I-FOBT result would be referred to Kariadi hospital for colonoscopy and histology examination. A total of 221 patients were included, 66.1% were female, mean age was 59.38 ± 7.48 years. Participation rate was 63%, 37 patients (16.7%) were I-FOBT positive, 26 patients (70.27%) underwent colonoscopy. Colonoscopy compliance rate was 70.27%. The colonoscopy results were haemorrhoid (30.8%), polyps (30.8%), malignancy (19.2%), colitis (7.7%), diverticulosis (7.7%), and normal (3.8%). The adenoma detection rate was 26.9%. BMI abnormality (overweight and obese) (OR 10.968; 95% CI 2.33-51.55) and family history of malignancy (OR 18.800; 95% CI 5.13-68.85) increased the risk of colorectal cancer and adenoma and respectively. The prevalence of I-FOBT positive in primary health care centers is high. The CRC screening program based on primary care should be considered. Public awareness education should be considered to increase colonoscopy compliance.