Colorectal Cancer Screening Using Immunochemical Faecal Occult Blood test in Perak – A Cross-Sectional Study

Colorectal cancer (CRC) is the second most common cancer in Malaysia (13.5%).1 Immunochemical faecal occult blood test (iFOBT) is known to be a newer, simpler, more sensitive, less expensive and non-invasive approach to CRC screening available.2, 3 The objectives of this study was to describe sociodemographic characteristics, prevalence of positive iFOBT tests and association between positive iFOBT tests, sociodemographic characteristics and colonoscopic findings of detecting CRC in Perak. This was a retrospective cross-sectional study, involving secondary data review of all patients screened for CRC using iFOBT in 96 government health clinics in Perak, from 1/1/2019 until 31/12/2019. Universal sampling method was used. Total of 819 patients were screened. Detailed colonoscopic findings were obtained from database in Perak State Health Department. Mean age was 62.64 (±7.37) years, 50.7% were females and 49.3% were males. Majority of respondents were Malays (57.4%) and iFOBT tests were done in urban government health clinics (67.8%). Out of 819 respondents, 3.1% obtained positive iFOBT results, majority being Malays (1.7%), females (1.6%) with age <65 years old (1.8%). Among the 3.1%, only 4 had pre-cancerous/cancerous lesion colonoscopic findings. Analysis of association between positive iFOBT results, sociodemographic characteristics and colonoscopic findings revealed no significant association between age and gender with colonoscopic findings. There was significant association between ethnicity and colonoscopic findings (p=0.037), however, only 4 tested positive. The detection rate for carcinoma is suboptimal using iFOBT test, probably due to the low numbers screened. Further strengthening of the program is needed to achieve a more favourable outcome.