Assessing feasibility of community-based colorectal cancer screening in Pune, India

The colorectal cancer (CRC) rates in India are lower than the other Southeast Asian countries but there is a rising trend in incidence as well as mortality. We are reporting the results of a large community-based CRC screening project implemented through a house-to-house survey. Consenting men and women aged 50 to 75 years were informed about the purpose of the study and the benefits of CRC screening. They were educated on how to collect the stool sample for occult blood test in the sample collection tube. The health visitors collected the stool sample from the study participants on the next day. Samples were tested with CANCHECK-FOBT which is CE approved and is a rapid, qualitative, two-site sandwich immunoassay for the detection of faecal occult blood (iFOBT) concentration in human faeces. Participants with a positive iFOBT result underwent colonoscopy as an out-patient procedure at the gastroenterologist’s clinic. A total of 5003 participants provided the consent and 4352 (86.98%) provided the stool sample. iFOBT was positive among 70/4352 (1.61%) participants of whom 31 (44.92%) completed the colonoscopy procedure. Five participants were diagnosed with adenomatous polyps and 1 participant had CRC. The detection rate of histologically confirmed CRC was 0.23 and that of adenomatous polyp was 1.15 per 1000 screened persons. Although the screen positivity, adenomatous polyps and CRC detection rates in our study are much lower than the neighbouring Southeast Asian countries, these findings highlight the importance of investing in preventive healthcare in India.