Abstract
Purpose
The purpose of the study was to investigate whether fecal occult blood test (FOBT) home-delivery and individual education or combined with family education increases FOBT uptake rates in Singapore.
Methods
This is a randomized controlled intervention study of Singaporean residents aged 50 years and above, conducted in May 2012 till May 2013. Eligible individuals in randomly selected households were screened, and one member was randomly selected and allocated to one of the four arms: Group A (individual and family education, FOBT kits provided), Group B (individual education only, FOBT kits provided), Group C (no education, FOBT kits provided) and Group D (no education or FOBT kits provided).
Results
Overall response rate was 74.7 %. The FOBT return rates for groups A, B, C and D were 24.5 % [CI 16.2–34.4 %], 25.3 % [CI 16.4–36.0 %], 10.7 % [CI 4.7–19.9 %] and 2.2 % [CI 0.3–7.7 %], respectively. Respondents who were provided education and home-delivered FOBT kits were 15 times more likely to return FOBT kits [Group A: OR 15.0 (3.4–66.2); Group B: OR 15.5 (3.5–68.8)] and those provided with home-delivered FOBT without education were five times more likely to return FOBT kits [Group C: OR 5.8 (1.2–28.3)] than those without education and FOBT kits (Group D). There was no significant difference in return of FOBT kits whether education was provided to subject with or without a family member.
Conclusion
Home delivery of FOBT kits increased FOBT return rates and individual education combined with home-delivered FOBT increased FOBT return rates even further. However, additional combination with family education did not increase FOBT rates further.
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Acknowledgments
We thank Ms. Ong Whee Sze for her significant contribution in sampling and statistical support. Also, staff at Department of Statistics Singapore for providing us the samples from customized sampling frame, the pool of interviewers for their hard work, Madam Alice Poh and Ms. Wendy Ong Yong Siew as our part-time staff who assisted us throughout the project. We would like to also thank the Singapore Cancer Society for their generous contribution in providing FOBT kits and the necessary logistical support. This work was funded by the National Cancer Centre Research Fund. The funding body has no role in study design; in the collection, analysis, and interpretation of data; in writing of the report; and in the decision to submit the paper for publication.
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Appendices
Appendix 1: CRC Screening Form
Appendix 2: CRC Screening Knowledge Questionnaire
Appendix 3: Standardized education package for CRC screening administered using iPad
Outline in presentation | Information provided |
---|---|
What is CRC? | Cancer of the large intestine (colon and rectum) In Singapore, most common cancer among men and second most common among women 8,206 new cases (2006–2010) At risk of CRC: 50 years and above Diet high in fat and low dietary fiber Sedentary lifestyle and obese |
Importance of screening | Detect cancer early even though no symptoms Detect early, better chance of cure Less complications in treatment Less medical costs |
Recommended frequency of screening | Average-risk individuals, beginning at the age of 50 years Once a year for FOBT (fecal occult blood testing) |
What is the FOBT | Showing what the kit looks like graphically |
Contents of FOBT pack | Showing the contents of FOBT graphically |
Using of FOBT kits for collection of stool sample | Using step-by-step picture guide from the Singapore Cancer Society and Health Promotion board to illustrate in this section |
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Ha, T.C., Yong, S.K., Yeoh, KW. et al. The effect of test kit provision, and individual and family education on the uptake rates of fecal occult blood test in an Asian population: a randomized controlled trial. Cancer Causes Control 25, 1473–1488 (2014). https://doi.org/10.1007/s10552-014-0449-4
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DOI: https://doi.org/10.1007/s10552-014-0449-4