A pilot six-month community outreach program in Osun State, Nigeria helped boost local knowledge about colorectal cancer and detection of early stage cancer and precancerous polyps.
As reported in the journal Cancer, the international research team found that awareness of colorectal cancer in the local area increased from 16.8% before the campaign to 96.9% afterwards. The campaign directed 116 people to have a colonoscopy and picked up stage 0 colorectal cancer in two patients and advanced adenomas in 11, allowing early treatment to take place.
“According to the 2022 GLOBOCAN report, colorectal cancer is the third most commonly diagnosed malignancy worldwide and the second leading cause of cancer‐related death,” write lead author Peter Kingham, MD, a surgical oncologist and researcher at Memorial Sloan Kettering Cancer Center, New York, and colleagues.
“Prognosis is particularly poor in Nigeria, given that 80% of patients with colorectal cancer present at an advanced stage.”
In this study, a six-month community awareness campaign was carried out in Osun State, Nigeria including posters, radio jingles, social media, and messaging from both health and religious organizations.
Overall, 322 of 497 possible participants filled out a questionnaire on colorectal cancer both before and after the study period. The study directed 329 people to the early diagnosis clinic, 168 of whom were eligible to participate. Of these, 116 with risk factors for colorectal cancer, such as anal bleeding, family history or recent change in bowel habits, underwent colonoscopy to screen for signs of the disease.
In the group of 322 people who filled out questionnaires at the beginning and the end of the study, awareness of colorectal cancer went up significantly after the campaign from 54 people (16.8%) knowing about the condition to 311 (96.9%) people. The group knowledge about risk factors for colorectal cancer and what symptoms to look out for also improved a lot during the six-month study.
In the group of people who were referred to have a colonoscopy, most had non-cancerous internal hemorrhoids, which can cause anal bleeding. However, 31 had intestinal polyps, which can develop into colorectal cancer and of these, 13 had reached the precancerous stage and were classified as advanced adenomas.
The researchers also found four cases of colorectal cancer, two were very early at stage 0, one was stage 2 and one stage 3.
“This program is the first of its kind to demonstrate a program in sub-Saharan Africa that includes both community education and symptoms that trigger navigation to a colorectal cancer early diagnosis clinic to prevent cancer in patients with advanced adenomas and identify colorectal cancer in curable stages,” said Kingham.
“This pilot program shows that symptom‐based early detection can work in low resource settings, and may help save lives if expanded nationally,” conclude the authors.
