Participation in colorectal cancer screening among asymptomatic average-risk Chinese aged 50 to 75: A population-based survey

ISRCTN ISRCTN19611025
DOI https://doi.org/10.1186/ISRCTN19611025
Secondary identifying numbers 2019.396
Submission date
21/08/2019
Registration date
23/08/2019
Last edited
04/01/2023
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Colorectal cancer is the first and second most common cancer among male and female respectively in Hong Kong. In September 2016, the Department of Health launched a three-year voluntary colorectal cancer screening pilot programme in Hong Kong and subsidised eligible Hong Kong Chinese to undergo fecal immunochemical tests (FIT). Despite the success of the programme in the detection of adenoma and adenocarcinoma (cancer), the overall screening participation rate in the programme was only 8.3%. The decision on whether to go for a test or not could be related to a few reasons or factors that influence individuals’ behaviours. In 2019, the implementation of Government-subsidised colorectal cancer screening programme to Hong Kong Chinese has been regularized and whether such subsidies will change people’s intention and their final decision on whether to participate in the screening or not still remain unknown. In order to inform further health-promoting intervention and enhance the screening uptake, it is necessary to understand the participation of colorectal cancer screening among asymptomatic Chinese and the associated factors.
Aim of the study: To assess the colorectal cancer screening participation among the asymptomatic average-risk population of HK Chinese aged 50 to 75 and to identify the association between predisposing, enabling and need factors, personal health practice and colorectal cancer screening participation.

Who can participate?
Hong Kong Chinese aged 50 to 75 years with no history of colorectal cancer

What does the study involve?
Participants will take part in a telephone survey regarding their general health

What are the possible benefits and risks of participating?
The study finding may help to improve understanding of the influence of individual and community factors on Hong Kong Chinese in the use of colorectal cancer screening. The findings may also inform the revision of current promoting strategies and intervention to increase and enhance colorectal cancer screening uptake. There are no risks.

Where is the study run from?
Faculty of Medicine, The Chinese University of Hong Kong

When is the study starting and how long is it expected to run for?
August 2019 to June 2020

Who is funding the study?
Faculty of Medicine, The Chinese University of Hong Kong

Who is the main contact?
Dr Dorothy Chan
dorothycns@cuhk.edu.hk

Contact information

Dr Dorothy Chan
Public

Rm 812, 8/F, Esther Lee Building
The Chinese University of Hong Kong
Shatin
Hong Kong
-
China

ORCiD logoORCID ID 0000-0001-6848-9947
Phone +852 39438165
Email dorothycns@cuhk.edu.hk

Study information

Study designCross-sectional study
Primary study designObservational
Secondary study designCross sectional study
Study setting(s)Community
Study typeScreening
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleParticipation in colorectal cancer screening among asymptomatic average-risk Chinese aged 50 to 75: A population-based survey
Study objectivesTo explore the factors associated with colorectal cancer screening behavior
Ethics approval(s)Approved 19/08/2019, Ethics committee of the Joint Chinese University of Hong Kong - New Territories East Cluster (8/F, Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong SAR, NT, China; +852 2144 5926), ref: 2019.396
Health condition(s) or problem(s) studiedColorectal cancer
InterventionParticipants will be recruited via telephone using random sampling. A random digit dialling approach will be used to ensure that households in different districts and individuals have an equal opportunity to be contacted. Any respondent meeting the inclusion criteria will be invited to join the study. For any household with more than one respondent, the respondent with the birthday closest to the interview date will be invited to join. When a number cannot be reached at the first attempt, at least two more attempts will be made at different times on various days of the week.

The study will involve a structured survey guided by the Andersen Behavioral Model in data collection. The survey consists of five sections, namely:
1. Socio-demographic data (predisposing and enabling factors)
2. Perceived and evaluated health status
3. Personal health practice
4. Screening intention and participation
5. Health beliefs
(Chinese version of the survey will be used in the study)

Data will be summarized and presented using appropriate descriptive statistics. Normality of continuous variables will be assessed using skewness and kurtosis statistics and graphically by normal probability plot. Appropriate transformations will be made on skewed variables to correct their skewness before being entered statistical analyses. The primary outcome variables of the study are uptakes of a colorectal cancer screening, namely FOBT and colonoscopy. Logistic regression will be used to examine influencing factors associated with each of the outcomes. Univariate analysis of each of the potential influencing factors associated with each of the outcomes will be performed using binary logistic regression. Those factors with p < 0.25 will be selected as candidate independent variables for multivariable logistic regression to delineate factors independently associated with each outcome. Subgroup analysis will also be done to reveal any difference between male and female participants. The goodness-of-fit of the final multivariable logistic regression models for each outcome will be assessed by Hosmer-Lemeshow test, the results of the model will be presented by the odds ratios (OR) and their associated 95% confidence intervals (CI) of the factors retained in the model.
Intervention typeOther
Primary outcome measureFecal occult blood test uptake and colonoscopy uptake assessed by medical history interview at baseline.
Secondary outcome measuresIntention to have fecal occult blood test assessed by interview at baseline
Overall study start date22/02/2019
Completion date30/12/2020

Eligibility

Participant type(s)Healthy volunteer
Age groupAdult
SexBoth
Target number of participants1316
Total final enrolment1317
Key inclusion criteria1. Hong Kong Chinese aged 50 to 75 years
2. Absence of symptoms suggestive of colorectal cancer, such as a change in bowel habits in the past month, melena, weight loss of more than 5 kilograms in the past six months
3. No history of colorectal cancer
4. Able to understand or communicate in Cantonese
Key exclusion criteria1. Hearing impairment
Date of first enrolment26/08/2019
Date of final enrolment30/04/2020

Locations

Countries of recruitment

  • China
  • Hong Kong

Study participating centre

The Chinese University of Hong Kong
Rm 812, 8/F
Esther Lee Building
The Chinese University of Hong Kong
Shatin, NT
Hong Kong
NT
China

Sponsor information

The Nethersole School of Nursing
University/education

The Chinese University of Hong Kong
Shatin
Hong Kong
NT
China

Phone 39438174
Email nursing@cuhk.edu.hk
ROR logo "ROR" https://ror.org/00t33hh48

Funders

Funder type

University/education

Faculty of Medicine, The Chinese University of Hong Kong

No information available

Results and Publications

Intention to publish date30/06/2021
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryOther
Publication and dissemination planProduce 2 manuscripts in a high-impact peer-reviewed journal and present in 3 international conferences
IPD sharing planAll data generated or analysed during this study will be included in the subsequent results publication

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 20/06/2022 04/01/2023 Yes No

Editorial Notes

04/01/2023: The following changes have been made:
1. Publication reference added.
2. The final enrolment number has been added from the reference.
12/05/2020: The following changes have been made:
1. The overall trial end date has been changed from 30/04/2020 to 30/12/2020.
2. The intention to publish date has been changed from 30/08/2020 to 30/06/2021.
22/08/2019: Trial’s existence confirmed by Ethics committee of the Chinese University of Hong Kong