A 5-year evaluation of early-and late-onset sporadic colorectal cancer screening in central Saudi Arabia
Georgios Zacharakis1, Abdulaziz Almasoud2, Omar Arahmaner3, Khaled Aldossary4, Jamaan Alzahrani4, Sameer Al-Ghamdi4, Abdullah AlShehri5, Pavlos Nikolaidis6, Abdullah Bawazir1, Talal Alfayez1, Moataz Daadour1, Faisal Alslimah1, Mohammed Altamimi1, Sami Alshalawi1
1 Department of Internal Medicine, Division of Gastroenterology, College of Medicine, Prince Sattam Bin, Abdulaziz University, Prince Sattam Bin Abdulaziz University Hospital, Al-Kharj, Saudi Arabia
2 Department of Gastroenterology, Prince Sultan Military Medical City, Riyadh; Endoscopy Unit, Al-Kharj Military Hospital, Al-Kharj, Saudi Arabia
3 Endoscopy Unit, King Khaled Hospital and Prince Sultan Centre for Health Care, Al-Kharj, Saudi Arabia
4 Department of Family and Community Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
5 Department of Family Medicine, Al-Kharj Military Hospital, Al-Kharj, Saudi Arabia
6 College of Computer and Information Sciences, Al-Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
Division of Gastroenterology, Department of Internal Medicine, Prince Sattam bin Abdulaziz University Hospital, Prince Sattam bin Abdulaziz University, College of Medicine, Al-Kharj
Source of Support: None, Conflict of Interest: None
Background: The Al-Kharj colorectal cancer (CRC) screening program was implemented for five years (2017-2022) in a central urban area of Riyadh Province, Saudi Arabia, to assess the participation and impact of the program in average-risk individuals.
Methods: The high sensitivity-guaiac based-fecal occult blood test (HSgFOBT) was used as a first-line investigation to identify asymptomatic patients, aged 45–75 years, requiring CRC screening using colonoscopy. The program was run in three tertiary hospitals in the area.
Results: The five-year participation rate was 73% (35,640/48,897). The average age was 53 years (range 45–75), 49% were female (17,464/35,640), all were asymptomatic, and 77% had adequate bowel preparation. The HSgFOBT (+) rate was 6.3% (n = 2245), and 76% (n = 1701) of these underwent colonoscopy. The prevalence of findings were as follows: CRC, 4.8% (81/1701); advanced adenoma, 9.5% (162/1701); adenoma, 15.9% (270/1701); non-adenomatous polyps, 7.9% (135/1701); and no polyps or tumors, 25.4% (432/1701). Among participants aged 45–50 years, early onset-CRC had female predominance, while those ≥50 years with late onset-CRC were predominantly male. CRC was more prevalent in the left colon (P < 0.005).
Conclusions: Approximately one-third of the participants diagnosed with CRC had early-onset CRC. Screening participation was desirable for the defined target population. Public education is necessary along with expanded colonoscopy resources to continue further citizen participation.