Saudi Journal of Gastroenterology
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A 5-year evaluation of early-and late-onset sporadic colorectal cancer screening in central Saudi Arabia

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

Correspondence Address:
Georgios Zacharakis,
Division of Gastroenterology, Department of Internal Medicine, Prince Sattam bin Abdulaziz University Hospital, Prince Sattam bin Abdulaziz University, College of Medicine, Al-Kharj
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjg.sjg_333_22

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.

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