The Effect of Test Kit Provision, and Individual and Family Education on the Uptake Rates of Faecal Occult Blood Test in an Asian population: a Randomised Controlled Trial
Screening for colorectal cancer (CRC) using Faecal Occult Blood Test (FOBT) has not reached sufficient levels in Singapore. This study aims to investigate whether FOBT home-delivery and individual education or combined with family education increases FOBT uptake rates.
METHODS:
This is a randomised-controlled intervention study of Singaporean residents aged 50 years and above. The study was conducted over 2100 household units 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) and group C (no education, FOBT kits provided) and Group D (no education or FOBT kits provided). The primary outcome measure was FOBT return rates which was defined as the proportion of all those in each group who returned at least one completed FOBT kit to Singapore Cancer Society (SCS) within 3 months of interview.
RESULTS:
Overall response rate was 74.7%. The FOBT return rates for Group A, B, C and D were 24.5%, 25.3% 10.7% and 2.2% 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 5 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.
CONCLUSIONS:
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.