Testing the effectiveness of a new screening system for colorectal cancer screening: a community trial

Background and study aims
Colorectal cancer incidence is the third, globally, after lung and breast cancer; unfortunately, there is rising incidence, especially among young age groups in Saudi Arabia in the last 18 years due to changes in diet that mimic western countries. On the other hand, there is a great gap in the screening service that matches the current context in Saudi Arabia; this is reflected by the lack of a well-structured screening service that encourages participation and adherence. Low awareness about the importance of screening, fear of cancer, and the absence of a clear vision on how to implement and provide the service are the main obstacles for a successful screening program. This study aims to test the effectiveness of a new system for colorectal cancer screening composed of an integrated network of professionals. This system is expected to facilitate participation by providing psychological support, health education and testing at the health facility level and outreach using community mobilization, health education campaigns, and media.
Who can participate?
Individuals of both genders, aged 40 and over, who are at risk of colorectal cancer attending the selected hospitals (King Fahad and King Khalid Hospitals in Tabuk) in addition to 18 public health centers
What does the study involve?
Participating facilities are randomly allocated to either the intervention or the control group. The control group receive routine care. The intervention is an integrated system composed of a psychologist, an endoscopy physician, a family physician, and audiovisuals in the waiting area; in addition to text messages of information, education and communication (IEC) delivered to the participants at the hospital center, outreach, and education campaigns in order to mobilize the individuals going for screening. Trained health staff provide counseling and education; likewise, well-designed IEC materials and videos are displayed on the waiting area screen, as well as social media and short text messages. Participants attend two counseling and educational sessions: an initial session with a psychologist to educate participants on the importance of the screening and to discuss the screening methods; illiterate participants are given pictorial IEC messages. Experts in IEC prepare and pilot all materials.