Colorectal cancer screening pilot project in Tehran-Iran, a feasibility study

Scientists from the International Agency for Research on Cancer (IARC), in collaboration with researchers from Tehran University of Medical Sciences (Islamic Republic of Iran) report that implementing the first step of an organized screening programme for colorectal cancer in the Islamic Republic of Iran seems feasible from organizational and acceptability standpoints. However, the authors suggest a current focus on improving awareness of colorectal cancer in the general population and an early diagnosis approach among symptomatic patients and high-risk individuals, until the necessary components of a screening programme can be established in the country. The results were published in Archives of Iranian Medicine.

In this feasibility study, community health workers from 33 primary health centres offered colorectal cancer screening tests to more than 7000 individuals aged 50–75 years. Almost 5000 individuals accepted the invitation and received a faecal immunochemical test (FIT) to complete at home; 97% of them returned a sample. A total of 471 people had a positive test result (a FIT positivity rate of about 10%) and were referred for a colonoscopy. Only about one third of the referred patients underwent the examination.

Participants’ opinions and satisfaction levels were assessed with a questionnaire. Almost 100% of participants were satisfied with many aspects of the process, such as the time spent for FIT testing, and mentioned that they would recommend FIT to their relatives and friends. About 90–95% of participants agreed that colorectal cancer is a concerning disease and that FIT testing was easy to do. About two thirds of participants mentioned that stool collection was disgusting.

Colorectal cancer is the third most common cause of cancer death worldwide, and its incidence is increasing in resource-constrained countries, particularly in the World Health Organization (WHO) Eastern Mediterranean Region. Many countries, such as the Islamic Republic of Iran, are discussing their readiness to implement a colorectal cancer screening programme. Challenges are reported in all settings in relation to the adequacy of colonoscopy services, the absence of referral systems, and the lack of knowledge about colorectal cancer among local populations. This study provides valuable information about the acceptability and feasibility of colorectal cancer screening and about compliance rates with colonoscopy. The results could have implications for other developing countries with similar trends of colorectal cancer incidence and related mortality.

Salimzadeh H, Sauvaget C, Delavari A, Sadeghi A, Amani M, Salimzadeh S, et al.
Colorectal cancer screening pilot project in Tehran-Iran, a feasibility study
Arch Iran Med, Published online 1 March 2023;
https://doi.org/10.34172/aim.2023.22