title: Organised colorectal cancer screening in Lampang Province, Thailand: preliminary results from a pilot implementation programme.
abstract: OBJECTIVE
  Colorectal cancer (CRC) is the third-most and fifth-most common cancer in men and women, in Thailand. The increasing CRC incidence and mortality can be reduced by screening and treating adenomas and early cancers. A pilot CRC screening programme using immunochemical faecal occult blood testing (iFOBT) and colonoscopy for test-positives were implemented through the routine Government Health Services in Lampang Province, to inform the acceptability, feasibility and scaling-up of screening in Thailand. This report describes the implementation, coverage and performance indicators of this project.
  
  
  METHODS
  A target population aged 50-65 years was informed about and invited face to face to undergo CRC screening by community health workers (HWs). The HWs provided faecal sample collection kits and participants brought their samples to one of the primary health units or community hospitals where nurses performed iFOBT. iFOBT-positive persons were referred for colonoscopy at the Lampang cancer hospital, and endoscopic polypectomy/biopsies were performed according to the colonoscopic findings. Those with confirmed CRC received appropriate treatment.
  
  
  RESULTS
  Of the 127 301 target population, 62.9% were screened using iFOBT between April 2011 and November 2012. Participation was higher among women (67.8%) than men (57.8%) and lower in 50-54 year-old persons than in 60-65-year-olds. Of those screened, 873 (1.1%) were found positive; positivity was higher in men (1.2%) than in women (1.0%). To date 627 (72.0%) iFOBT-positive persons have had colonoscopy in which 3.7% had CRC and 30.6% had adenomas.
  
  
  CONCLUSIONS
  The successful implementation of the pilot CRC screening with satisfactory process measures indicate the feasibility of scaling-up organised CRC screening through existing health services in Thailand.
authors.affiliation: National Cancer Institute, Bangkok, Thailand.
authors.forename: Thiravud
authors.initials: T
authors.lastname: Khuhaprema
authors.forename: Suleeporn
authors.initials: S
authors.lastname: Sangrajrang
authors.forename: Somkiat
authors.initials: S
authors.lastname: Lalitwongsa
authors.forename: Vanida
authors.initials: V
authors.lastname: Chokvanitphong
authors.forename: Tawarat
authors.initials: T
authors.lastname: Raunroadroong
authors.forename: Tawee
authors.initials: T
authors.lastname: Ratanachu-Ek
authors.forename: Richard
authors.initials: R
authors.lastname: Muwonge
authors.forename: Eric
authors.initials: E
authors.lastname: Lucas
authors.forename: Christopher
authors.initials: C
authors.lastname: Wild
authors.forename: Rengaswamy
authors.initials: R
authors.lastname: Sankaranarayanan
mesh_terms: D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015397:Program Evaluation; D013785:Thailand
keywords: Primary Care