A six-month community awareness campaign has significantly increased colorectal cancer awareness in part of Nigeria, leading researchers to recommend expanding the model to the national level.
Colorectal cancer incidence in western sub-Saharan Africa increased 182% from 1990 to 2019, compared to a 55% rise in high-income North America. Even bigger jumps in incidence were seen in other regions with low- and middle-income countries, where lifestyles are changing in ways that raise the risk of the cancer type.
Many colorectal cancer cases are currently diagnosed too late in low- and middle-income countries for patients to receive curative therapies. Recognizing the need for early-detection programs, researchers ran a six-month community awareness campaign in Osun State, Nigeria, and published their findings in the journal, Cancer.
The campaign used posters, radio jingles, social media and messaging via health and religious institutions to raise awareness of colorectal cancer. The researchers interacted with 497 eligible participants, 322 of whom completed pre- and postcampaign surveys, to assess the campaign's impact.
At baseline, 16.8% of participants were aware of colorectal cancer. The figure jumped to 96.9% by the end of the campaign. The researchers also reported a statistically significant increase in the number of people with good knowledge of the disease’s risk factors and symptoms.
An early diagnosis clinic saw 329 people, around half of whom were eligible for the protocol. More than 100 people underwent a colonoscopy. The tests led to the diagnosis of four people with colorectal cancer. Two patients had stage 0 cancer, the earliest stage of the disease. The researchers also identified advanced adenomas, which in some cases can turn into cancer, in 13 patients.
Senior author T. Peter Kingham, M.D., said in a statement that the program is the first in sub-Saharan Africa to use community education and symptoms to trigger navigation to an early-diagnosis clinic “to prevent cancer in patients with advanced adenomas and identify colorectal cancer in curable stages.”
Kingham and his co-authors recommended expanding the model nationally. Running the community awareness campaign at a larger scale could show the broader impact and cost-effectiveness of the model while revealing potential implementation challenges, the researchers said.