Letters | Colorectal cancer: help elderly Hongkongers make the most of early screening services

Despite government subsidisation, colorectal cancer screening uptake rates in Hong Kong remain low. A survey suggests that increased promotion of the subsidised screening programme for elderly Hongkongers is required

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A sign in Wan Chai promotes a colorectal cancer screening programme for Hong Kong residents aged 50 to 75. Photo: K.Y. Cheng

Published: 6:43am, 27 Jun 2021Updated: 6:43am, 27 Jun 2021

Colorectal cancer is one of the most common forms of the disease diagnosed in Hong Kong. It is often asymptomatic in the early stages, and screening can effectively detect and prevent this cancer.

Faecal occult blood tests (FOBT), sigmoidoscopies and colonoscopies are common tests performed to detect the condition. To promote the service, the Department of Health in September 2016 launched a three-year voluntary colorectal cancer screening pilot programme. In 2018, the programme was regularised, and in 2020, it was finally fully implemented, to subsidise such screening among asymptomatic Hong Kong residents aged between 50 and 75.

The decision to undergo screening can be influenced by a variety of factors.

A research team from the Chinese University of Hong Kong conducted a survey to review colorectal cancer screening uptake among asymptomatic average-risk Chinese individuals aged 50 to 75 and to identify the association between individual and community factors, government subsidies and uptake rates.

The survey, conducted from August 2019 to December last year, was completed by 1,317 participants recruited from the community. Of them, 432 reported having previously used the government subsidy for colorectal cancer screening (32.8 per cent), and 578 reported having ever had an FOBT (43.9 per cent). However, despite government subsidisation, colorectal cancer screening uptake rates in Hong Kong remain low compared to elsewhere.

This may be attributed to the Covid-19 pandemic, which has led to neglect of the importance of screening in early cancer detection. The top two most significant factors positively associated with FOBT uptake were the use of the government subsidy for screening and receiving information about cancer screening from booklets. However, perceived barriers to screening continued to be an important deterrent, reducing uptake rates.