One-stop screening of CRC, breast and prostate cancer shows promising early results

A programme that offers one-stop screening of colorectal cancer (CRC), breast cancer and prostate cancer is effective with a high level of acceptance among asymptomatic individuals in Hong Kong, researchers from the Chinese University of Hong Kong (CUHK) have reported.

The CUHK Jockey Club Multi-Cancer Prevention Programme, a 5-year programme launched in 2018, aims to provide free cancer screening to asymptomatic Hong Kong residents aged 40–75 years, and to raise public awareness about screening of obesity-related cancers.

With a target recruitment of 10,000, a total of 3,446 individuals (male, 44.7 percent; overweight or obese, 87.6 percent) had been enrolled into the programme between 6 August 2018 and 18 August 2020.

Among 3,230 participants eligible for faecal occult blood test, 367 (11.4 percent) had a positive result and were offered colonoscopy. As of 18 August 2020, colonoscopy results were available for 347 of the participants, of whom 151 (43.5 percent) were found to have 1–3 adenomas, while 95 (27.4 percent) had advanced adenoma and 10 (2.9 percent; 0.3 percent of those eligible for faecal occult blood test) had CRC.

Most participants (n=3,146) were also eligible for breast (n=1,717) or prostate (n=1,429) cancer screening. A majority of these individuals (1,703 women and all men) were willing to undergo breast or prostate cancer screening following CRC screening.

Including those who were not eligible for CRC screening, a total of 1,846 female participants and 1,516 male participants were eligible for screening mammography and evaluation of prostate-specific antigen (PSA) level with or without Prostate Health Index (PHI), respectively.

Among 1,828 female participants with mammography reports available, 45 (2.4 percent) had a positive result (ie, Breast Imaging Reporting and Data System [BI-RADS] 4 or 5) and were offered breast ultrasound as well as biopsy. Breast cancer was diagnosed on biopsy in 15 women (0.8 percent of those eligible for mammography).

Of the 1,516 male participants who underwent prostate cancer screening, 98 were offered prostate ultrasound and biopsy. Prostate cancer was diagnosed on biopsy in 37 men (2.4 percent of those eligible for PSA test).

Screening for metabolic syndrome was also offered to the participants, with 50 new cases of diabetes diagnosed through the programme. These diabetes patients were referred for further management, while overweight or obese participants were given classes on exercise and diet to facilitate weight management and reduce cancer risk.

According to the researchers, these results demonstrate the feasibility and effectiveness of one-stop screening for CRC, breast cancer and prostate cancer among asymptomatic individuals.

Overweight or obesity is associated with an increased risk of CRC, breast cancer and prostate cancer. [Gut 2014;63:1130-1136; Obesity Reviews 2003;4:157-173; Recent Results Cancer Res 2016;208:137-153]

“The programme aims to raise awareness of colorectal health and overweight or obesity among Hong Kong residents aged 40–75 years. Recruitment has been ongoing,” said Professor Joseph Sung, programme director and Mok Hing Yiu Professor of Medicine, CUHK.