Purpose: Colorectal cancer (CRC) incidence and mortality rates continue to climb in Egypt and other low- and middle-income countries, where few screening intervention programs exist. In Egypt, CRC screening is not a routine part of preventive care and most CRC diagnoses happen with advanced disease and poor prognosis. This pilot study aims to develop, implement, and examine the feasibility of a culturally relevant intervention to promote CRC screening among healthy adults in Alexandria, Egypt.

Methods: This feasibility study was conducted in two clinics in Alexandria, Egypt in December 2019-March 2020. Participants were individuals age 50 and above who were visiting the clinics. Medical students were trained to recruit patients, increase awareness on the importance of CRC screening, and provide a voucher and instructions for returning a guaiac fecal occult blood test (gFOBT) kit. Students followed up with phone call reminders to return the kit, report results, and encourage participants with abnormal results to receive further no-cost testing. Our outcome measure was the number of total participants returning the gFOBT kit. We hypothesized that 20% of patients who received the intervention would return the kits, assuming a null screening rate of 2% and target screening rate after the intervention of 20%. A sample size of 120 would achieve 99% power to detect a difference of 18% at a 1% significance level.

Results: Of the 117 patients who were recruited, 44 patients (37.6%) returned a kit, with 95% exact confidence interval of (28.8, 47.0). Of the 44 patients who returned a kit, five (11.4%) had a positive FOBT test, with 95% exact confidence interval of (3.8, 24.6). Of these five patients, three (60%) followed up with colonoscopy.

Conclusion: This feasibility study provides promising findings to lay the foundation for a larger pragmatic trial that would address barriers to CRC screening in Egypt

Citation Format: Lori Brand Bateman, Ahmed Nawwar, Somaia Khamess, Mona N. Fouad, Waleed Arafat, Salah-Eldin Abdelmoneim, Sejong Bae, Katie Falkner, Laura Q. Rogers, Isabel Scarinci. Examining a Culturally Relevant Intervention to Promote Colorectal Cancer Screening in Egypt [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 59.