Training medical students to promote preventive colorectal cancer screening in Egypt

ABSTRACT Colorectal cancer screening identifies pre-cancerous lesions and polyps earlier, affording more treatment options and higher survivability. Screening is especially important in Egypt, where there are no national colorectal cancer screening guidelines; physicians typically order colonoscopy only after patients are symptomatic, and younger-age CRC rates (ages 30–49 years) are higher. We designed and implemented a pilot training program for a colorectal cancer screening intervention wherein we recruited and trained medical students as ‘Health Champions’ to provide one-on-one education to patients about the disease and distribute no-cost vouchers for fecal occult blood test kits. Health Champions then reported results to patients and encouraged those with abnormal results to follow-up for a no-cost colonoscopy and subsequent cancer treatment, if indicated. Pre- and post-intervention surveys assessed the Health Champions’ colorectal cancer awareness, confidence levels, and abilities regarding patient communication and promotion of behavior change. Participants received three days of training before implementation in Alexandria, Egypt. Thirteen participants completed Health Champion training, half of whom were second-year medical students. Between December 2019 and March 2020, Health Champions demonstrated what they learned by recruiting 117 asymptomatic patients and providing them with education and screening kit vouchers. There were increases of 46.1% in Health Champions’ knowledge of colorectal cancer risks, 35.7% in knowledge of screening options, and 57.1% in awareness of treatment options for colorectal cancer post-training. This feasibility training pilot successfully increased Health Champions’ knowledge and skills associated with initiating and supporting health behavior changes while familiarizing them with initiating preventive screenings for patients.