Kesan dan Cabaran Pelaksanaan Saringan Kanser Kolorektal dalam Komuniti PPR Kuala Lumpur: Perspektif Pembangunan Komuniti
Abstract
Kanser kolorektal (CRC) merupakan penyebab kedua tertinggi kematian berkaitan kanser di Malaysia, dengan prevalen 13.8% dan kadar pengesanan lewat melebihi 70%. Komuniti berpendapatan rendah bandar, khususnya penghuni Program Perumahan Rakyat (PPR), berisiko tinggi kerana kekangan sosioekonomi, literasi kesihatan yang rendah, serta stigma budaya. Kajian ini meneliti kesan penyertaan komuniti dalam saringan CRC serta mengenal pasti cabaran utama dalam pelaksanaannya. Kajian kes kualitatif ini dijalankan bagi meneliti kesan penyertaan komuniti dalam saringan CRC dan mengenal pasti cabaran utama dalam pelaksanaannya. Empat PPR di Kuala Lumpur dipilih, dengan 16 informan terdiri daripada penduduk, pemimpin komuniti, sukarelawan KOSPEN, dan pelaksana program. Data dikumpul melalui temu bual mendalam separa berstruktur, disokong triangulasi dokumen dasar, dan dianalisis secara tematik menggunakan ATLAS.ti. Kesan positif penyertaan termasuk peningkatan pengetahuan asas, rawatan pencegahan awal, kesedaran terhadap risiko kesihatan, dan pemerkasaan komuniti melalui kolaborasi dengan pelbagai agensi. Namun, pelaksanaan berdepan cabaran seperti kekurangan sumber logistik, kurang kompetensi sukarelawan, komitmen komuniti yang terhad, jurang maklumat, kesedaran awam rendah, stigma terhadap ujian najis, serta sikap tidak peduli terhadap kesihatan. Program saringan CRC di PPR berpotensi sebagai medium pemerkasaan komuniti dan pengurangan ketidaksamarataan kesihatan bandar. Walau bagaimanapun, ia menuntut transformasi melalui pendekatan navigasi pesakit berasaskan komuniti, latihan berterusan sukarelawan, komunikasi peka budaya, dan kolaborasi rentas agensi.
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References
Abu Bakar, N., Rahman, F., & Ismail, S. (2023). Barriers to colorectal cancer screening among urban poor communities in Malaysia. Malaysian Journal of Public Health Medicine, 23(2), 45–53.
Al-Oseely, H., Lee, C. S., & Karim, A. M. (2023). Socioeconomic determinants of colorectal cancer screening participation in Southeast Asia. Asian Pacific Journal of Cancer Prevention, 24(5), 1679–1687.
Arnstein, S. R. (1969). A ladder of citizen participation. Journal of the American Institute of Planners, 35(4), 216–224.
Azzani, M., Roslani, A. C., & Su, T. T. (2019). Determinants of colorectal cancer screening uptake in Malaysia: A cost analysis. BMJ Open, 9(3), e024464. https://doi.org/10.1136/bmjopen-2018-024464
Chandran, N., Subramaniam, S., & Goh, K. L. (2020). Uptake of colorectal cancer screening in Malaysia: Challenges and solutions. Asian Pacific Journal of Cancer Prevention, 21(9), 2689–2695.
Farmer, J., Carlisle, K., Dickson-Swift, V., Teasdale, S., Kenny, A., Taylor, J., & Croker, F. (2017). Applying co-production in practice: Developing a community engagement strategy to improve primary healthcare services. BMC Health Services Research, 18(1), 681. https://doi.org/10.1186/s12913-017-2671-2
Jaganathan, S., Devi, S., & Chong, V. (2024). Patient navigation for colorectal cancer screening in low-resource settings: A systematic review. International Journal of Public Health, 69(2), 201–213.
Kementerian Kesihatan Malaysia. (2021). National Strategic Plan for Colorectal Cancer (NSPCRC) 2021–2025. Putrajaya: Kementerian Kesihatan Malaysia. http://www.moh.gov.my
Kementerian Kesihatan Malaysia. (2024). Prevention and control of noncommunicable diseases in Malaysia: The case for investment. Putrajaya: Kementerian Kesihatan Malaysia.
Muda, Nora & Azahari, Anisa & Ahmad Shahabuddin, Faridatulazna & Zamzuri, Zamira & Mohd ariff, Noratiqah & Abu Bakar, Mohd Aftar & Mohd Suradi, Nur Riza. (2020). Health Vulnerability Versus Multiple Vulnerability Factors Among Low-Income Group in Malaysia. Pertanika Journal of Social Science and Humanities, 28, 1415-1427.
Muhamad, N., Alias, Z., & Abdullah, N. (2023). Stage at diagnosis and survival of colorectal cancer patients in Malaysia: A population-based study. BMC Cancer, 23(1), 1042.
Ng, C. J., Lee, P. Y., & Hashim, S. (2016). Barriers and facilitators to colorectal cancer screening in Asia: A systematic review. World Journal of Gastroenterology, 22(29), 6744–6750.
Ng, C. J., Low, W. Y., Wong, L. P., Sudin, M. R., & Mohamed, R. (2017). Community-based colorectal cancer screening in Malaysia: A model from the EMPOWERED program. BMC Public Health, 17(1), 174.
Nutbeam, D. (2000). Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15(3), 259–267.
O’Mara-Eves, A., Brunton, G., Oliver, S., Kavanagh, J., Jamal, F., & Thomas, J. (2015). The effectiveness of community engagement in public health interventions for disadvantaged groups: A meta-analysis. BMC Public Health, 15(1), 129. https://doi.org/10.1186/s12889-015-1352-y
Ramanathan, K., Aziz, A. F., & Lim, T. Y. (2022). Cultural stigma and colorectal cancer screening in Malaysia: A qualitative study. Journal of Cancer Education, 37(5), 1180–1188.
Shah, S. A., Mahmood, M. I., & Ahmad, N. (2020). Low socioeconomic status associated with poor cancer screening perceptions in Malaysia: Analysis of determinants of health among the general population. Asian Pacific Journal of Cancer Prevention, 21(3), 849–855.
Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., & Brand, H. (2012). Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health, 12(1), 80.
UNICEF. (2024). Families on the edge: Urban poor children in Malaysia after COVID-19. Kuala Lumpur: UNICEF Malaysia.
Yim, L. S. (2020). Colon Screening In the Community–A Community Program and Lesson Learnt. Journal of Oncology Research Review & Reports, 1–3. https://doi.org/10.47363/JONRR/2020(1)102.
Zimmerman, M. A., & Rappaport, J. (1988). Citizen participation, perceived control, and psychological empowerment. American Journal of Community Psychology, 16(5), 725–750.
