Involvement of community pharmacy pharmacists in fecal immunochemical test screening without government support in Japan

Abstract

Colorectal cancer (CRC) is the third most common malignancy and second leading cause of death worldwide. However, the screening rate, which is a typical preventive measure, remains low. A community pharmacy pharmacist (CPP)-mediated procedure was used to increase the CRC screening rate. A total of 37 community pharmacies in Kagoshima, a core city in Japan, participated in this study. The results were statistically compared with the results of two procedures in Kagoshima City: hospital/clinic institution-mediated and health examination institution-mediated procedures. The cost was set at 1,100 JPY to perform a fecal immunochemical test, considering the costs as the self-payment of the other two procedures. In March 2023, 2,611 kits were distributed, and 273 tests were conducted under the research conditions. A significantly higher percentage of people in their 40s were tested using CPP-mediated procedures (35.2% vs. 14.3% in the hospital/clinic, and 21.8% in the health examination institution, respectively, p < 0.01). The percentage of participants who underwent a detailed examination at CPP facilities was significantly lower than in the other two groups (46.7% vs. 87.3% in the hospital/clinic, and 83.0% in the health examination institution, p < 0.05). In the CPP-mediated procedure, the test result turn-around time was approximately one day. Although a 2-day method was used, the implementation rate was 100%. The CPP-mediated procedure did not differ significantly from hospital/clinic or health examination institution procedures in terms of the number of detailed examination findings. In particular, the CPP-mediated procedure may address gaps by increasing the number of young people and people with reduced opportunities who receive CRC screening. The CPP-mediated procedure could be implemented as a new procedure with certain advantages. Moreover, it should be considered that this procedure can be implemented and sustained in society without government support.