CULTURAL PRACTICE OF AT-RISK PEOPLE OF COLORECTAL CANCER AND RISK REDUCTION IN INDONESIA: ETHNOGRAPHY STUDY
Keywords:
At-risk people, colorectal cancer, cultural practice, ethnography, Indonesia, risk reductionAbstract
The incidence of colorectal cancer (CRC) increases yearly, particularly in low- and middle-income countries. Avoiding risk factors serves to effectively and efficiently reduce CRC incidence. In this ethnography study, we explored the health behavior of at-risk people of CRC to reduce the risk in Palembang, Indonesia. Purposive sampling was used, and involved 9 participants. The data were collected using participant observation, in-depth interviews, and focus group discussions, and then analysed using thematic analysis. There were 9 themes that emerged: food preparation, food cooking, food consumption, moderate physical activity, health checks and medical treatment, trying traditional herbs, alternative therapy and spiritual power as treatment, controlling risky health related behaviours, cancer information, and self-health perspectives. Multiple-sectoral strategies and collaboration between academics, practices, communities, and government are needed to carry out risk reduction activities and increase awareness along with community empowerment and capacity building in accordance with cultural understanding.
References
Anderson, A.S., Caswell, S., Macleod, M., Craigie, A.M., Stead, M., Steele, R.J. C., and BeWEL Team. (2015). Awareness of lifestyle and colorectal cancer risk: Findings from the BeWEL Study. BioMed Res. Int., 2015:871613.
Arnold, M., Sierra, M.S., Laversanne, M., Soerjomataram, I., Jemal, A., and Bray, F. (2016). Global patterns and trends in colorectal cancer incidence and mortality. Gut, 66(4):683-691.
Assan, J.K., Assan, S.K., Assan, N., and Smith, L. (2009). Health inequality in resource poor environments and the pursuit of the MDGs: Traditional versus modern healthcare in rural Indonesia. Journal of Health Management, 11(1):93-108.
Badan Penelitian dan Pengembangan Kesehatan. (2012). Health Facility Research Report 2011 Hospitals. (Laporan Akhir Riset Fasilitas Kesehatan 2011 Puskesmas). Ministry of Health, Jakarta, Indonesia.
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R., Torre, L., and Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA-Cancer J. Clin., 68(6):394-424.
Chen, Y.H., Zou, X.N., Zheng, T.Z., Zhou, Q., Qiu, H., Chen, Y.L., He, M., Du, J., Lei, H.K., and Zhao, P. (2017). High spicy food intake and risk of cancer: a meta-analysis of case-control studies. Chinese Med. J., 130(18):2,241-2,250.
Dahm, C.C., Keogh, R.H., Lentjes, M.A., Spencer, E.A., Key, T.J., Greenwood, D.C., Cade, J.E., Burley, V.J., Shipley, M.J., Brunner, E.J., Stephen, A.M., Mishra, G., Kuh, D., Fentiman, I.S., White, I.S., Luben, R., Khaw, K.T., and Rodwell Bingham, S.A. (2010). Intake of dietary fats and colorectal cancer risk: prospective findings from the UK Dietary Cohort Consortium. Cancer Epidemiol., 34(5):562-567.
Favoriti, P., Carbone, G., Greco, M., Pirozzi, F., Pirozzi, R.E.M., and Corcione, F. (2016). Worldwide burden of colorectal cancer: a review. Updates in Surgery, 68(1):7-11.
Ghazali, A.R., Sipain, Y., Rajab, N.F., Ling, S.E., Ramli, N., Abdullah, R., Harun, Z., and Kamarulzaman, F. (2012). Genotoxic potential of shrimp pastes (Belacan) extracts using umu test. Food and Nutrition Sciences, 03:522-525.
Greenward, B. (2015). Reducing the risk for colon cancer with healthy food choices and physical activity. Gastroenterol. Nurs., 38(4):307-310.
Guest, G., Bunce, A., and Johnson, L. (2006). How many interviews are enough? An experiment with data saturation and variability. Family Health International, 18(1):59-82.
Iskandarsyah, A., De Klerk, C., Suardi, D.R., Sadarjoen, S.S., and Passchier, J. (2014). Consulting a traditional healer and negative illness perceptions are associated with non-adherence to treatment in Indonesian women with breast cancer. Psycho-Oncol., 23(10):1,118-1,124.
Kang, D.W., Chung, J.Y., Lee, M.K., Lee, J., Park, J.H., Kim, D.I, Jones., L.W., Ahn, J.B., Kim., N.K., and Jeon, J.Y. (2014). Exercise barriers in Korean colorectal cancer patients. Asian Pac. J. Cancer P., 15(18):7,539-7,545.
Kushi, L.H., Doyle, C., McCullough, M., Rock, C.L., Demark-Wahnefried, W., Bandera, E.V., Gapstur, S., Patel, A.V., Andrew, K., Gansler, T., and the American Cancer Society 2010 Nutrition and Physical Activity Guidelines Advisory Comittee. (2012). American Cancer Society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA-Cancer J. Clin., 62:30-67.
Lambert, R., Sauvaget, C., and Sankaranarayanan, R. (2009). Mass screening for colorectal cancer is not justified in most developing countries. Int. J. Cancer, 125(2):253-256.
Lowery, J.T., Ahnen, D.J., Schroy, P.C., Hampel, H., Baxter, N., Boland, C.R., Burt, R.W., Butterly, L., Doerr, M., Doroshenk, M., Feero, W.G., Henrikson, N., Ladabaum, U., Lieberman, D., McFarland, E.G., Peterson, S.K., Raymond, M., Samadder, N.J., Syngal, S., Weber, T.K., Zauber, A.G., and Smith, R. (2016). Understanding the contribution of family history to colorectal cancer risk and its clinical implications: a state-of-the-science review. Cancer, 122(17):2,633-2,645.
Lv, J., Qi, L., Yu, C., Yang, L., Guo, Y., Chen, Y., Bian, Z., Sun, D., Du, J., Ge, P., Tang, Z., Hou, W., Li, Y., Chen, J., Chen, Z., and Li, L. (2015). Consumption of spicy foods and total and cause specific mortality: Population based cohort study. BMJ, 351:1-10.
Makmun, D., Simadibrata, M., Abdullah, M., Ari Fahrial, S., Fauzi, A., Renaldi, K., Rani, A., and Krisnuhoni, E. (2014). Changing trends in gastrointestinal malignancy in Indonesia: the Jakarta experience. Journal of Cancer Research and Therapy, 2(9):160-168.
Meyskens, F.L., Mukhtar, H., Rock, C.L., Cuzick, J., Kensler, T.W., Yang, C.S., Ramsey, S.D., Lippman, S.M., and Alberts, D.S. (2016). Cancer prevention: Obstacles, challenges, and the road ahead. J. Nat. Cancer I., 108(2):1-8.
Palmquist, A.E.L., Upton, R., Lee, S., Panter, A.T., Hadley, D.W., and Koehly, L.M. (2011). Beliefs about cancer and diet among those considering genetic testing for colon cancer. J. Nutr. Educ. Behav., 43(3):150-156.
Pietrzyk, Ł. (2017). Food properties and dietary habits in colorectal cancer prevention and development. Int. J. Food Prop., 20(10):2,323-2,343.
Polit, D.F. and Beck, C.T. (2014). Essentials of Nursing Research: Appraising Evidence for Nursing Practice. 8th ed. Lippincott Williams & Wilkins, Philadelphia, 493p.
Pourhoseingholi, M.A., Vahedi, M., and Baghestani, A.R. (2015). Burden of gastrointestinal cancer in Asia; an overview. Gastroenterology and Hepatology from Bed to Bench, 8(1):19-27.
Prabawani, B. (2017). Jamu brand Indonesia: consumer preferences and segmentation. Archives of Business Research, 5(3):80-94.
Ransohoff, D.F. and Sox, H.C. (2016). Clinical practice guidelines for colorectal cancer screening: New recommendations and new challenges. JAMA, 315(23):2,529-2,531.
Richardson, A., Hayes, J., Frampton, C., and Potter, J. (2016). Modifiable lifestyle factors that could reduce the incidence of colorectal cancer in New Zealand. New Zeal. Med. J., 129(1447):13-20
Sharif, R., Ghazali, A.R., Rajab, N.F., Haron, H., and Osman, F. (2008). Toxicological evaluation of some Malaysian locally processed raw food products. Food Chem. Toxicol., 46(1):368-374.
Stewart, B.W. and Wild, C.P. (2014). World Cancer Report 2014. International Agency for Research on Cancer, World Health Organization, Lyon, France.
Tayyem, R.F., Bawadi, H.A., Shehadah, I., Agraib, L.M., AbuMweis, S.S., Al-Jaberi, T., Al-Nussair, M., Bani-Hani, K.E., and Heath, D.D. (2016). Dietary patterns and colorectal cancer. Clinical Nutrition, 36(3):848-852.
Tiranda, Y. and Safitriana. (2018). Colorectal cancer prevalence in Palembang, South Sumatera, Indonesia. Kes Mas: Jurnal Fakultas Kesehatan Masyarakat, 12(2):91-95.
Willett, W.C. (2005). Diet and cancer: an evolving picture. JAMA, 293(2)233-234.
Wu, S., Feng, B., Li, K., Zhu, X., Liang, S., Liu, X., Han, S., Wang, B., Wu, K., Miao, D., Liang, J., and Fan, D. (2012). Fish consumption and colorectal cancer risk in humans: a systematic review and meta-analysis. Am. J. Med., 125(6):551-559.
Xu, M., Fang, Y.J., Chen, Y.M., Lu, M.S., Pan, Z.Z., Yan, B., Zhong, X., and Zhang, C.X. (2015). Higher freshwater fish and sea fish intake is inversely associated with colorectal cancer risk among Chinese population: a case-control study. Sci. Rep., 5:12976.
Xu, S., Markson, C., Costello, K.L., Xing, C.Y., Demissie, K., and Llanos, A.A. M. (2016). Leveraging social media to promote public health knowledge: Example of cancer awareness via Twitter. Journal of Medical Internet Research Public Health and Surveillance, 2(1):e17.








