Knowledge and Awareness of Colorectal Cancer Early Warning Signs and Risk Factors among University Students in Jordan

Knowledge, Awareness, and Practices toward Colorectal Cancer and Its Dietary and Lifestyle-Related Risk Factors among Jordanian University Students: A Cross-Sectional Study

Background

Globally, colorectal cancer (CRC) incidence is rising, and it is a leading cause of mortality, with greater death rates pronounced in developing countries, including Jordan. Understanding knowledge and awareness of etiologic factors, unhealthy lifestyles, and dietary patterns is crucial for combating ailments. Hence, this study is aimed at investigating the level of knowledge and awareness of CRC-related risk factors, practices, and possible associations of studied variables among young Jordanians. Methodology. A cross-sectional, observational study was conducted using an online self-reported assessment of anthropometrics, knowledge, awareness, and dietary and lifestyle practices toward CRC and its related risk factors.

Results

A study of 795 Jordanian university students found that 93.8% were Jordanians, 73.0% were female, aged 18-24, and single. Most participants were from medical and science schools (69.4%). The vast majority (about 84%) were found to have good knowledge and awareness of CRC and its risk factors, but this was not reflected in their dietary practices. There are significant differences in physical activity, smoking, vegetable consumption, and serving sizes of red meat and processed meats between the sexes. Academic study specialties significantly impact knowledge and awareness.

Conclusion

The study reveals that while young Jordanian university students have good knowledge and awareness about CRC and its risk factors, these levels are not reflected in their dietary behaviors and food choices for CRC prevention, highlighting the need for national programs to improve these practices, particularly in the younger population.

Colorectal Cancer Awareness and Related Factors Among Adults Attending Primary Healthcare in North-Eastern of Iran: A Cross-sectional Study

BACKGROUND

Colorectal cancer (CRC) is the third most prevalent cancer in Iran. This study aimed to assess the level of awareness regarding CRC warning signs, risk factors, screening program, and related factors among adults in North-Eastern Iran. Study Design: A cross-sectional study.

METHODS

The multi-stage sampling method was used to survey 2614 participants attending primary healthcare centers in Mashhad, Iran. The data collection tools were the demographics section and Bowel/ CRC Awareness Measure (Bowel/Colorectal CAM). The data were analyzed by SPSS, version 25. The significance level of the data analysis was less than 0.05.

RESULTS

Mean awareness for CRC warning signs and CRC risk factors were 2.85±2.13 and 3.63±1.85, respectively. Most participants (97.2%) had no awareness of the CRC screening program. There was a significant association between marital status, education, job, income, and family history of CRC with awareness of warning signs (P<0.001); moreover, there was a significant association between age, education, job, income, and family history of CRC with awareness of risk factors (P<0.001). The results of logistic regression indicated that there was a significant association between age (P=0.022, OR=1.794, 95% confidence interval [CI]: 1.087, 2.962), gender (P=0.005, OR=0.488, 95% CI: 0.296, 0.803) and warning sign awareness (P<0.001, OR=1.278, 95% CI: 1.124, 1.454) with awareness of the CRC screening program.

CONCLUSION

In this study, most of the participants had low awareness of CRC. More aimed educational interventions are needed to promote Iranian adults' awareness of CRC.

Perceived barriers to early presentation and symptom-specific time to seek medical advice for possible colorectal cancer symptoms among Palestinians

This study explored the anticipated time to seek medical advice for possible colorectal cancer (CRC) signs/symptoms and its association with CRC symptom awareness. In addition, it examined perceived barriers that may delay seeking medical advice. Palestinian adults were recruited from hospitals, primary healthcare centers, and public spaces in 11 governorates. A modified, translated-into-Arabic version of the validated Bowel Cancer Awareness Measure was used. The questionnaire comprised three sections: sociodemographics, assessment of CRC symptom awareness and time to seek medical advice, and barriers to early presentation. A total of 4623 participants were included. The proportion that reported seeking immediate medical advice for possible CRC signs/symptoms with blood or mass ranged from 47.1% for 'blood in stools' to 59.5% for 'bleeding from back passage'. Less than half of the participants reported immediate seeking of medical advice for non-specific symptoms (ranging from 5.4% for 'loss of appetite' to 42.0% for 'anemia') and other gastrointestinal symptoms (ranging from 7.7% for 'feeling persistently full' to 35.7% for 'change in bowel habits'). Good CRC symptom awareness was associated with higher likelihood of seeking medical advice within a week from recognizing a CRC symptom. About 13.0% reported a delay to visit their doctor after recognizing a CRC symptom. The most reported barriers were practical with 'would try some herbs first' (50.9%) as the leading barrier. CRC symptoms with blood or mass prompted earlier help seeking. Participants with good CRC awareness were more likely to seek medical advice within a week.

Colorectal Cancer and the Role of the Gut Microbiota-Do Medical Students Know More Than Other Young People?-Cross-Sectional Study

(1) Background: Malignant neoplasms account for an increasing share of the disease burden of the world population and are an increasingly common cause of death. In the aspect of colorectal cancer, increasing attention is paid to the microbiota. According to current knowledge, the composition of gut microbiota in patients diagnosed with colorectal cancer significantly differs from the composition of microorganisms in the intestines of healthy individuals. (2) Material and methods: The survey included 571 students from the three universities located in Silesia. The research tool was an original, anonymous questionnaire created for the study. The ratio of correct answers to the total number of points possible to obtain was evaluated according to the adopted criteria (≤25%—very low level of knowledge; >75%—high level of knowledge). (3) Results: From the questions about the gut microbiota, the subjects scored an average of six points (SD ± 1.31) out of nine possible points. Statistical analysis showed differences between the number of correct answers among students of the Medical University of Silesia and the University of Silesia (p = 0.04, p < 0.05). On the other hand, in the field of colorectal cancer, the respondents scored on average four points (SD ± 2.07) out of eight possible. Statistical analysis showed significant differences between the ratio of correct answers and the respondent’s university affiliation (p < 0.05). Both age and place of residence did not positively correlate with knowledge level (p = 0.08 NS). In contrast, chronic diseases were found to have a significant effect on the amount of information held by the students surveyed (p < 0.05). (4) Conclusions: The level of knowledge of the surveyed students of the Silesia Province is unsatisfactory. The higher awareness among the students of medical universities results from the presence of issues related to microbiota and CRC in the medical educational content. Therefore, there is a need to consider the introduction of educational activities in the field of cancer prevention, including CRC, especially among non-medical university students.

Awareness and Knowledge of Colorectal Cancer Screening Among Medical Students at the University of Aleppo: A Cross-Sectional Study

Background  Colorectal cancer (CRC) is the third leading cause of malignancy in Syria. The aim of our study was to assess the awareness and knowledge of CRC and its screening methods among medical students at the University of Aleppo.

Methods  A cross-sectional study of medical students at the University of Aleppo was conducted using a self-administered 12-element questionnaire. The questionnaire consisted of demographics, awareness of CRC, knowledge of CRC and its screening methods. Awareness of CRC included three questions asking students if they ever heard of CRC and its screening methods. Knowledge of CRC was evaluated through three sets of questions about CRC risk factors, signs and symptoms, and preventative methods. The students were selected randomly during academic lectures. A χ² or Fisher's exact tests for categorical variables were used for statistical analysis, as appropriate. A two-sided p  < 0.05 was considered statistically significant. We stratified students based on pre-clinical versus clinical years and average academic score.

Results  A total of 824 students completed the questionnaire. The majority of students were aware of CRC (98.9%) and CRC screening methods (79.8%). Students had poor knowledge of CRC risk factors (16.5% for non-modifiable factors and 11.7% for modifiable factors), signs and symptoms (52.6%), and protective factors (9.9%). Only 31.7% of students were able to identify the appropriate age to initiate screening for average-risk individuals. Clinical students had better awareness and knowledge of CRC and its screening methods. Clinical students with higher academic score showed better awareness and knowledge in some elements.

Conclusion  Our study reported high awareness and poor knowledge rates of CRC and its screening methods among medical students at the University of Aleppo. Although clinical students had higher awareness and knowledge of CRC compared to pre-clinical students, the impact of academic score revealed variable results.

Public awareness of colorectal cancer in the Chinese population: An online cross-sectional survey study

OBJECTIVES

To investigate public awareness of colorectal cancer (three components: total knowledge, confidence and anticipated delay) in the Chinese population, to explore factors associated with total knowledge and to elucidate relationships among three components of public awareness of colorectal cancer.

METHODS

We recruited 562 adult Chinese participants with no history of colorectal cancer between March and May 2020 by convenience sampling method. Data were collected online using a self-designed demographic questionnaire and a simplified Chinese version of the Bowel Cancer Awareness Measure. Univariate analysis and multivariate linear regression were applied.

RESULTS

The mean score for total knowledge was 10.56 (SD: 5.89). Over half of the participants (58.2%) lacked confidence about detecting warning signs. For 42.7% of participants, the anticipated delay was not within the acceptable range (2 weeks). Totally eight demographic variables were identified as significant predictors of total knowledge, accounting for 36.2% of the variance. Total knowledge was positively correlated with confidence (r = 0.126, p < 0.01) and negatively associated with anticipated delay (F = 8.891, p < 0.01).

CONCLUSION

Public awareness of colorectal cancer was low in the Chinese population. Hence, educational interventions targeted for improving knowledge, enhancing individuals' confidence in detecting symptoms and reducing barriers to seeking medical help may be urgently required.

Knowledge and awareness of colorectal cancer risk factors, screening, and associated factors in advanced colorectal cancer patients: a multicenter cross-sectional study in China

Background

Colorectal cancer (CRC) is the 3rd most common malignancy globally, and its disease burden is increasing rapidly in China. But CRC patients' knowledge and awareness of CRC have not yet been examined, which could facilitate the identification of targeted population from public for intervention.

Methods

A nationwide multicenter cross-sectional survey was conducted in 19 tertiary hospitals (10 cancer hospitals and 9 general hospitals) from March 2020 to March 2021 in China. During study period, all Stage III and IV CRC patients were invited to complete a semi-structured survey that had been designed to collect information about their socio-demographic characteristics, and knowledge and awareness of CRC risk factors and screening. A multivariate logistic regression model was used to identify factors associated with their knowledge and awareness.

Results

In total, 4,589 advanced CRC patients were enrolled in this study, of whom, 46.2% were from tertiary cancer hospitals, and 59.5% were male. Patients had a mean age of 60.1±11.6 years. Before diagnosis, 65.1% of the patients had no related knowledge of the CRC risk factors, and 84.9% were unaware of the CRC screening-related information. Only 30.4% of patients had actively sought to acquire CRC-related knowledge before diagnosis. The 3 most common knowledge sources were relatives or friends who had been diagnosed with CRC (13.2%), popular science television/broadcast shows (12.9%), and community publicity and education (9.6%). Generally, knowledge and awareness were positively associated with better education level [odds ratios (ORs) ranged from 1.49 to 2.54, P<0.001], annual household income ranged from 50,000 Chinese Yuan (CNY) to 100,000 CNY (OR =1.32, P<0.001), being manual laborer (OR =1.25, P<0.001) and being white-collar worker (OR =1.47, P<0.001).

Conclusions

Advanced CRC patients' knowledge and awareness of CRC were severely limited before diagnosis. Thus, those who had limited knowledge and awareness should has a priority for intervention.

Gastrointestinal cancer prevention policies: A qualitative systematic review and meta-synthesis

This qualitative systematic review was conducted to summarize the policies for prevention of common gastrointestinal cancers worldwide. This study was conducted using PubMed, Web of Science, SCOPUS, and ProQuest databases. Two independent reviewers assessed included studies for methodological quality and extracted data by using standardized tools from Joanna Briggs Institute (JBI). Primary study findings were read and reread to identify the strategies or policies used in the studies for prevention of gastrointestinal cancers. The extracted findings were categorized on the basis of their similarity in meaning. These categories were then subjected to a meta-synthesis. The final synthesized findings were graded according to the ConQual approach for establishing confidence in the output of qualitative research synthesis. From the nine included studies in this review, 39 findings were extracted and based on their relevance in meaning were aggregated into 12 categories. Four synthesized findings were developed from these categories. We used World Health Organization report on 2000 for synthesizing the findings. The four synthesized findings were “service provision”, “resource generation”, “financing”, and “stewardship”. In order to reach a comprehensive evidence informed policy package for the prevention of gastrointestinal cancers, there should be a great communication among the interventions conducted directly on patients, health system infrastructures, and resources.

Awareness of Colorectal Cancer and Associated Factors Among Adult Patients in Jimma, South-West Ethiopia: An Institution-Based Cross-Sectional Study

Background

Colorectal cancer (CRC) is the first commonest diagnosed cancer in men and the fourth commonest in women in Ethiopia. Awareness of CRC and associated factors is crucial in the prevention of CRC. However, there have not been studies about the awareness of CRC and associated factors among adult patients in Ethiopia. Therefore, the study aimed to assess the awareness of CRC and associated factors among adult patients in Jimma, South-West Ethiopia, 2020.

Methods

This institution-based cross-sectional study design was conducted among 422 adult patients. The study respondents were recruited by a systematic random sampling method. The Cancer Awareness Measure questions were used to measure awareness of CRC of adult patients. Descriptive and logistic regression analyses were conducted.

Results

More than half (57.6%) of respondents had low-level awareness of CRC. Respondents who were females (adjusted odds ratio [AOR] = 1.86; 95% CI: 1.26, 2.75), who are residing in urban areas (AOR = .45; 95% CI: .30, .67), who had a monthly income of 3000 Ethiopian Birr and above (AOR = 4.72; 95% CI: 3.11, 7.15), who heard about CRC (AOR = 4.48; 95% CI: 2.90, 6.93), who get information through social media about CRC (AOR = 2.51; 95% CI: 1.18, 5.37), and who had a family history of CRC (AOR = 3.27; 95% CI: 1.45, 7.36) had a high level of awareness of CRC, while those who cannot read and write (AOR = 2.83; 95% CI: 1.49, 5.37) and learn elementary school (AOR = 2.12; 95% CI: 1.15, 3.93) had a low level of awareness of CRC.

Conclusion

This study indicated that awareness of CRC of adult patients was inadequate. Adult patients’ gender, residency, level of education, monthly income, heard about CRC, sources of information about CRC, and a family history of CRC were found to be independent predictors of the awareness of CRC. Therefore, there is a need for health education and awareness campaigns for promoting awareness of CRC of adult patients, and the government should develop policy on CRC prevention and screening program.

Psychosocial influences on help-seeking behaviour for cancer in low-income and lower middle-income countries: a mixed-methods systematic review

Introduction

Starting cancer treatment early can improve outcomes. Psychosocial factors influencing patients’ medical help-seeking decisions may be particularly important in low and lower middle-income countries (LMIC) where cancer outcomes are poor. Comprehensive review evidence is needed to understand the psychosocial influences on medical help-seeking for cancer symptoms, attendance for diagnosis and starting cancer treatment.

Methods

Mixed-methods systematic review registered on PROSPERO (CRD42018099057). Peer-reviewed databases were searched until April 2020 for studies assessing patient-related barriers and facilitators to medical help-seeking for cancer symptoms, diagnosis and treatment in adults (18+ years) living in LMICs. Quality of included studies was assessed using the Critical Appraisal Skills Programme tool. Data were synthesised using meta-analytic techniques, meta-ethnography or narrative synthesis as appropriate.

Results

Of 3963 studies identified, 64 were included. In quantitative studies, use of traditional, complementary and alternative medicine (TCAM) was associated with 3.60 higher odds of prolonged medical help-seeking (95% CI 2.06 to 5.14). Qualitative studies suggested that use of TCAM was a key barrier to medical help-seeking in LMICs, and was influenced by causal beliefs, cultural norms and a preference to avoid biomedical treatment. Women face particular barriers, such as needing family permission for help-seeking, and higher stigma for cancer treatment. Additional psychosocial barriers included: shame and stigma associated with cancer such as fear of social rejection (eg, divorce/disownment); limited knowledge of cancer and associated symptoms; and financial and access barriers associated with travel and appointments.

Conclusion

Due to variable quality of studies, future evaluations would benefit from using validated measures and robust study designs. The use of TCAM and gender influences appear to be important barriers to help-seeking in LMIC. Cancer awareness campaigns developed with LMIC communities need to address cultural influences on medical help-seeking behaviour.

Knowledge and attitudes of pharmacists towards colorectal cancer health education in Jordan: A cross-sectional study

AIMS OF THE STUDY

The purpose of this study was to assess pharmacists' knowledge and attitude towards early detection of colorectal cancer (CRC) in Jordan and to explore potential predictor variables of such knowledge and attitude.

METHODS USED TO CONDUCT THE STUDY

An electronic, self-reported questionnaire was used to collect data about demographics, knowledge and attitude regarding early detection of CRC. Both content and face validity were tested in a panel of experts. The participants' responses were analysed using descriptive statistics and multiple linear regressions.

RESULTS OF THE STUDY

The 352 pharmacists (78% females, 94% Jordanian) had a median age of 28 years and graduated mostly (83%) from public universities. Surprisingly, 90% were not able to identify carcinoembryonic antigen (CEA) as a non-accurate diagnostic method and almost one-third did not identify the correct screening tests. On a scale of 5, the majority of participants (59%) had moderate knowledge scores (3 or 4) in case scenarios. The median knowledge Percent of Maximum Possible (POMP) score was 67% and higher scores were associated with more years since graduation, pharmacists with MSc degree and higher, working in urban areas, studying oncology course and received oncology training (P < .05). Most participants showed a positive attitude towards early detection of CRC (median attitude POMP score was 78%). However, none of the analysed variables predicted their level of attitude.

CONCLUSIONS DRAWN FROM THE STUDY AND CLINICAL IMPLICATIONS

Although the majority of pharmacists demonstrated a positive attitude towards early detection of CRC, their knowledge was inadequate. The study highlighted the importance of optimising the education programmes to improve the pharmacists' knowledge about CRC early detection and preparing the pharmacists for participating in future national screening initiatives.

A Qualitative Transcriptional Signature for the Risk Assessment of Precancerous Colorectal Lesions

It is meaningful to assess the risk of cancer incidence among patients with precancerous colorectal lesions. Comparing the within-sample relative expression orderings (REOs) of colorectal cancer patients measured by multiple platforms with that of normal colorectal tissues, a qualitative transcriptional signature consisting of 1,840 gene pairs was identified in the training data. Within an evaluation dataset of 16 active and 18 inactive (remissive) ulcerative colitis subjects, the median incidence risk score of colorectal carcinoma was 0.6402 in active ulcerative colitis subjects, significantly higher than that in remissive subjects (0.3114). Evaluation of two other independent datasets yielded similar results. Moreover, we found that the score significantly positively correlated with the degree of dysplasia in the case of colorectal adenomas. In the merged dataset, the median incidence risk score was 0.9027 among high-grade adenoma samples, significantly higher than that among low-grade adenomas (0.8565). In summary, the developed incidence risk score could well predict the incidence risk of precancerous colorectal lesions and has value in clinical application.

Effects of a health education intervention on knowledge and attitudes towards chronic non-communicable diseases among undergraduate students in Jordan

Aim

To assess the effect of a health promotion course on knowledge and attitudes towards chronic non-communicable diseases (CNCDs) among undergraduate students in a Jordanian university.

Design

A one-group pre-test-post-test study design was used.

Methods

A convenience sample of 178 undergraduate students registered in a 3-credit health promotion course was enrolled in the study and completed both pre- and post-tests. This course is offered as an elective course for undergraduate students by the Faculty of Nursing at a large public university in Jordan. Twelve, one-hour interactive sessions regarding CNCDs topics were delivered over 3 weeks as part of the health promotion course. A computer-based questionnaire was used to evaluate students' knowledge and attitudes towards CNCDs including diabetes, hypertension and cancer, before and after undertaking the course.

Results

There was a significant improvement in the overall knowledge (Cohen's d effect size (d) = 1.08) and attitudes (d = 0.62) among all the students, regardless of gender. The overall knowledge and attitudes scores were significantly higher among females in the pre-test, but the differences in their overall scores became insignificant in the post-test. Education on specific topics was effective in improving university students' knowledge and attitudes about health-promoting behaviours, thereby preventing CNCDs. It is important to incorporate health promotion education regarding CNCDs into university curricula using innovative approaches to enhance healthy behaviours in young adults.

Public Awareness and Barriers to Seeking Medical Advice for Colorectal Cancer in the Gaza Strip: A Cross-Sectional Study

PURPOSE

Raising awareness of colorectal cancer (CRC) symptoms for early recognition, reduction of modifiable risk factors, and removing barriers to seeking medical help could lower its mortality. This study aimed to assess the level of public awareness of CRC in the Gaza Strip.

MATERIALS AND METHODS

This was a cross-sectional study conducted at three hospitals and 10 high schools between September and October 2017. The Arabic version of the validated Bowel Cancer Awareness Measure (BoCAM) questionnaire was used to evaluate awareness of CRC symptoms and risk factors, and barriers to seeking medical help. Adults (age ≥ 18 years) in three major hospitals and adolescents (ages 15 to 17 years) in 10 schools were recruited for face-to-face interviews to complete the BoCAM.

RESULTS

Of 3,172 potential participants, 3,080 completed the BoCAM (response rate, 97.1%). Among these, 1,578 (51.2%) were adults and 1,614 (52.4%) were females. Persistent abdominal pain was the most commonly recognized CRC symptom (n = 1,899; 61.7%), whereas anorectal pain was the least common (n = 1,056; 34.3%). In total, 2,177 (70.7%) were not confident in recognizing CRC symptoms or signs. Having a bowel disease was the most frequently recognized CRC risk factor (n = 1,456; 47.3%) and diabetes the least recognized (n = 591; 19.2%). The overall mean scores ± standard deviations for recalling and recognizing CRC symptoms were 1.2 ± 1.3 and 4.3 ± 2.3, respectively (out of 9 points). The overall mean scores ± standard deviations for recalling and recognizing CRC risk factors were 0.7 ± 0.8 and 8.0 ± 3.1, respectively (out of 16 points). Emotional barriers were the most commonly reported barriers to seeking medical help, with feeling worried about what a doctor might find as the most common barrier (n = 1,522; 49.4%).

CONCLUSION

Public awareness of CRC is suboptimal in Gaza. Improving CRC awareness with educational interventions is needed, including in local schools.

Colorectal Cancer Knowledge and Awareness Among University Students in a Caribbean Territory: a Cross-sectional Study

INTRODUCTION

The burden of colorectal cancer (CRC) has been on the rise globally over the last decade. Several studies point to the fact that there is a lack of knowledge and awareness for CRC which may be attributed to the increase in the burden over time. Therefore, we aimed to assess the level and predictors for knowledge of CRC and its risk factors.

METHODS

This study was a cross-sectional study conducted on the student population of the University of the West Indies, St. Augustine Campus, Trinidad. We assessed CRC knowledge using scales examining their level of knowledge for CRC and its risk factors. Lifestyle behaviors (smoking, physical activity, dietary behaviors, and alcohol consumption) and perceived risk for developing CRC were also collected using a standard survey. Predictors for CRC knowledge were assessed using forward stepwise linear and logistic regression models.

RESULTS

The overall CRC knowledge was 54.740% ± 19.721%. Poor knowledge levels were seen among 36.23% while satisfactory/good knowledge was seen among 63.77%. Predictors of poor CRC knowledge were males (OR = 1.559; p = 0.003), frequent/excessive alcoholic drinkers (OR = 1.924; p = 0.029), and low physical activity (OR = 1.331; p = 0.042). Predictors of satisfactory/good CRC knowledge were those with higher scores for the prudent dietary pattern (OR = 0.893; p = 0.016), and compared with those who reported no risk, participants reporting low risk had an increased likelihood of obtaining good CRC knowledge scores (OR = 0.526; p = < 0.001) and high risk (0.310; p = < 0.001).

CONCLUSION

The level of awareness/knowledge on CRC and its risk factors is low. Improvement of CRC awareness and healthy lifestyle campaigns among young adults is needed for the Caribbean region.

Meat and colorectal cancer in Middle Eastern and North African countries: update of literature review

Background

This review discusses the findings from epidemiological studies that have examined the possible role of meat and colorectal cancer (CRC) risk in Middle Eastern and North African (MENA) countries.

Methods

We conducted a literature search in the PubMed, Clinical Trials, Google Scholar, Science Direct, and Cochrane databases for observational studies that investigated the association between meat and CRC risk in adults from the MENA region.

Results

Eleven studies were included in this review. For red meat overall, significant associations were found. Regarding beef meat intake, the study included found controversial results with OR = 0.18 (95% CI 0.03–0.09). A positive association was observed between chicken and CRC risk, at OR = 2.52 (95% CI 1.33–4.77) to OR = 4.00 (95% CI 1.53–10.41) to OR = 15.32 (95% CI 3.28–71.45). A significant association was observed between processed meat intake and CRC risk, OR = 9.08 (95% CI 1.02–80.58).

Conclusion

This is the first literature review which illustrated the association between meat consumption and CRC risk in MENA region. We concluded that these studies included in this review have been controversial and not sufficient to establish a clear relationship between CRC and meat consumption in the MENA region. Further studies are necessary to be carried out in this region, with a larger sample size and submit to rigorous criteria. This review will help researchers to improve the quality of future studies about the association between CRC and nutritional diet in general and meat in particular.

Awareness of Cancer Risk: Variation in Measurement Approaches

Cancer is a major cause of morbidity and mortality. Diet, nutrition, physical inactivity, and obesity have been identified as important contributors to the increasing cancer incidence worldwide. To effectively plan interventions to reduce cancer incidence and to influence the public's decisions regarding health behaviors, it is important for professionals to have an understanding of the ways in which people understand risk with regard to development of cancer. Selecting an appropriate method to evaluate awareness of cancer risk is an important consideration. Quantitative approaches such as surveys may be used to investigate awareness of risk, and recall of risk factors as well as recognition of such factors may form part of such assessments. Such quantitative methods may be used to evaluate risk in different demographic groups, as well as to examine the link between risk factors and behavior. Qualitative approaches include in-depth interviews, focus groups, and open-ended survey items and may be used to explain findings derived using quantitative methods. Mixed methods approaches may also be employed, involving use of a survey as well as interviews or focus groups to gather in-depth information. Assessment of awareness of cancer risk using an appropriate method has important implications for educators, as professionals must evaluate understanding of risk factors and tailor messages accordingly for educational programs. Ongoing evaluation of awareness is a key part of determining the effectiveness of education initiatives and identifying new and emerging issues.

Knowledge of Colorectal Cancer Symptoms and Risk Factors in the Kingdom of Bahrain: a Cross- Sectional Study

Background: Colorectal cancer (CRC) is second in incidence rates in both genders in the Kingdom of Bahrain, with the number of new CRC cases sharply increasing in the last two decades. This study aimed to assess the levels of knowledge regarding CRC among people living in the Kingdom. Methods: A cross-sectional survey design was used to recruit a convenient sample of 505 adults aged 25 years or above. Face to face structured interviews were conducted to supplement data gained from the questionnaire. Results: The mean age of participants was 37 (±10.43) years. Changes in bowel habits were the most commonly identified symptoms (46%) followed by lower abdominal pain (44%). Family history was the most commonly identified risk factor (38%) followed by smoking (28%). The overall score of knowledge of CRC was 56 (±18.4). The scores for symptoms and risk factors were 59 (±26.2) and 53 (±17.5) respectively. It was found that female participants had better knowledge 59 (±17) than males 54 (±19) (P = .001). Participants with high levels of education had better knowledge (63%) compared with other groups, although this was not statistically significant (P = .067). Conclusion: This study indicates poor knowledge among people living in Bahrain regarding CRC symptoms and risk factors. Strategies and educational initiatives need to be implemented to enhance the general public’s awareness in this respect.

Awareness of colorectal cancer among public in Asir region

Introduction:

Colorectal cancer (CRC) has different forms of colon cancer or rectal cancer. CRCs are often considered together because they possess many similar features. A severe form of the disease with higher mortality rate increases with increase in age. The most common CRC risk factors include smoking, diabetes, and obesity. This study aims to evaluate the awareness of CRC in a random population of Asir region and to identify the subpopulation that can be recipients of awareness and screening programs.

Material and Methods:

Cross-sectional nonprobable random sampling study using a self-administered questionnaire survey which was employed to include healthy males and females from Asir region. The questionnaire included ten questions in Arabic language and data were categorized according to gender, marital status, age, and level of education to determine whether these demographic groups possess difference in knowledge about CRC.

Results:

Most of the respondents (51% and 71.6%) knew what is colon and rectum. About 33.8% know the correct function of the colon while 22.5% know the correct incidence and 22.1% know the correct time of screening for CRC. Very few respondents know the symptoms, risks, and screening modalities of CRC. Pearson's Chi-square test was employed to evaluate the differences in responses in four demographic categories of the study population. P <0.05 was considered as statistically significant

Conclusions:

Single less educated males lack knowledge of CRC. In addition, there is very low awareness of CRC symptoms, risk factors, and screening modalities among the entire surveyed population.