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

Factors affect knowledge, attitudes, and practices in colorectal cancer screening: A systematic review

OBJECTIVES

This review aimed to synthesize the available evidence on exploring various factors that affect knowledge, attitudes, and practices (KAP) in colorectal cancer (CRC) screening.

METHODS

A systematic search across five databases was performed to identify factors influencing KAP scores towards CRC screening. The PRISMA guidelines were used to conduct the literature search, and the time spanned is from March to June 2023. The search included observational studies published between January 2000 and June 2023 that met the predetermined review criteria. Data were extracted following the Joanna Briggs Institute (JBI) appraisal checklist to evaluate the quality of the articles.

RESULTS

Out of 16,904 records, 1174 articles were reviewed in full text, resulting in 43 high-quality studies included based on the JBI checklist. These studies assessed knowledge (42), attitudes (26), and practices (11) related to CRC screening. Key factors to improving KAP towards CRC screening in the general public were sociodemographic, social media influence, and physician recommendations. For healthcare professionals, factors promoting KAP included screening methods, guidelines, qualifications, and understanding of CRC screening. Educators lacked awareness of CRC symptoms and needed training to teach CRC screening and prevention. Pharmacists showed positive attitudes towards early CRC detection but had varying knowledge levels.

CONCLUSIONS

KAP towards CRC screening is suboptimal among the general public, healthcare professionals, students, educators, and pharmacists worldwide. Routine CRC screening counselling is paramount to improving screening rates. Continuous medical education and training programmes are essential for healthcare professionals to enhance their KAP towards CRC screening. Students and university teachers should be educated and trained about CRC screening to improve their knowledge and foster positive behavioural changes. These comprehensive measures are critical for establishing an effective screening programme.

Awareness of Colorectal Cancer Preventive Measures Among Residents of Riyadh

Background Colorectal cancer (CRC) poses a significant challenge to healthcare providers. Spreading awareness, providing preventive measures, and implementing screening programs are essential for detecting and halting the progression of the disease and decreasing the mortality associated with this type of malignancy. This study aimed to assess public knowledge and awareness of colorectal cancer preventive measures and screening programs among residents of Riyadh, Saudi Arabia, and also to design better healthcare interventions or policy development. Methods This cross-sectional study was carried out among residents in Riyadh, Saudi Arabia. A self-administered questionnaire was sent to participants using a Google survey. The questionnaire consisted of socio-demographic characteristics (age, gender, marital status, and occupation), a general understanding of CRC and its prevention, risk factors for developing CRC, barriers to undergoing CRC screening, and a 21-item questionnaire to assess awareness of CRC preventive measures. Results Of the 420 respondents, 301 (71.7%) were female, and 134 (31.9%) were between 18 and 29 years old. The overall mean awareness score was 12.5 (SD 3.05) out of 21 points. Accordingly, 240 (57.1%) were categorized as having moderate awareness, 70 (16.7%) as good, and 110 (26.2%) had poor awareness levels. Being younger, being unmarried, having heard of CRC and screening tests that detect colon cancer, and being aware of the CRC early detection campaign in Saudi Arabia were the factors associated with increased awareness. Conclusion There was modest awareness of CRC preventive measures among residents living in Riyadh. Significant predictors of increased awareness include younger age, being unmarried, having heard of CRC, having heard of screening tests to detect CRC, and awareness of the CRC early-detection campaigns in Saudi Arabia. Healthcare providers have a vital role in increasing awareness of CRC's preventive measures.

Enhancing colorectal cancer prevention: a national assessment of public awareness in Egypt

BACKGROUND

Despite the increasing incidence of colorectal cancer (CRC) in the Egyptian population, it still seems that there is a significant lack of awareness regarding the disease. This study aimed to assess the Egyptian population's awareness of CRC regarding its risk factors, the screening procedures, and the appropriate responses to its diagnosis.

METHOD

A cross-sectional study was conducted in Egypt between July 2022 and March 2023 and recruited a convenient sample of adults from seven governorates representing different geographic areas, and socioeconomic and educational backgrounds with the help of the validated Bowel Cancer Awareness Measure (CAM) version 2.1. The modified Arabic questionnaire was validated through a pilot study including 30 patients. Then it was presented through a Google form before being shared via online methods and face-to-face interviews. The questionnaire provided both numerical and categorical data, which were analyzed accordingly. The Chi-square, the Fisher exact, and the Man-Whitney test were used to compare colorectal cancer poor and good knowledge groups. Logistic regression analysis was conducted to predict the factors that affected the awareness level of the study population.

RESULTS

Nine hundred forty individuals participated in the survey. Their ages ranged from 18 to 86 years old, with an average of 37.38 ± 12.22 years. The mean Knowledge score was 14.29 ± 7.05 out of 37 with most of our participants (71%) having poor knowledge about CRC. Most of the participants (64.1%) chose colonoscopy as the best screening modality, followed by an abdominal CT (27.8%), and fecal occult blood (15.5%). The study revealed significant differences between participants with good and poor knowledge of colorectal cancer. (78.5%) of participants with good CRC knowledge lived in cities, (85.4%) attained university or higher educational level, and (87.2%) of them were nonsmokers (p < 0.05%).

CONCLUSION

In general, there was a lack of awareness about Colorectal cancer among the Egyptian population especially among rural and lower educational levels, and more health education campaigns are required to enhance CRC prevention efforts in Egypt.

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.

Development and validation of a prediction model for early screening of people at high risk for colorectal cancer

BACKGROUND

Colorectal cancer (CRC) is a serious threat worldwide. Although early screening is suggested to be the most effective method to prevent and control CRC, the current situation of early screening for CRC is still not optimistic. In China, the incidence of CRC in the Yangtze River Delta region is increasing dramatically, but few studies have been conducted. Therefore, it is necessary to develop a simple and efficient early screening model for CRC.

AIM

To develop and validate an early-screening nomogram model to identify individuals at high risk of CRC.

METHODS

Data of 64448 participants obtained from Ningbo Hospital, China between 2014 and 2017 were retrospectively analyzed. The cohort comprised 64448 individuals, of which, 530 were excluded due to missing or incorrect data. Of 63918, 7607 (11.9%) individuals were considered to be high risk for CRC, and 56311 (88.1%) were not. The participants were randomly allocated to a training set (44743) or validation set (19175). The discriminatory ability, predictive accuracy, and clinical utility of the model were evaluated by constructing and analyzing receiver operating characteristic (ROC) curves and calibration curves and by decision curve analysis. Finally, the model was validated internally using a bootstrap resampling technique.

RESULTS

Seven variables, including demographic, lifestyle, and family history information, were examined. Multifactorial logistic regression analysis revealed that age [odds ratio (OR): 1.03, 95% confidence interval (CI): 1.02-1.03, P < 0.001], body mass index (BMI) (OR: 1.07, 95%CI: 1.06-1.08, P < 0.001), waist circumference (WC) (OR: 1.03, 95%CI: 1.02-1.03 P < 0.001), lifestyle (OR: 0.45, 95%CI: 0.42-0.48, P < 0.001), and family history (OR: 4.28, 95%CI: 4.04-4.54, P < 0.001) were the most significant predictors of high-risk CRC. Healthy lifestyle was a protective factor, whereas family history was the most significant risk factor. The area under the curve was 0.734 (95%CI: 0.723-0.745) for the final validation set ROC curve and 0.735 (95%CI: 0.728-0.742) for the training set ROC curve. The calibration curve demonstrated a high correlation between the CRC high-risk population predicted by the nomogram model and the actual CRC high-risk population.

CONCLUSION

The early-screening nomogram model for CRC prediction in high-risk populations developed in this study based on age, BMI, WC, lifestyle, and family history exhibited high accuracy.

Knowledge and awareness of colorectal cancer among a predominantly Indigenous Caribbean community

OBJECTIVE

To assess awareness levels and knowledge of colorectal cancer (CRC) and CRC screening among an Indigenous Caribbean community.

METHODS

A community-based participatory research project was developed to perform a needs assessment of cancer prevention and education in an Indigenous non-metropolitan community in Dominica. Purposive sampling occurred at a local health clinic. Data was collected from 58 eligible patients via a 57-item structured interview. Descriptive statistics were calculated, and demographic correlates of CRC knowledge and awareness were assessed using chi-square and Fisher Exact tests.

RESULTS

Of 58 participants, 72.4% identified as Indigenous, and 36.5% had heard of CRC. Most respondents (96.1%) believed CRC screening to be "important," yet only 3.0% of those who were age eligible had received screening in the prior 10 years, and 12.5% knew how to get screened. More respondents with incomes over $5,000 ECD had heard of CRC (72.2%) compared to those who had not (21.7%), and those who were unsure (16.7%, p < 0.01). Among those with a family cancer history, 14.3% knew how to get tested for CRC, 60.0% did not, and 25.0% were unsure (p < 0.03).

CONCLUSION

Despite limited familiarity with CRC screening, participants broadly believed CRC screening to be important. Health education research is needed to develop patient-centered, culturally appropriate materials about CRC screening and prevention. Future work facilitating productive community partnerships and incorporating prevailing community traditions may align cancer prevention and education initiatives with community priorities.

Factors Associated With Colorectal Cancer Screening Via Immunochemical Fecal Occult Blood Test in an Average-Risk Population From a Multiethnic, Middle-Income Setting

PURPOSE

The Malaysian Ministry of Health had launched free opportunistic screening for colorectal cancer using immunochemical fecal occult blood test (iFOBT) targeting the average-risk individuals since 2014. This study aims to determine factors associated with colorectal cancer screening using iFOBT among the average-risk Malaysian population.

METHODS

A cross-sectional study was conducted at five government-run health clinics in the state of Selangor. Adults with an average risk of colorectal cancer (age > 50 years, asymptomatic, and no family history of colorectal cancer) were recruited using systematic random sampling. An interviewer-administered questionnaire adapted from the Cancer Awareness Measure and Health Belief Model was used.

RESULTS

The median age of participants was 61 years (interquartile range, 56 to 66). Almost 60% of participants indicated their willingness to be screened. However, only 7.5% had undergone iFOBT. Good knowledge of risk factors of colorectal cancer, perceived susceptibility to the disease, and the doctor's recommendation were associated with increased willingness to be screened: adjusted odds ratio (aOR), 1.66 (95% CI, 1.12 to 2.46); aOR, 1.70 (95% CI, 1.08 to 2.70); and aOR, 5.76 (95% CI, 2.13 to 15.57), respectively. Nevertheless, being elderly (aOR, 0.67; 95% CI, 0.45 to 0.99) and high negative perception toward the testing method (iFOBT) (aOR, 0.12; 95% CI, 0.05 to 0.30) were independently associated with lower willingness to be screened. Multivariable analysis within the average-risk individuals who were willing to be screened for colorectal cancer showed that the doctor’s recommendations remained as an important cue for positive action, whereas negative perception toward the test was a significant barrier to the actual uptake of iFOBT.

CONCLUSION

The present findings must be factored in when tailoring colorectal cancer screening promotion activities in multiethnic, middle-income settings.