Colorectal cancer awareness and its predictors among adults aged 50–74 years attending primary healthcare in the State of Qatar: a cross-sectional study

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Abstract

Objective

The current study aimed to assess the awareness of colorectal cancer (CRC) symptoms and risk factors among the at-risk population visiting the primary healthcare (PHC) centres in Qatar. The secondary objective was to assess the differences in awareness among population subgroups.

Design

A cross-sectional study design was employed.

Setting

The study was conducted across six PHC centres in Qatar.

Participants

Patients, or their accompanying people, aged 50–74 years and Arabic or English speakers, were recruited from the main waiting areas of the selected PHC centres.

Data collection and analysis

Participants were interviewed using the validated Bowel/Colorectal Cancer Awareness Measure questionnaire. A non-probability convenient sampling technique was applied to recruit participants. Descriptive and analytic statistics were used when appropriate. A multivariate linear regression model was constructed to identify the independent predictors of CRC awareness.

Results

The study includes 448 participants (response rate=87%). The mean age of the participants was 58.48 years (SD ±6.37). The mean awareness score among the participants was 3.63/9 (SD ±2.7) for CRC symptoms and 5.43/11 (SD ±3.3) for CRC risk factors. The overall mean awareness score was 9.03/20 (SD ±5.5). Multivariate linear regression identified the female gender (2.52 (95% CI 1.15 to 3.88)), non-Qatari Arab (2.91 (95% CI 1.64 to 4.18)) or non-Arab nationalities (1.76 (95% CI 0.28 to 3.24)), and tertiary education (4.10 (95% CI 2.55 to 5.66)) as independent predictors of higher CRC awareness.

Conclusion

In general, the awareness of CRC symptoms and risk factors was low among the at-risk population in Qatar. Specifically, the regression analysis showed men, Qataris, and those with no formal education had low awareness of CRC symptoms and risk factors. Such results emphasise the importance of tailoring future educational campaigns that are relevant, specific and appealing to such cohort.

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Most cited references 10

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Worldwide variations in colorectal cancer.

Melissa M Center, Ahmedin Jemal, Robert A Smith … (2009)

Previous studies have documented significant international variations in colorectal cancer rates. However, these studies were limited because they were based on old data or examined only incidence or mortality data. In this article, the colorectal cancer burden and patterns worldwide are described using the most recently updated cancer incidence and mortality data available from the International Agency for Research on Cancer (IARC). The authors provide 5-year (1998-2002), age-standardized colorectal cancer incidence rates for select cancer registries in IARC's Cancer Incidence in Five Continents, and trends in age-standardized death rates by single calendar year for select countries in the World Health Organization mortality database. In addition, available information regarding worldwide colorectal cancer screening initiatives are presented. The highest colorectal cancer incidence rates in 1998-2002 were observed in registries from North America, Oceania, and Europe, including Eastern European countries. These high rates are most likely the result of increases in risk factors associated with "Westernization," such as obesity and physical inactivity. In contrast, the lowest colorectal cancer incidence rates were observed from registries in Asia, Africa, and South America. Colorectal cancer mortality rates have declined in many longstanding as well as newly economically developed countries; however, they continue to increase in some low-resource countries of South America and Eastern Europe. Various screening options for colorectal cancer are available and further international consideration of targeted screening programs and/or recommendations could help alleviate the burden of colorectal cancer worldwide.

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Assessing awareness of colorectal cancer symptoms: Measure development and results from a population survey in the UK

Emily Power, Alice Simon, Dorota Juszczyk … (2011)

Background This paper describes the development of a Cancer Awareness Measure for colorectal (CRC) cancer (Bowel/Colorectal CAMa) (study 1) and presents key results from a population-representative survey using the measure (study 2). Methods Study 1 Items were taken from the literature and reviewed by expert groups. A series of three validation studies assessed reliability and validity of the measure. To establish test-retest reliability, 49 people over 50 years of age completed the Bowel/Colorectal CAM on two occasions (range 9-14 days, mean 13.5 days). Construct validity was assessed by comparing responses from bowel cancer experts (n = 16) and the lay public (n = 35). Lastly, a brief intervention study tested sensitivity to change with participants (n = 70) randomly allocated to be given a control leaflet or an intervention leaflet and their responses were compared. Study 2 1520 respondents completed the Bowel/Colorectal CAM in a population survey carried out by TNS-British Market Research Bureau International (TNS-BMRB) in March 2010. Results Study 1 Internal reliability (Cronbach's alpha = 0.84) was high. Test-retest reliability was over r = 0.7 for warning signs, risk factors and age people are first invited for screening, but lower (between 0.6 and 0.7) for other items (lifetime risk, awareness of bowel cancer screening, age at risk). Bowel cancer experts achieved higher scores than equally educated controls (54.7 [4.3] vs. 42.9 [5.7]; P < 0.001) demonstrating the measure has construct validity and intervention participants showed higher knowledge than controls (51.4 [5.9] vs. 42.9 [5.7]; P < 0.001) suggesting the measure is sensitive to change. Study 2 Respondents recalled on average, one CRC sign and one risk factor. There was particularly low prompted awareness of the signs 'lump in the abdomen' (64%) and 'tiredness' (50%) and several lifestyle risk factors for CRC, e.g. exercise (37%). Respondents from more affluent groups had consistently higher knowledge of signs and risk factors compared to those from more deprived groups. Conclusions The Bowel/Colorectal CAM meets accepted psychometric criteria for reliability and construct validity and should therefore provide a useful tool for assessment of CRC awareness. The population survey revealed low awareness of several CRC signs and risk factors and emphasises the importance of continuing public education, particularly about the link between lifestyle behaviours and CRC.

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Level of colorectal cancer awareness: a cross sectional exploratory study among multi-ethnic rural population in Malaysia

Tin SU, Jun Yan Goh, Jackson Tan … (2013)

Background This paper presents the level of colorectal cancer awareness among multi-ethnic rural population in Malaysia. Methods A rural-based cross sectional survey was carried out in Perak state in Peninsular Malaysia in March 2011. The survey recruited a population-representative sample using multistage sampling. Altogether 2379 participants were included in this study. Validated bowel/colorectal cancer awareness measure questionnaire was used to assess the level of colorectal cancer awareness among study population. Analysis of variance (ANOVA) was done to identify socio-demographic variance of knowledge score on warning signs and risk factors of colorectal cancer. Results Among respondents, 38% and 32% had zero knowledge score for warning signs and risk factors respectively. Mean knowledge score for warning signs and risk factors were 2.89 (SD 2.96) and 3.49 (SD 3.17) respectively. There was a significant positive correlation between the knowledge score of warning signs and level of confidence in detecting a warning sign. Socio-demographic characteristics and having cancer in family and friends play important role in level of awareness. Conclusions Level of awareness on colorectal cancer warning signs and risk factors in the rural population of Malaysia is very low. Therefore, it warrants an extensive health education campaign on colorectal cancer awareness as it is one of the commonest cancer in Malaysia. Health education campaign is urgently needed because respondents would seek medical attention sooner if they are aware of this problem.

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Author and article information

Journal

Journal ID (nlm-ta): BMJ Open

Journal ID (iso-abbrev): BMJ Open

Journal ID (hwp): bmjopen

Journal ID (publisher-id): bmjopen

Title: BMJ Open

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2044-6055

Publication date Collection: 2020

Publication date (Electronic): 7 July 2020

Volume: 10

Issue: 7

Electronic Location Identifier: e035651

Affiliations

[1 ]departmentCommunity Medicine, Medical Education Department , Hamad Medical Corporation , Doha, Qatar

[2 ]departmentOperations Department , Primary Health Care Corporation , Doha, Qatar

[3 ]departmentClinical Affairs Department , Primary Health Care Corporation , Doha, Qatar

[4 ]departmentDepartment of Workforce Training , Primary Health Care Corporation , Doha, Qatar

[5 ]departmentDepartment of Public Health and Preventive Medicine , Cairo University , Cairo, Egypt

Author notes

[Correspondence to ] Dr Ayman Al-Dahshan; ayman.aldahshan@ 123456hotmail.com

Author information

Ayman Al-Dahshan http://orcid.org/0000-0001-6132-3223

Article

Publisher ID: bmjopen-2019-035651

DOI: 10.1136/bmjopen-2019-035651

PMC ID: 7342467

PubMed ID: 32641359

SO-VID: dac1f9d3-7d99-4549-ab9c-5ca65d8c67cc

License:

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

History

Date received : 10 November 2019

Date revision received : 20 May 2020

Date accepted : 28 May 2020

Funding

Funded by: Research Department of the Primary Health Care Corporation‎;

Award ID: PHCC/RC/18/05/001

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ScienceOpen disciplines: Medicine

Keywords: epidemiology,gastrointestinal tumours,primary care,preventive medicine,public health

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ScienceOpen disciplines: Medicine

Keywords: epidemiology, gastrointestinal tumours, primary care, preventive medicine, public health

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Colorectal cancer awareness and its predictors among adults aged 50–74 years attending primary healthcare in the State of Qatar: a cross-sectional study

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Abstract

Objective

Design

Setting

Participants

Data collection and analysis

Results

Conclusion

Related collections

Jiangsu Journal of Preventive Medicine

Most cited references 10

Worldwide variations in colorectal cancer.

Assessing awareness of colorectal cancer symptoms: Measure development and results from a population survey in the UK

Level of colorectal cancer awareness: a cross sectional exploratory study among multi-ethnic rural population in Malaysia

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Cited by 17

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