Canadians' Attitudes and Awareness Towards Colorectal Cancer Screen-ing: Results of a National Survey

Abstract

Background and Purpose: Colorectal cancer (CRC) is a significant cause of morbidity and mortality world- wide, and screening is widely accepted as a means of improving outcomes. However, screening uptake remains low amongst Canadians aged 50-74. The study's objective was to obtain national-level baseline data regarding Canadians' at- titudes towards and awareness of CRC screening. Methods: A telephone survey using random digit dialing methodology was conducted. A total of 2,444 respondents aged 50 -74 were surveyed regarding their attitudes, awareness and past screening behaviours related to cancer generally and CRC specifically. Logistic regression identified predictors of CRC screening participation. Results: While 80.9% of respondents were aware that screening tests for CRC exist, far more had heard of colonoscopy (87.2%) than fecal occult blood testing (FOBT, 42.8%). Only a minority (40.0 %) recognized that cancer screening occurs before symptom onset. The strongest predictor of CRC screening participation was having discussed it with their doctor (OR 6.81); yet only 29.0% recalled having such discussions. Belief that early detection increases one's chance of survival was positively associated with prior screening (OR 2.50), while belief that CRC screening was unnecessary in the absence of symptoms showed a negative association (OR 0.42). Conclusion: This study provides important national-level baseline data regarding Canadians' attitudes towards and aware- ness of CRC and its screening, and identifies factors associated with screening behaviour. The findings indicate important gaps in respondents' understanding regarding CRC screening. Potential interventions include public education to promote awareness of FOBT and optimal timing of screening, and greater support for physicians in promoting screening uptake.