S3250 Knowledge, Attitude and Obstacles of Colorectal Cancer Screening in Primary Health Care in Bali, Indonesia

Abstract

Introduction: The incidence of colorectal cancer (CRC) in Indonesia is rising. Screening is an essential effort for Early diagnosis of cancers, and was done mainly at primary health care centers (PHCs) by primary care physicians (PCPs). We aimed to evaluate the knowledge and attitudes of PHC provider regarding CRC screening and identify the obstacles associated with the screening plan. Methods: A cross-sectional study was conducted among PHC physicians and nurses in public primary health care centers in Bali, Indonesia. A 44-item self-administered questionnaire was used to assess the knowledge, attitude and obstacle practice of CRC screening. All respondence signed the informed concern electronically before participating in this study. Results: Two hundred and five respondents have participated in this study. The range of Age was 20- 55 year. 60% female, and the rest were males. 63.9% are PCPs, and 36.1% are nurses. The average duration of doing practice in PHC is 6.6 years. In knowledge of CRC, 50.2% of them have good knowledge, and there is no difference between PCPs vs nurses (51.9% vs 47.3%; P = 0.53). In attitude toward CRC screening, 58.5% out of the have good attitude, and there is no difference between PCPs vs nurses (60.3% vs 55.4%; P = 0.50). The obstacle of the screening was divided into two areas, a barrier from the health care system and patients. Cost of screening (95%) and lack of health care facilities (85%) as the main reason for the health care system obstacle. And Fear to know they have a cancer as a main reason from patients’ aspect (90%). There is no association between knowledge and attitude towards CRC screening (P = 0.63). Conclusion: In this study, Both of PCP and nurses has inadequate knowledge of CRC screening and only half of them has a good attitude toward CRC screening, because there is no national population-based screening program in Indonesia. There is no association between knowledge and attitude, because they did not translate their knowledge to daily practice. This condition also related to the lack of CRC screening facilities in PHC and high cost. Lack of knowledge from people in the population suggest need a big effort to reduce the barrier from health care system and population to reach success in CRC screening program as a conclusion, Knowledge and attitude of PCPs and nurses in the practice of CRC screening were inadequate. Lack of facilities, cost of screening and lack of knowledge as main barrier for screening.