Bowel Cancer Awareness Research Articles

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

BackgroundDespite 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.MethodA 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.ResultsNine 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%).ConclusionIn 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.

Understanding the interplay of colorectal cancer awareness and attitudes among Palestinians: a national cross-sectional study

BackgroundIn Palestine, colorectal cancer (CRC) is the second most common cause of cancer-related mortality after lung cancer. No studies have examined the relationship between CRC awareness and attitudes. This study aimed to investigate the interplay between CRC awareness and attitudes among the Palestinian population.MethodsA nationwide cross-sectional survey was carried out between July 2019 and March 2020. Convenience sampling was used to collect data from hospitals, primary healthcare facilities, and public areas in 11 governorates. Modified, translated-into-Arabic versions of the validated Bowel Cancer Awareness Measure and Cancer Awareness Measure-Mythical Causes Scale were utilized to assess the awareness of CRC signs/symptoms, risk factors, and causation myths. The cumulative awareness score for each domain was computed and stratified into tertiles. The top tertile denoted ‘high’ awareness, while the remaining two tertiles denoted ‘low’ awareness.ResultsThe final analysis included 4,623 participants; of whom, 3115 (67.4%) reported positive attitudes toward CRC. In total, 1,849 participants (40.0%) had high awareness of CRC signs/symptoms. There was no association between displaying a high awareness of CRC signs/symptoms and having positive attitudes toward CRC. A total of 1,840 participants (38.9%) showed high awareness of CRC risk factors. Participants with high CRC risk factor awareness were more likely to display positive attitudes toward CRC (OR = 1.22, 95% CI: 1.07–1.39). Only 219 participants (4.7%) had high awareness of CRC causation myths. Participants with high awareness of CRC causation myths were more likely to exhibit positive attitudes toward CRC (OR = 2.48, 95% CI: 1.71–3.58).ConclusionA high awareness level of CRC risk factors and causation myths was associated with a greater likelihood of demonstrating positive attitudes toward CRC in terms of perceived susceptibility, importance of early detection, and consequences of developing the disease. Future educational interventions should focus on raising public awareness about CRC, with a particular emphasis on risk factors and causation myths, to maximize the potential for shaping favorable attitudes toward the disease.

Differences in colorectal cancer awareness between screening eligible vs. ineligible Palestinians: a national cross-sectional study.

This study aimed to compare colorectal cancer (CRC) awareness between screening-eligible and ineligible individuals in Palestine. Convenience sampling was utilized to recruit Palestinian adults from diverse settings, including hospitals, primary healthcare centers and public spaces across 11 governorates. The evaluation of CRC awareness in terms of signs/symptoms, risk factors and causation myths was conducted using Arabic-translated, modified versions of the validated instruments, the Bowel Cancer Awareness Measure and the Cancer Awareness Measure-Mythical Causes Scale. The final analysis included 2698 participants, with 2158 (80.9%) eligible for CRC screening and 540 (19.1%) ineligible for it. The most recognized CRC sign/symptom was 'lump in the abdomen' in both screening-eligible (n = 386, 71.5%) and ineligible (n = 1582, 73.3%) groups. 'Lack of physical activity' was the most recognized risk factor in both groups (eligible: n = 451, 83.5%; ineligible: n = 1766, 81.8%). The most reported causation myth in both groups was 'having a physical trauma' (eligible: n = 340, 63.0%; ineligible: n = 1353, 62.7%). In the screening-eligible group, only 210 participants (38.9%) demonstrated high awareness of CRC signs/symptoms, 213 participants (39.4%) showed high awareness of CRC risk factors and only 46 participants (8.5%) displayed high awareness of CRC causation myths. There were no significant associations between being eligible for screening colonoscopy and the awareness levels of CRC signs/symptoms, risk factors and causation myths. Overall, awareness levels of CRC signs/symptoms, risk factors and causation myths were notably low among screening-eligible participants. There were no differences in awareness levels between individuals eligible for colonoscopy and those who were not.

Differences in Colorectal Cancer Awareness Between Vegetarians and Nonvegetarians: A National Cross-Sectional Study From Palestine.

To compare colorectal cancer (CRC) awareness between vegetarians and nonvegetarians in Palestine. The validated Bowel Cancer Awareness Measure and Cancer Awareness Measure-Mythical Causes Scale were translated into Arabic and used to assess awareness of CRC signs/symptoms, risk factors, and mythical causes. The total awareness score of each domain was calculated and categorized into tertiles; the top tertile was considered as good awareness. Multivariable logistic regression analysis was used to examine the association between being a vegetarian and displaying good awareness in each domain. This study included 4,623 participants: 560 vegetarians (12.1%) and 4,063 nonvegetarians (87.9%). Lump in the abdomen was the most recognized CRC sign/symptom among both nonvegetarians (n = 2,969, 73.1%) and vegetarians (n = 452, 80.7%). Vegetarians were less likely than nonvegetarians to display good awareness of CRC signs/symptoms (odds ratio, 0.59 [95% CI, 0.48 to 0.72]). Lack of physical activity was the most identified modifiable CRC risk factor in both nonvegetarians (n = 3,368, 82.9%) and vegetarians (n = 478, 85.4%). Similarly, having a bowel disease was the most identified nonmodifiable risk factor among both nonvegetarians (n = 2,889, 71.1%) and vegetarians (n = 431, 77.0%). There were no associated differences between both groups in the awareness levels of CRC risk factors. The most recognized food-related CRC causation myth in nonvegetarians was drinking from plastic bottles (n = 1,023, 25.2%), whereas it was eating burnt food in vegetarians (n = 176, 31.4%). Having a physical trauma was the most recognized food-unrelated myth in both nonvegetarians (n = 2,356, 58.0%) and vegetarians (n = 396, 70.7%). There were no associated differences in the awareness of CRC causation myths between both groups. Awareness of CRC was notably low in both Palestinian vegetarians and nonvegetarians. Particularly, vegetarians demonstrated lower awareness of CRC signs and symptoms.

Screening Perspectives: The Role of Colorectal Cancer Awareness in Shaping Attitudes Toward Colonoscopy in Palestine.

To assess colorectal cancer (CRC) awareness and its influence on attitudes toward colonoscopy in Palestine. Convenience sampling was used to recruit Palestinian adults from hospitals, primary health care centers, and public spaces across 11 governorates. To evaluate the awareness of CRC signs/symptoms, risk factors, and mythical causes, the Bowel Cancer Awareness Measure and Cancer Awareness Measure-Mythical Causes Scale were used after translation into Arabic. For each correctly recognized item, one point was given. The total awareness score of each domain was calculated and categorized into tertiles; the top tertile was considered high awareness, and the other two tertiles were considered low awareness. A total of 4,623 questionnaires were included. Only 1,849 participants (40.0%) exhibited high awareness of CRC signs/symptoms. High awareness of CRC symptoms was associated with higher likelihood of showing positive attitudes toward colonoscopy (odds ratio [OR], 1.21 [95% CI, 1.07 to 1.37]). A total of 1,840 participants (38.9%) demonstrated high awareness of CRC risk factors. Participants with high awareness of CRC risk factors were more likely to display positive attitudes toward colonoscopy (OR, 1.20 [95% CI, 1.07 to 1.37]). Only 219 participants (4.7%) demonstrated high awareness of CRC causation myths. There was no association between awareness of CRC causation myths and positive attitudes toward colonoscopy. Awareness of CRC was poor with less than half of the study participants demonstrating high awareness of CRC signs/symptoms and risk factors, and a minority (<5%) displaying high awareness of CRC causation myths. High awareness of CRC signs/symptoms and risk factors was associated with greater likelihood of demonstrating positive attitudes toward colonoscopy. Educational initiatives are needed to address knowledge gaps and dispel misconceptions surrounding CRC.

Pivot to prevent bowel cancer: Reflections on adapting an Aboriginal bowel cancer screening awareness program to a digital call to action-A commentary.

The Sydney Local Health District (SLHD) Health Promotion Unit was awarded a Cancer Institute NSW grant to raise awareness of bowel cancer and promote the National Bowel Cancer Screening Program (NBCSP) among Aboriginal communities in SLHD. The COVID-19 pandemic thwarted initial plans for face-to-face workshops and plans pivoted to digital products and dissemination of messages on a range of communication platforms. The coronavirus (COVID-19) pandemic provided staff with the freedom, flexibility, and ability to be creative in ways not possible prior to the pandemic and ultimately ended up with a superior product with a reach further than anticipated. A more comprehensive suite of digital resources addressing barriers to bowel cancer screening in the Aboriginal community was produced that is able to be used more broadly. These resources have reached a much larger population group through websites, social media, as well as TV and radio advertisements, and have the potential to be used and adapted in other local health districts and states across Australia. Adapting an Aboriginal bowel cancer screening awareness program to a digital platform is a promising approach. SO WHAT?: COVID-19 provided an opportunity to create new long-lasting partnerships and to be creative beyond the scope of the original grant. This in turn produced a product with a reach further than anticipated that can also be built on and sustained.

Bowel cancer awareness: yarning with the Aboriginal community to promote bowel cancer screening

Bowel cancer awareness: yarning with the Aboriginal community to promote bowel cancer screening

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.

Bowel cancer knowledge gaps evident among Irish residents: results of a national questionnaire survey.

The extent of knowledge of bowel cancer, its symptoms and risk factors are unknown in Irish residents. An understanding of bowel cancer awareness may be useful in aiding healthcare professionals, and policy makers develop improved bowel cancer awareness programmes and public health initiatives in Ireland. A 22-question online questionnaire survey was designed to gather data to assess residents' awareness of bowel cancer, its symptoms, and risk factors and to determine reasons for not participating in BowelScreen Ireland. There were 449 participants (329 women, 119 menand 1 'prefer not to say'). The majority of participants were aged 35-49years (42.8%), and 82.6% had completed a third level qualification. Irish residents (non-healthcare professionals/scientists (NHCP/S)) recalled on average less than three warning signs/symptoms. Among NHCP/S the most well-recalled protective diet and lifestyle choices were active lifestyle/exercise (62.1%), a fibre rich diet (45.4%) and no/low alcohol consumption (32.1%). Many were unable to recall red and processed meat as risk factors with only 10.7% and 4.9%, respectively, citing these foods. However, prompted awareness was superior with 71.1% agreeing or strongly agreeing that consumption of red and processed meat is a risk factor. 43.4% said they would be 'fairly confident' in recognising a sign/symptom, but more than a third (38.7%) reported they were 'not very confident'. This survey emphasises the need to improve the awareness of bowel cancer as gaps in this specific cancer knowledge were evident among Irish residents.

The Deborah James effect on bowel cancer awareness and referrals

After being diagnosed with bowel cancer in 2016, Deborah James devoted her life to raising public awareness of the condition, resulting in a positive impact on referrals, especially among young people

Patient delay to diagnosis and its predictors among colorectal cancer patients: A cross-sectional study based on the Theory of Planned Behavior.

The prognosis for colorectal cancer is closely related to the time of diagnosis. However, patient delay is common and become a major contributor to delays in cancer diagnosis. We aimed to investigate patient delay and its predictors based on the Theory of Planned Behavior among colorectal cancer patients. In total, 303 colorectal cancer patients were recruited from a Grade-A tertiary cancer center in southern China by convenience sampling. The participants' general information, stigma, self-efficacy, and knowledge about colorectal cancer were assessed by a self-designed general information questionnaire, the Social Impact Scale, the General Self-Efficacy Scale, and the section of the Bowel Cancer Awareness Measure on total knowledge of colorectal cancer. Descriptive statistics, univariate analysis, and binary logistic regression were applied for data analysis. The median patient delay was four months (range: 1 day-10 years). The prevalence of prolonged patient delay (≥3 months) was 57.8%. Identified by binary logistic regression, prolonged patient delay was associated with having no close family members/friends in medical professionals, unwillingness to accept colonoscopy, blood in stools, dyspepsia, insufficient support from family members, more measures taken to control symptoms, lower perceived severity of symptoms, knowledge shortage, negative help-seeking attitudes, lower self-efficacy, and higher stigma. Patient delay was considerable in individuals with colorectal cancer in China. Factors associated with patient delay are complex in Chinese culture. To shorten patient delay, culturally sensitive interventions may be required to improve knowledge, alleviate cancer stigma, enhance self-efficacy to seek medical attention, and promote positive help-seeking behaviors.

Awareness of Colorectal Cancer Risk Factors in Palestine: Where Do We Stand?

PURPOSETo assess the public awareness level of colorectal cancer (CRC) risk factors in Palestine and identify factors associated with the good awareness level.MATERIALS AND METHODSAdult Palestinians were recruited using convenience sampling from hospitals, primary health care centers, and public locations in 11 governorates. The recognition of 11 CRC risk factors was evaluated using a translated-into-Arabic version of the validated bowel cancer awareness measure. Participants were given one point for each correctly recognized risk factor. The awareness level was determined by the number of CRC risk factors recognized: poor (0-3), fair (4-7), and good awareness (8-11).RESULTSA total of 4,877 participants, of 5,254 approached, completed the questionnaire (response rate = 92.3%). The final analysis included 4,623 questionnaires, 2,700 from the West Bank and Jerusalem (WBJ) and 1,923 from the Gaza Strip. Participants from the WBJ were older, gained higher monthly income, and had more chronic diseases than participants from the Gaza Strip. The most recognized modifiable CRC risk factor was not doing 30 minutes of moderate physical activity five times a week (n = 3,846, 83.2%), whereas the least recognized was having a diet low in fiber (n = 1,985, 42.9%). The most recognized nonmodifiable CRC risk factor was having a bowel disease (n = 3,320, 71.8%), whereas the least recognized was having diabetes (n = 1,581, 34.2%). Only 1,840 participants (39.8%) demonstrated good awareness of CRC risk factors. Participants from the Gaza Strip were more likely than participants from the WBJ to have good awareness (46.5.0% v 35.0%). Female sex, knowing someone with cancer, and completing postsecondary education were all associated with good awareness.CONCLUSIONAwareness of CRC risk factors was found to be low in Palestine. There is a substantial need to raise awareness of CRC risk factors through educational campaigns and programs.

Awareness of colorectal cancer signs and symptoms: a national cross-sectional study from Palestine

BackgroundIn low-resource settings, the awareness level of colorectal cancer (CRC) signs and symptoms plays a crucial role in early detection and treatment. This study examined the public awareness level of CRC signs and symptoms in Palestine and investigated the factors associated with good awareness.MethodsThis was a national cross-sectional study conducted at hospitals, primary healthcare centers, and public spaces in 11 governorates across Palestine between July 2019 and March 2020. A translated-into-Arabic version of the validated bowel cancer awareness measure (BoCAM) was utilized to assess the awareness level of CRC signs and symptoms. For each correctly identified CRC sign/symptom, one point was given. The total score (ranging from 0 to 12) was calculated and categorized into three categories based on the number of symptoms recognized: poor (0 to 4), fair (5 to 8), and good awareness (9 to 12).ResultsOf 5254 approached, 4877 participants completed the questionnaire (response rate = 92.3%). A total of 4623 questionnaires were included in the analysis; 1923 were from the Gaza Strip and 2700 from the West Bank and Jerusalem (WBJ). Participants from the Gaza Strip were younger, gained lower monthly income, and had less chronic diseases than participants in the WBJ.The most frequently identified CRC sign/symptom was ‘lump in the abdomen’ while the least was ‘pain in the back passage’. Only 1849 participants (40.0%, 95% CI: 39.0%-41.0%) had a good awareness level of CRC signs/symptoms. Participants living in the WBJ were more likely to have good awareness than participants living in the Gaza Strip (42.2% vs. 37.0%; p = 0.002). Knowing someone with cancer (OR = 1.37, 95% CI: 1.21–1.55; p < 0.001) and visiting hospitals (OR = 1.46, 95% CI: 1.25–1.70; p < 0.001) were both associated with higher likelihood of having good awareness. However, male gender (OR = 0.80, 95% CI: 0.68–0.94; p = 0.006) and following a vegetarian diet (OR = 0.59, 95% CI: 0.48–0.73; p < 0.001) were both associated with lower likelihood of having good awareness.ConclusionLess than half of the study participants had a good awareness level of CRC signs and symptoms. Future education interventions are needed to improve public awareness of CRC in Palestine.

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

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. 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. 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 (2weeks). 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). 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.

Public Awareness of Bowel Cancer Risk Factors, Symptoms and Screening in Tasmania, Australia: A Cross-Sectional Study.

Tasmania has one of the highest bowel cancer incidence and death rates in the world. Public awareness of risk factors, symptoms, and early detection of bowel cancer is important for minimising the burden of disease. This study measured awareness levels of bowel cancer risk factors, symptoms and screening in Tasmania. An online survey of 3703 participants aged 18 years and older found that alcohol consumption, low physical activity levels, and having diabetes were the least known risk factors for bowel cancer. Over half of all participants were unaware the risk of bowel cancer increased with age, and 53 percent were not confident they would notice a bowel cancer symptom. Over a third of survey respondents did not know that screening commenced at the age of 50. The results indicate that a targeted campaign to increase bowel cancer awareness in Tasmania may help reduce the high rates of morbidity and mortality from the disease.

Ethnic inequalities in older adults bowel cancer awareness: findings from a community survey conducted in an ethnically diverse region in England

BackgroundTo date, research exploring the public’s awareness of bowel cancer has taken place with predominantly white populations. To enhance our understanding of how bowel cancer awareness varies between ethnic groups, and inform the development of targeted interventions, we conducted a questionnaire study across three ethnically diverse regions in Greater London, England.MethodsData were collected using an adapted version of the bowel cancer awareness measure. Eligible adults were individuals, aged 60+ years, who were eligible for screening. Participants were recruited and surveyed, verbally, by staff working at 40 community pharmacies in Northwest London, the Harrow Somali association, and St. Mark’s Bowel Cancer Screening Centre. Associations between risk factor, symptom and screening awareness scores and ethnicity were assessed using multivariate regression.Results1013 adults, aged 60+ years, completed the questionnaire; half were of a Black, Asian or Minority ethnic group background (n = 507; 50.0%). Participants recognised a mean average of 4.27 of 9 symptoms and 3.99 of 10 risk factors. Symptom awareness was significantly lower among all ethnic minority groups (all p’s < 0.05), while risk factor awareness was lower for Afro-Caribbean and Somali adults, specifically (both p’s < 0.05). One in three adults (n = 722; 29.7%) did not know there is a Bowel Cancer Screening Programme. Bowel screening awareness was particularly low among Afro-Caribbean and Somali adults (both p’s < 0.05).ConclusionAwareness of bowel cancer symptoms, risk factors and screening varies by ethnicity. Interventions should be targeted towards specific groups for whom awareness of screening and risk factors is low.

Google trends to identify public’s Interest in bowel cancer, A Web Based Analysis.

Aims: Bowel Cancer is one of the commonest cancers in UK. Google Trends were used to evaluate public’s search interest regarding bowel cancer. We hypothesize that the search data in Google Trends may be influenced by “Bowel cancer awareness month” campaign and that in future this might be a useful surrogate to monitor the effectiveness of public health campaigns. Methods: Google Trends were used to extract data presented as “Relative search volume index”(SVI) ranging between 0 to 100. “Bowel Cancer” was used as a search term to collect the relevant data for the last 5 years ( January 2015 to December 2019), All the peaks were assessed and their correlation with bowel cancer awareness month was noted. Results: We noticed an upward trend for the searched term during the months of April for most of the years where peak of search touched 90%. It corresponds with bowel cancer awareness month campaign. A downward trend was also noticed during the months of December during all years where it went down to 53%. This may represent avoidance of health related searches during the happy holiday period. Conclusion: Our study shows an encouraging association between bowel cancer awareness month campaign and public’s search interest. Results can be used in future to start effective awareness strategies and leverage future interventions.

Knowledge on colorectal cancer prevention among adults attending at a tertiary level hospital

Colorectal cancer ranks among the third most common cancer worldwide, second in terms of mortality due to cancer and has shown an increasing trend of incidence in Asian region lately. In Nepal, It is among the top five most common cancers in both males and females. Over the next ten years, countries in the low- income Asia pacific region including Nepal are projected to have the highest colorectal cancer growth rates of 70%. Owing to the growing burden, there is demand for more research in the field and hence strategies to increase the knowledge on colorectal cancer. The American cancer society asserts that colorectal cancer is common after age 50 and its screening should start after age 45. This study aimed to assess the level of knowledge on colorectal cancer including knowledge on preventive lifestyle and screening tests among adults. A cross sectional descriptive study was conducted from 2018 october- 2019 January among 110 non- cancer patients and adults aged 40-75 years attending Nepal Medical college Teaching Hospital. Non-probability purposive sampling was done. Structured interview questionnaire adopted from standard bowel cancer awareness measure (CAM) developed by cancer research UK was used for data collection. Frequency distribution, mean values and chi-square value were computed for statistical analysis. Results show that 81.8% had heard of colorectal cancer in their lifetime while 18.2% had never heard of it before. The main source of information was friends (47.7%) Of those who had heard of colorectal cancer, 92.2% believed colorectal cancer is preventable while 23.3% had in fact heard about colorectal cancer screening tests and mean knowledge percentage on the domain was only 14.44%. Mean knowledge percentage was found highest (74.6%) for knowledge regarding preventive lifestyle practices. Majority (65.6%) had moderate level of knowledge, 24.4% had inadequate knowledge while only 10% had adequate level of knowledge. Significant statistical association was not found between level of knowledge and selected demographic variables like age, sex, education, occupation (p<0.05) There is need of extensive public awareness programs on colorectal cancer with a focus on screening tests to fill the gaps of knowledge and promote utilization of early screening methods for prevention. Health care professional should be able to provide planned, structured health teaching on colorectal cancer to disseminate authentic information on the topic.

Like, comment, tag, share: Facebook interactions in health research

Background and objectivesA key aspect of the Internet that facilitates research is social media, especially the meteoric rise in the use of Facebook as one of the primary applications for social connectivity. Facebook can be considered a rich source of data due to the high amounts of demographic information shared by users and stored in the system, as well as the way in which users share their thoughts and behaviour in their natural environment. This report focuses on one functionality that as yet remained under-discussed and perhaps under-utilised as a tool in health research – the ability for participants or interested parties to leave comments directly on Facebook posts relating to research projects. Further, this report provides some considerations for researchers intending to use Facebook in recruiting participants for research. MethodsThe study was a Bowel Cancer Awareness Study conducted by the Centre for Rural Health, University of Tasmania to assess bowel cancer risk awareness in Tasmania. Participants were recruited to complete a survey on LimeSurveyTM via a Facebook page used to advertise the study. Several comments were made on the Facebook page over a three-month period, which were then further categorised and thematically analysed. Specifically, these comments were reviewed to determine how valuable Facebook comments can be for research. ResultsThe Facebook advertisement for the survey reached 136,640 people at a cost of $0.04 (4 cents) per person. From the range of comments received, four separate functions of these comments became apparent upon analysis – the capacity to ask questions, the ability to interact with others, promotion of the survey, and suggestions for future research. DiscussionFrom the bowel cancer awareness study, we found that Facebook comments on our study page allowed for an opportunity for ongoing contact with respondents, opportunity to receive feedback, address concerns and harness future research ideas. The ability to further utilize the potential for Facebook comments to enrich data collection and health research warrants a continuous and sustained interest, as research methodology progressively utilises the Internet and social media platforms as an effective and affordable option.

Ethnic differences in bowel cancer awareness: findings from a pharmacy-based community survey

BackgroundWe used London-based multilingual community pharmacies to better understand ethnic inequalities in levels of bowel cancer awareness. MethodsWe invited 206 community pharmacies for this study through the Middlesex Group of Local Pharmaceutical Committees. Participating pharmacies interviewed customers (aged 60 years or older) using a modified version of the Bowel Cancer Awareness Measure. Awareness was divided into symptom, risk factor, and screening awareness. Variation in risk factor and symptom awareness were assessed using stepwise linear regression, whereas variation in screening awareness was assessed using logistic regression. The fully-adjusted model controlled for main spoken language, age, gender, and pharmacy postcode-based index of multiple deprivation rank. No ethical monitoring was required due to complete anonymity of responders and implied consent by return of questionnaire. Findings40 community pharmacies (19% of those invited) interviewed 913 customers. There was no statistically significant difference in area-level deprivation between participating and non-participating community pharmacies (p=0·50). To minimise confounding, individuals who reported a history of bowel cancer were excluded from the analysis (n=49; 5%) leaving 864 participants (95% of the full sample). Among these 864 participants, the sample comprised 578 (67%) English speakers, 412 (48%) women, 406 (47%) men, 406 (47%)white-British, 228 (26%) Indian, 43 (5%) white-Irish, 39 (5%) black Caribbean, 23 (3%) Pakistani, 21 (2%) black African, 16 (2%) of other white ethnicity, and 29 (3%) of other ethnicity. At the univariate level, ethnicity was associated with symptom awareness (p=0·0021) and screening awareness (p<0·0001), but not risk factor awareness (p=0·41). In a fully-adjusted model, screening awareness was statistically significantly lower among black African (adjusted odds ratio 0·37 [95% CI 0·17–0·80; p=0·012), black Caribbean (0·28 [0·10–0·83]; p=0·022), and participants from other ethnic groups (0·19 [0·07–0·48]; p=0·0014), compared with white-British participants. However, symptom awareness was no longer associated with ethnicity. Screening awareness was also higher in pharmacies situated in more affluent areas (7·83 [2·14–28·65]; p=0·002) even after adjusting for other demographics. There was however no association between levels of area-level deprivation and symptom or risk awareness. InterpretationOverall, administering bowel cancer awareness measure was feasible. Although participation of community pharmacies was low, the number of surveys completed was substantial and there was little evidence to suggest selection bias in terms of deprivation. The association between ethnicity and screening awareness was independent of language, which means that unlike symptom awareness, campaigns trying to reduce inequalities in awareness of screening programmes cannot just rely on providing materials in people's native language. Instead, academics and community outreach workers should work with community pharmacies and their customers to co-create materials to improve awareness of the bowel cancer screening programme. Future Bowel Cancer Awareness Measure surveys would also benefit from larger sample sizes among individual ethnic groups and the least and most deprived. FundingNorgine, St Mark's Bowel Cancer Screening Centre.