Colorectal Cancer Screening Knowledge Research Articles

Colorectal Cancer Screening Among Adults in Zuni Pueblo: Factors Associated with FOBT and Colonoscopy Utilization.

Although strategies to mitigate barriers to colorectal cancer (CRC) screening have proven successful in some parts of the US, few of these strategies have been studied in rural, American Indian communities that may exhibit unique culturally driven attitudes toward and knowledge of colorectal cancer and experience increased barriers to healthcare access. In this study, we describe the results of a survey among CRC screen-eligible members of Zuni Pueblo (N = 218) on an array of questions regarding CRC screening behaviors, knowledge, satisfaction with and access to healthcare services, social support for CRC screening, perceptions toward FOBT, and preference for evidence-based interventions or strategies for improving CRC screening rates. Results from the multivariable model suggest age, having a regular healthcare provider, and harboring fewer negative perceptions toward FOBT are key drivers of ever completing CRC screening. Respondents reported strong support for Community Guide-recommended interventions and strategies for increasing CRC screening for nearly all proposed interventions. Results confirm the need for multilevel, multicomponent interventions, with a particular focus on improving Zuni Pueblo community members' access to a regular source of care, improving knowledge of CRC risk factor, and addressing negative perceptions toward CRC screening. These results provide critical, community-specific insight into better understanding the drivers of low guideline-adherent screening rates and inform local healthcare providers and community leaders of context-specific strategies to improve CRC screening in Zuni Pueblo.

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

ObjectiveTo assess awareness levels and knowledge of colorectal cancer (CRC) and CRC screening among an Indigenous Caribbean community.MethodsA 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.ResultsOf 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).ConclusionDespite 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.

Abstract B056: Increasing knowledge of colorectal cancer (CRC) risk factors and screening through a community-based education initiative

Abstract Background: Colorectal cancer (CRC) screening such as colonoscopy and stool test has been shown to be effective in reducing CRC burden, especially in the underprivileged communities. However, CRC awareness and screening uptake remained suboptimal, especially in racial/ethnic minority populations and non-Hispanic whites. Both CRC incidence and mortality rates are highest in non-Hispanic blacks (approximately 20% and 40%, respectively), and CRC screening uptake rates are lower in racial/ethnic minorities relative to non-Hispanic whites (NHWs). The cause for the disparities in incidence and mortality is multifactorial. One important aspect is the suboptimal knowledge and awareness of risk factors. Methods: To increase awareness of CRC prevention and screening, we collaborated with community-based organizations (CBOs) to develop culturally tailored educational materials targeting African/Black Americans (BAs), Asian Americans (AAs), and Hispanic Americans (HAs). The topics included essential CRC and screening knowledge, a healthy diet (Mediterranean diet), and at-home workout routines. Eligible participants from the Greater Philadelphia area and New York City participated in one-time education. Pre- and post-intervention surveys were designed based on the Colorectal Cancer Quiz provided by the Centers for Disease Control and Prevention (CDC) and were administered to assess the immediate impact of the educational sessions. Results: The analysis sample included 413 participants, among which 388 completed the post-survey. One in ten (10.3%) reported a family history of CRC, and a half (50.6%) had never had a colonoscopy. The baseline CRC knowledge score was 9.5 out of 16, indicating a moderately low level of knowledge. Participants scored particularly low on the age of CRC screening initiation, needs for screening even without symptoms, and the impact of physical activity on CRC risk. The knowledge score significantly increased to 10.9 (p &amp;lt; .001) at post-survey, indicating a significant impact of the educational workshops. Conclusion: The findings of our project confirm that the CRC screening rates are low in racial/ethnic minorities compared to the U.S. national rate of 71.6%. Meanwhile, it also confirmed that culturally tailored, community-based educational initiatives can effectively raise knowledge of CRC in medically underserved populations. Citation Format: Ellen J. Kim, LIn Zhu, Wenyue Lu, Safa Ibrahim, Steven Zhu, Nathaly Rubio-Torio, Evelyn González, Marilyn A. Fraser, Ming-Chin Yeh, Grace X. Ma, Olorunseun O. Ogunwobi, Yin Tan. Increasing knowledge of colorectal cancer (CRC) risk factors and screening through a community-based education initiative [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B056.

Colorectal Cancer Screening Knowledge and Practices Among Practicing Obstetrician-Gynecologists and Residents.

Colorectal cancer (CRC) is the second leading cause of cancer death in the US, the third most diagnosed cancer in women, and the second leading cause of cancer death in women. The aims of our study are to (1) investigate knowledge of and adherence to CRC screening guidelines by obstetrician-gynecologists (Ob/Gyns) and (2) assess whether this knowledge/adherence vary by demographic and practice characteristics. An anonymous cross-sectional survey was distributed to a convenience sample of 142 practicing Obs/Gyns drawn from National Medical Association section members/conference attendees and hospital Ob/Gyn department members. Most respondents (80.3%) viewed colorectal screening within the scope of Ob/Gyn practice, and 71.8% used the American College of Obstetricians and Gynecologists guidelines for screening. Most respondents were knowledgeable regarding CRC screening but not in all areas. On average they only identified half of the 10 risk factors listed and only one-quarter correctly identified the age when screening can stop. Residents were somewhat more knowledgeable about screening guidelines and risk factors than attendings. More than half of respondents (57.8%) reported always initiating CRC screening for the appropriate age and risk factors. Respondents identified education and awareness (56.3%) and patients' unwillingness to undergo an invasive procedure (75.4%) as barriers to screening. Knowledge regarding CRC screening was less than optimal and differed by attending/resident status. Greater emphasis should be placed on CRC screening and guidelines training for primary care providers like Ob/Gyns. Some of this could be accomplished through maintenance of certification and continued integration into residency education.

Knowledge, Attitude, and Practice of Colorectal Cancer Screening Among Primary Healthcare Physicians in Riyadh Second Health Cluster.

Colorectal cancer is the third common cancer, and the second common cause of cancer death in the world. According to the 2014 Cancer Incidence Report of the Kingdom of Saudi Arabia, colorectal cancer account for 11.5% from all cancers reported among Saudi nationals. By the year 2030, the incidence of colorectal cancer could increase fourfold among both genders. The study aimed to conduct to understand the knowledge, attitude, and practice of primary healthcare physicians regarding colorectal cancer screening in Riyadh Second Health Cluster in the city of Riyadh, Saudi Arabia. A cross-sectional study design, probability proportional to size sampling at the cluster zones level and convenient sampling for the physicians, were used among physicians working in the primary healthcare centers in the city of Riyadh between October 2022 and November 2022. Of the 213 respondents, the mean age of the physician was 35, the majority were males (59%), Saudi Arabian nationality (60%), Resident Physicians (54%) and ≤ five years' work experience (45%). Sixty-four percent of the study participants believe that the majority of asymptomatic average-risk patients have to start the screening at the age of 45 years old. Ninety-seven percent believe that colorectal cancer screening for asymptomatic average-risk patients aged 45 years and older is effective. Ninety-two percent of the physicians perform colorectal cancer screening for asymptomatic average-risk patients aged 45 years. The mean knowledge score is 4.65 (SD=2.33) with a range of 0 to 10. The mean attitude score is 4.19 (SD=1.28) with a range of 0 to 6. The study found that the physicians had higher attitude and practice towards colorectal cancer screening and adequate knowledge towards colorectal cancer screening. The knowledge and attitude scores are associated with practicing colorectal cancer screening.

Impact of Alzheimer's disease and related dementias on colorectal cancer screening utilization, knowledge, and associated health disparities.

Background: Colorectal cancer screening can detect colorectal cancer at an early stage and reduce mortality. None of the existing clinical practice guidelines provide specific recommendations for colorectal cancer screening in patients with Alzheimer’s disease and related dementias (ADRD). Limited studies have assessed the impacts of ADRD on colorectal cancer screening use and knowledge, and no studies have focused on the associated health disparities. Objectives: To examine the utilization, knowledge, and associated health disparities of colorectal cancer screening in older adults with ADRD. Methods: This study used the Medicare Current Beneficiary Survey from 2015 to 2018. Two types of colorectal cancer screening, including fecal occult blood test (FOBT) and colonoscopy/sigmoidoscopy, were measured. The colorectal cancer screening knowledge was evaluated by asking if the participants have heard of two screening methods and whether they knew Medicare pays for colorectal cancer screenings. Logistic regression models were used to examine the impact of ADRD diagnosis on the utilization and knowledge of colorectal cancer screening. Results: The overall colorectal cancer screening rate in older adults increased from 86.4% to 88.96% from 2015 to 2018. Patients with AD were 39% (OR: 0.61; 95% CI: 0.50–0.76) less likely and those with RD were 25% (OR: 0.75; 95% CI: 0.62–0.91) less likely to use any colorectal cancer screening when compared to older adults without ADRD. The rate of knowledge of colonoscopy/sigmoidoscopy remained high between 84.23% and 84.57% while the knowledge of FOBT increased from 64.32% to 78.69% during the study period. Compared to older adults without ADRD, those with AD were 77% (OR: 1.77; 95% CI: 1.12–2.81) more likely to hear of colonoscopy/sigmoidoscopy. The rate of knowledge of Medicare pay for colorectal cancer screening increased from 42.19% to 45.27% during the study period. Compared to older adults without ADRD, those with AD were 19% (OR: 0.81; 95% CI: 0.70–0.94) less likely to know that Medicare pays for colorectal cancer screening. Conclusion: ADRD was significantly associated with colorectal cancer screening utilization and knowledge. In addition, this study identified health disparities in race/ethnicity, gender, and urban/rural residence in colorectal cancer screening use and knowledge.

Awareness and Knowledge of Colorectal Cancer Screening Among Medical Students at the University of Aleppo: A Cross-Sectional Study.

Background Colorectal cancer (CRC) is the third leading cause of malignancy in Syria. The aim of our study was to assess the awareness and knowledge of CRC and its screening methods among medical students at the University of Aleppo. Methods A cross-sectional study of medical students at the University of Aleppo was conducted using a self-administered 12-element questionnaire. The questionnaire consisted of demographics, awareness of CRC, knowledge of CRC and its screening methods. Awareness of CRC included three questions asking students if they ever heard of CRC and its screening methods. Knowledge of CRC was evaluated through three sets of questions about CRC risk factors, signs and symptoms, and preventative methods. The students were selected randomly during academic lectures. A χ 2 or Fisher's exact tests for categorical variables were used for statistical analysis, as appropriate. A two-sided p < 0.05 was considered statistically significant. We stratified students based on pre-clinical versus clinical years and average academic score. Results A total of 824 students completed the questionnaire. The majority of students were aware of CRC (98.9%) and CRC screening methods (79.8%). Students had poor knowledge of CRC risk factors (16.5% for non-modifiable factors and 11.7% for modifiable factors), signs and symptoms (52.6%), and protective factors (9.9%). Only 31.7% of students were able to identify the appropriate age to initiate screening for average-risk individuals. Clinical students had better awareness and knowledge of CRC and its screening methods. Clinical students with higher academic score showed better awareness and knowledge in some elements. Conclusion Our study reported high awareness and poor knowledge rates of CRC and its screening methods among medical students at the University of Aleppo. Although clinical students had higher awareness and knowledge of CRC compared to pre-clinical students, the impact of academic score revealed variable results.

Knowledge, Attitudes, and Beliefs About Colorectal Cancer Screening in Puerto Rico

The purpose of this study was to describe the psychosocial factors influencing participation in colorectal cancer screening (CRCS) among Puerto Rican men and women. We conducted seven focus groups in metropolitan and rural areas of Puerto Rico (PR) with men and women (using gender specific groups) aged 50 to 80 years (n = 51) who were non-adherent to CRC guidelines. The focus group guide included questions related to colorectal cancer (CRC) and CRC screening knowledge, attitudes, and beliefs. We analyzed data using a modified grounded theory approach to identify emergent themes. Focus groups revealed seven major themes that represented barriers to CRCS: (1) lack of CRC knowledge, (2) lack of knowledge about colorectal cancer screening tests as well as the required preparation, (3) embarrassment, (4) low perceived benefit of CRCS and sense of fatalism, (5) transportation (mostly among participants in rural areas), (6) lack of time, and (7) financial burden. All participants understood the benefits of CRCS once the procedure was explained. Additionally, participants reported a lack of provider recommendation for CRCS. In this group of Puerto Rican participants who were non-adherent to CRCS, there were misconceptions about CRC, screening tests available, and preparation and testing procedures. Participants’ low levels of knowledge and negative attitudes concerning CRCS and low reported provider recommendation were important deterrents to screening. These findings suggest the need for educational efforts to increase knowledge and attitudes about CRCS and improved patient-provider communication to reduce missed opportunities to recommend.

Awareness and knowledge of Colorectal Cancer Screening among Latinos in Omaha, Nebraska.

Colorectal cancer (CRC) screening rates remain low in Latino communities. We sought to determine the screening awareness and attitudes in Omaha, Nebraska. We interviewed 150 Latinos at an urban Federally Qualified Health Center, June-October 2017. Chi-square or Fisher-exact tests and multiple logistic regression models were used for data analysis. Participants reported low educational attainment, low income, and limited access to insurance or a primary provider. Less than one-third of participants aged 50 + had ever heard of FOBT (32.6%) or colonoscopy (30.4%). For individuals 50+, access to a primary care provider (p = .03) and knowing the screening initiation age (p = .03) were associated with ever having a colonoscopy. Higher knowledge score was a strong predictor of any CRC screening. Knowledge predicted screening, suggesting interventions should aim to educate this population regarding CRC screening guidelines and options and work with stakeholders to make CRC screening more accessible.

Colorectal cancer screening knowledge and uptake in lebanon: a national survey

ObjectiveThe main aim of this national survey was to identify the levels of colorectal cancer screening knowledge and uptake in Lebanon. MethodsA total of 1200 participants were enrolled in this cross-sectional household survey targeting the Lebanese population aged 50 years and above. The sample was recruited using a two-stage stratified cluster sampling approach. ResultsOf the total sample, 38.3% knew about any screening test for colorectal cancer but only 7.5% had ever used any. Thirty-nine percent of the participants rated their risk of getting colorectal cancer as very low or low, and only 53.5% were confident in their ability to undertake a screening test. Almost all participants agreed that medical advice and test reimbursement would encourage them to do a screening test. At the multivariate analysis level, hearing of an awareness campaign in the last two years showed the strongest association with the knowledge of a colorectal cancer screening test with an estimated ORadj = 5.12 (95%CI: 3.67 – 7.15). Other factors that were significantly associated with this knowledge variable included: a family history of colorectal cancer, a personal history of colorectal illness, having a health coverage, and knowledge of colorectal cancer signs and symptoms. DiscussionThis national study highlights an alarming lack of uptake and low levels of knowledge of colorectal cancer screening tests even though it is among the most prevalent cancers in Lebanon and its prevalence has been continuously increasing in the past years. The evidence suggests that people who had an experience with colorectal cancer diagnostic tests, either personally or through a family member, and those who have heard of an awareness campaign about colorectal cancer in the last two years are more likely to know its screening tests. ConclusionColorectal cancer screening knowledge and uptake in Lebanon are limited and justify the need for public health interventions. This study gives evidence that awareness campaigns, coupled with the involvement of medical providers and the reimbursement of screening test fees, would alleviate the burden of colorectal cancer in Lebanon.

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

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.

Barriers and facilitators of colorectal cancer screening in Asia.

PurposeOne of the most common cancers in Asia is colorectal cancer (CRC). Early diagnosis and timely treatment are necessary for preventing complications and advanced stages of the disease. It is important to evaluate barriers and facilitators of screening in different countries. This systematic review aimed to identify the barriers and facilitators of CRC screening in Asia.MethodsIn this systematic review, for identifying barriers and facilitators of CRC screening, a comprehensive search was conducted in PubMed, Web of Science and Scopus in 12 December 2020. Combination keywords such as colorectal cancer, screening, sigmoidoscopy, colonoscopy, faecal occult blood test, barriers, facilitators and the names of each Asian country were used for searching. Full text original studies in English language were accepted in the review.ResultsIn total, 36 articles were included in the review. Barriers and facilitators were evaluated. The most common reported barriers were lack of knowledge, fear of result, fear of procedure, fear of pain, lack of awareness, high cost and lack of gastrointestinal symptoms. The most frequent facilitators were having knowledge and awareness of CRC screening, perceived risk and severity, family history of cancer and physician recommendation.ConclusionFor promoting success in CRC screening programmes, knowing what the barriers and facilitators are is necessary. Awareness and various personal, professional and social factors have been shown to be the major barriers toward CRC screening in most Asian countries.

Assessing Colorectal Cancer Screening Barriers in Rural Appalachia

The age-appropriate colorectal cancer (CRC) screening rate in the rural Appalachian area is low compared with the national rate, which may account for the overall higher incidence of CRC in this area. The purpose of this study was to explore potential barriers to CRC screening in the West Virginia Appalachian area. A cross-sectional survey was designed to identify patient-reported barriers to CRC screening using the health belief model to assess their attitudes and behaviors. Autonomous paper-based surveys were randomly handed to individuals older than 50 years at various locations, including healthcare and nonhealthcare facilities. All of the responses were then categorized into two groups: the screened group and the unscreened group. Differences among both groups were statistically analyzed. There were three main areas that significantly accounted for the discrepancies between the screened and unscreened groups: perceptions of discomfort from screening tests, psychological and behavior deterrents in CRC screening and diagnosis, and limited resources for accessing care, especially transportation. In particular, psychological and behavioral deterrents in CRC screening appeared to play a role in promoting aversion to CRC screening. Lack of CRC screening awareness and knowledge may be responsible for fatalism regarding CRC and aversion to screening. Thus, multidisciplinary interventions that provide education about CRC screening, early intervention prognosis, and treatment options, as well as addressing systemic barriers to screening, such as assistance with scheduling, prep instructions, and transportation, can improve the screening rate in Appalachia and eventually lead to better outcomes through the early diagnosis of CRC.

Colorectal Cancer Screening: Knowledge and Practice among Private General Practitioners in Northeast Peninsular Malaysia

Colorectal cancer screening is an important screening to detect colorectal cancer. Thus, the aim of this study is to determine the knowledge, practice and its associated factors of colorectal cancer screening among private general practitioners (PGPs) in Northeast Peninsular Malaysia. Crosssectional study was conducted involving 127 PGPs in Kelantan. The study used a validated selfadministrated questionnaire that contained three domains. The domains were sociodemographic, knowledge and practice of colorectal cancer screening. The inclusion criterion was doctors working in a private clinic for more than six months, while the exclusion criteria were non-residential doctors and doctors practicing in private specialised clinics. Only 21.3% of PGPs had good knowledge and 3.9% had good practice on colorectal cancer screening. The duration of practice as a PGP was significantly associated with good practice for colorectal cancer screening. Only 58.3% were aware of the current recommendation on colorectal cancer screening. Most PGPs would refer patients for a colonoscopy, but screening with faecal occult blood test (FOBT) in average-risk patients was low. Only 4% of PGPs followed the recommended guidelines for colorectal cancer screening. The main reasons for not offering FOBT screening were patients’ refusal, patients were not regular patients of the doctor and the referral system for colonoscopy was found to be difficult. This study noted that knowledge and practice of colorectal cancer screening among PGPs were inadequate. Overcoming barriers for screening is important to promote colorectal cancer screening.

Knowledge and attitude of primary healthcare physicians toward colorectal cancer screening in Qassim region, Saudi Arabia

Background: Colorectal cancer (CRC) is the most common cancer among men and the third most common cancer among women in Saudi Arabia. Screening for CRC is essential for early diagnosis, prevention, and treatment to reduce healthcare costs and mortality. Objectives: The current study aimed to assess the knowledge and attitude of primary healthcare physicians toward CRC screening in the Qassim region, Saudi Arabia. Participants and Methods: A multicentric prospective, observational study was conducted among 284 primary healthcare physicians in the Qassim region. All participants completed a questionnaire that evaluated their knowledge level related to CRC. The questionnaire also included questions related to demographic data, CRC screening knowledge, and the attitude of the participants. Results: This study included 284 physicians. Their age ranged from 24 to 63 years. The majority were females (55.3%) and non-Saudi (79.2%), only 15.5% knew about the annual screening of fecal occult blood testing, and 33.8% knew about the performance of colonoscopy every 10 years, and 50.7% knew about the performance of flexible sigmoidoscopy every 5 years. The mean score of the knowledge assessment was 4.57 ± 2.23. The overall mean attitude score was found to be 5.69 ± 1.48. Physicians with Board or Ph.D. showed higher levels of positive attitude and knowledge. Conclusion: A low level of knowledge but a fair level of attitude could be noted among the study participants. We found that multiple factors, including nationality, gender, years of experience, and job title, influence the knowledge and attitude levels.

Knowledge, Attitude and Practice of Physicians Regarding Screening of Colorectal Cancer in Qatar: A Cross-Sectional Survey.

PurposeThe aim of this study was to evaluate the rate of internal medicine residents’ and faculties’ (specialists and consultants) compliance to colorectal cancer screening in Hamad Medical Corporation (Doha, Qatar) and to identify barriers as well as facilitators that will assist in drawing up changes that would enhance physician-related cancer screening.MethodsA cross-sectional web-based survey was distributed among internal medicine physicians at three component hospitals of Hamad Medical Corporation (HMC); focusing on knowledge and practice of colorectal cancer screening, its barriers and facilitators. Chi-square and t-test statistics were used to draw conclusions where appropriate.ResultsThe response rate for the survey was 91% and over 75% of the survey respondents were post-graduate trainees. The majority (90.6%) of the physicians (n=144) mentioned that they would recommend colorectal cancer screening for their asymptomatic patients, though trainees tend to choose the correct modality of screening compared to the consultants, 86.21% vs 40.74%. Only 43.4% of the survey participants always to usually recommend screening to their patients in their clinics while only 29.4% do so for their inpatients. Even though there was no statistically significant difference among the frequency of outpatient colorectal cancer screening among trainees, specialists or consultants (p=0.628), there was a clear increase in the reported referrals as the training years or the years of experience increases (p=0.049 for trainees and p=0.009 for faculty). Unclear pathway was reported as the main obstacle to outpatient cancer screening by 30.2% (n= 48) and 54% (n=87) pointed out that an easy and clear pathway for cancer screening would facilitate the same.ConclusionWhile the attitude towards colorectal cancer screening is positive, the actual practice of recommendation is sub-optimal. Further initiatives are required to facilitate awareness and compliance to colorectal cancer screening.

Attitudes toward and Knowledge of Colorectal Cancer Screening among an Omani Adult Population Attending a Teaching Hospital.

Objective:Colorectal cancer (CRC) is the third most commonly diagnosed cancer in Oman after breast and thyroid. Awareness regarding the availability of CRC screening services could play a major role in promoting early detection and reducing mortality rates. The aim of this study was to identify public knowledge and attitudes toward CRC screening. Methods:This cross-sectional study was conducted among 410 members of the public attending the Sultan Qaboos University Hospital in Muscat, Oman. A questionnaire was developed to assess the participants’ general knowledge, barriers and factors affecting attitudes, beliefs and behaviors regarding CRC screening. Results:A total of 410 members of the public participated from 500 invited (response rate: 82.0%). Most of the participants had not heard of CRC screening (76.3%) and were unaware of different screening methods (92.9%). The majority (93.9%) had not undergone CRC screening in Oman; however, 70.6% reported that they would be willing to do so in the future, particularly if recommended by doctors (52.7%). Barriers to screening included feeling embarrassed by the idea of a colonoscopy (73.9%), not having any symptoms of CRC (65.1%) and a fear of being diagnosed with CRC (55.6%). A bivariate analysis indicated that males demonstrated significantly more awareness of CRC screening compared to females (64.9% versus 35.1%; p = 0.004) and younger participants (<40 years of age) were significantly more aware of CRC screening compared to their older counterparts (75.3% versus 24.7%; p = 0.025). Conclusions:The majority of public in Oman showed low knowledge and awareness of CRC screening and identified several emotional barriers that might result in poor participation should screening be considered. Public education and the involvement of healthcare professionals is paramount to the implementation of a large-scale CRC screening program in Oman. In addition, addressing the sources of emotional barriers to screening is necessary.

Assessing Knowledge and Perceptions of Colorectal Cancer Screening in Armenia

BackgroundArmenia has a high incidence of and mortality from colorectal cancer (CRC). No organized screening programs for CRC exist in Armenia. This study seeks to evaluate knowledge of and attitudes toward CRC and screening programs in Armenia. MethodsAdults aged 40-64 y were administered a survey using convenience sampling throughout polyclinics in Yerevan city. Survey questions were based on the Health Belief Model and were translated and modified for local relevance. ResultsA total of 368 surveys were completed. Eighty-four percent had knowledge of CRC, 91% believed that early detection leads to improved outcomes, but only 22% had knowledge of screening. Women were more likely to have knowledge of CRC (odds ratio 2.19, P < 0.05). Although 19% have personally worried about having CRC, only 7% admitted to discussing their worries with a provider and 76% were willing to undergo screening if recommended by their doctor. Seventy-eight percent of respondents would only undergo screening if free or less than ~$20 USD. ConclusionsSelf-reported knowledge of CRC is high, whereas knowledge of screening remains low in Armenia. There is a willingness to undergo screening if recommended by a health care professional; however, this willingness is cost-sensitive. Interventions aimed at (1) increasing awareness of the disease and screening tests, (2) improving physician counseling, and (3) reducing financial barriers to screening should be considered along with the implementation of a national screening program in Armenia.

Engagement of General Practice in an Australian Organised Bowel Cancer Screening Program: A Cross-Sectional Survey of Knowledge and Practice.

Background:Understanding factors causing variation in family physicians/general practitioners (GPs) screening knowledge, understanding and support of organised population-based colorectal cancer (CRC) programs can direct interventions that maximise the influence of a CRC screening recommendation from a GP. This study aims to assess contextual factors that influence knowledge and quality improvement (QI) practice directed to CRC screening in Australian general practice. Methods:A convenience sample of anonymous general practice staff from all Australian states and territories completed a web-based survey. Multivariate analyses assessed the association between CRC screening knowledge and QI-CRC practice scores and patient, organisational and environmental-level contextual factors. Results:Of 1,013 survey starts, 918 respondents (90.6%) completed the survey. Respondents less likely to recommend FOBT screening had lower knowledge and QI practice scores directed to CRC screening. Controlling for individual and practice characteristics, respondents’ rating of the Australian National Bowel Cancer Screening Program (NBCSP) support for preventive care, attending external education, and sufficient practice resources to implement QI practice (generally) were the strongest factors associated with QI practice directed towards CRC screening. Knowledge scores were less amenable to the influence of contextual factors explored. Conclusion:More active engagement of family medicine/general practice to improve screening promotion could be achieved through better QI resourcing without changing the fundamental design of population-based CRC screening programs.

Abstract A015: Integrating research and outreach to increase CRC screening knowledge in underserved communities: The Geographic Management of Cancer Health Disparities Program and National Outreach Network Screen to Save partnership

Abstract Introduction: The Geographic Management of Cancer Health Disparities Program (GMaP) is a national NCI program with the goal of increasing cancer health disparities (CHD) research. GMaP Region 1 North (R1N) is one of seven GMaP Regional “hubs” based at NCI-designated cancer centers (CCs) across the country, covering the states of DE, KY, ME, MD, NH, VA, VT, WV, and the District of Columbia. The National Outreach Network (NON) is a national NCI program with the goal of conducting cancer education and outreach in underserved communities to reduce CHD. NON Community Health Educators (CHEs) are based at 38 NCI-designated CCs across the country. Six NCI-designated CCs with NON CHEs fall within the GMaP R1N coverage area. Methods: GMaP R1N staff and NON CHEs within the R1N coverage area met bimonthly to collaborate on the Screen to Save (S2S): NCI Colorectal Cancer (CRC) Outreach and Screening Initiative. The goal of S2S was to educate underserved communities on CRC and CRC screening. NON CHEs conducted the projects in diverse urban and rural communities within their CC catchment areas. Participants attended a CRC education event that provided an inflatable colon or a PowerPoint presentation and completed demographic and pre-/post-event surveys to gauge their knowledge of CRC screening. Surveys were submitted to NCI Center to Reduce Cancer Health Disparities program staff for review and data entry. Raw data files were returned to NON CHEs and shared with GMaP R1N staff for analysis. R1N staff provided research expertise to compare results between urban and rural S2S participants. Results: There were a total of 328 participants in S2S (n=200 urban; n=128 rural) in the GMaP R1N/NON coverage area. The median age of urban participants was 59.5 vs. 49.0 for rural participants. 95% of urban participants and 96.1% of rural participants reported having health insurance (public or private). 92.9% of urban and 88.1% of rural participants attained at least a high school diploma or GED. 76.5% of urban and 41.4% of rural participants reported ever being screened for CRC by any method. The percent increase between pre- and post-test scores for the educational intervention was 15% for urban vs. 13.3% for rural participants, with an overall percent increase in knowledge of 14.2%. Conclusions: The urban and rural participants were similar in educational and health insurance attainment levels. Urban residents reported much higher rates of previous CRC screening than rural residents, but this is likely due to the fact that more rural participants were younger than the recommended CRC initial screening age at the time (age 50). The S2S educational intervention was effective in increasing knowledge of CRC screening among both rural and urban participants, with similar increase between the two groups. Overall, this project demonstrated that two different yet complementary programs, GMaP and NON, can work together by utilizing program strengths to successfully implement an educational intervention conducted across a wide and diverse geographic area. Citation Format: Mark Cromo, Rhonda Boozer-Yeary, Melinda L. Rogers, Katelyn Schifano, Jenna Schiffelbein, Katherine L. Jones, Marcela Blinka, Julia F. Houston, Betsy Grossman, Lindsay Hauser, James Zabora, Mark B. Dignan, Tracy Onega. Integrating research and outreach to increase CRC screening knowledge in underserved communities: The Geographic Management of Cancer Health Disparities Program and National Outreach Network Screen to Save partnership [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A015.