Factors Associated with Knowledge, Attitudes, and Practice towards Colorectal Cancer and Its Screening among People Aged 50-75 Years

Int J Environ Res Public Health. 2021 Apr 13;18(8):4100. doi: 10.3390/ijerph18084100.

Abstract

Background: Colorectal cancer (CRC) screening is effective for early detection of CRC, particularly for males aged 50 or above. However, the rate of participation in the screening program is still low. This study was to examine knowledge, attitudes, and practice toward CRC and its screening and explored their associated factors.

Methods: A descriptive cross-sectional study was conducted in a convenience sample of adults aged 50-75 years without cognitive problems, who were recruited at multi-elderly centers in Hong Kong. A questionnaire was used to measure knowledge, attitudes, and practice (KAP) towards CRC and its screening.

Results: The total of 300 Chinese people included 147 (49.0%) males with a mean age of 58.72 (SD 6.91) years old. This study population had good knowledge and practice, as well as very good attitudes toward CRC and its screening. The multivariate regression results showed that receiving insurance coverage was the most significant factor positively associated with knowledge, attitudes, and practice. Other than this, lower educational level had significant negative association with knowledge and practice. Having self-sufficient financial support and receiving screening program information had positive associations with knowledge.

Conclusion: People who are receiving insurance coverage have better KAP towards CRC and its screening. This indicates that they can receive adequate information about the screening procedure from their insurance agents and receive financial support under their insurance coverage. Therefore, they are more willing to participate in the screening program. Other factors, including having good self-sufficient financial support and receiving adequate information about CRC and its screening, significantly enhance knowledge. Based on the relationships among KAP, knowledge enhancement can improve attitude and practice in participating in the CRC screening program. Those who attained lower education should receive more attention. In this sense, adequate financial support from health insurance or subsidies from the government can increase an individual's willingness to participate in the CRC screening, particularly those at a low socioeconomic level. Educational programs should be promoted to enhance knowledge about CRC and its screening, especially to those who attained lower education levels.

Keywords: attitudes; colorectal cancer screening; factors; knowledge; practice.

MeSH terms

  • Adult
  • Aged
  • Colorectal Neoplasms* / diagnosis
  • Cross-Sectional Studies
  • Early Detection of Cancer
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Hong Kong / epidemiology
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Surveys and Questionnaires