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

Abstract

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 Suitability of a Colorectal Cancer Screening Program in Oman

“…Although patients' awareness of CRC in Oman was low, they were willing to undergo a screening test if advised by their doctor [20]. In the same study, the authors identified emotional and cultural barriers that older Omani men and women faced regarding CRC screening and advised further efforts to tackle these issues.…”

“…As with other cancers like breast or cervical cancers, the WHO recommends implementing CRC screening programs, and early detection effectively reduces the cancer burden on a country [19]. Previous studies advocate for Oman to adopt a CRC screening program [5,20,21].…”

Factors promoting breast, cervical and colorectal cancer screenings participation: A systematic review

“…39,46,47,54,[56][57][58][59][60][61][62][63][64][65][66][67] Furthermore, for colorectal cancer screening only, also disgust and worries about completing the faecal occult blood test (FOBt) incorrectly are additional barriers that should be carefully addressed. 68 Still considering the factor under the label "fears", some studies highlight those fears related to the screening in itself, namely fears related to the unknown procedure, 62,64 previous negative experiences, 66 test pain, 57,61 perceived mistrust in providers' confidentiality 63 and in the safety of the screening procedure. 67 However, nearly all the studies emphasize those "fears for the results", since many people consider cancer as a "deadly" diagnosis.…”

“…67 However, nearly all the studies emphasize those "fears for the results", since many people consider cancer as a "deadly" diagnosis. 39,47,57,[61][62][63][64][65][66][67] In particular, when asked to think/recall about barriers to screening, some people often report future fears related to cancer diagnosis (e.g., fear of suffering, changes in appearance, and death). 69 Furthermore, research suggests that unwillingness to screen is also linked to fears about the impact of a potential cancer diagnosis on relationships, that is, losing friends/job, being stigmatized and isolated by the society and even by own family.…”

“…The majority of research highlights the role of high knowledge/ awareness about cancer etiology, and screening recommendation/ procedure/types in effectively promoting cancer screening attendance, mainly among first-time attenders. 30,33,39,43,47,57,66,74,82,[88][89][90][91][92] This is particularly true considering the great number of misunderstandings (e.g., the person lose part of uterus during biopsy) and false myths (e.g., application of social norms which foster the overestimation of personal ability to prevent cancer by lifestyle choices such as monogamy for cervical cancer and breastfeeding for breast cancer). 21,61,63,75…”