Awareness of Stomach and Colorectal Cancer Risk Factors, Symptoms and Time Taken to Seek Medical Help Among Public Attending Primary Care Setting in Muscat Governorate, Oman

Abstract

Colorectal and stomach cancers are the top ranking cancers in Oman. Most of the patients are diagnosed at advanced disease stages. The aim of this study is to explore the knowledge of risk factors, symptoms and the time needed to seek medical care for stomach cancer and colorectal cancer (CRC) among Omani participants attending 28 local health centres (LHCs) in the governorate of Muscat, the capital city of Oman. The Bowel Cancer/CRC Awareness Measure (CAM) questionnaire (translated into Arabic) was used to collect data from Omani adult participants (aged 18 years and above) who attended the LHCs during the study period. There was a total of 405 participants in the study out of the 500 who were invited (response rate = 81%). The most recognised risk factors were excessive drinking of alcohol (73.1%) and smoking (70.6%); the least recognised were doing less exercise (37.3%), eating food which was high in salt (26.8%) and a diagnosis of diabetes mellitus (24.9%). Multinomial logistic regression showed that young participants recognised more risk factors than older participants; highly educated participants recognised more risk factors than the less-educated and married participants recognised more risk factors than single participants. Participants with a high level of education were more likely to identify signs and symptoms of stomach cancer and CRC than less-educated participants. Multinomial logistic regression showed women were more likely than men to report barriers to seeking medical help (fear, difficulty in arranging transport, worried what the doctor might find). Also, participants with less education were more likely to report barriers than the highly educated (worried about wasting the doctor's time, difficulty in arranging transport, did not feel confident talking about symptoms, embarrassed, scared, worried what doctor might find). The majority of participants (93.6%) were not aware of any CRC screening programme or had undergone any screening (98.3) for CRC. Only 52.6% of participants would have a colonoscopy if the doctors advised; the main reasons for refusal were embarrassment (40.0%), lack of trust in the doctors (33.3%) and religious or culture beliefs (21.3%). Around 39% of participants would prefer to have their colonoscopy examination abroad. There is an urgent need to increase the public's awareness of stomach cancer and CRC in Oman, particularly with evidence emerging of an increase in the incidence. School curriculums could include sessions on cancer education and the information be reiterated to students periodically. A strategy to establish a CRC screening programme in Oman might be paramount as the incidence of CRC increased.

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

“…While the majority of participants in the present study were willing to participate in CRC screening if recommended by doctors, they were nevertheless unaware of either the importance or availability of CRC screening measures in Oman. A previous study conducted in Oman similarly found that more than half of the participants would have a colonoscopy if doctors advised them to do so (Al-Azri et al, 2019). Furthermore, the majority of participants in the present study were of the belief that only doctors had the authority to request CRC screening measures.…”

“…However, a previous study conducted in Oman found that the majority of members of the public were not aware of CRC symptoms (Al-Azri et al, 2019). Alarmingly, they also reported several emotional barriers to seeking early medical help, including being worried about what the doctor might find or for wasting the doctor's time, feeling too scared or embarrassed to seek help and not feeling confident when talking about their symptoms (Al-Azri et al, 2019). Attitudes toward CRC screening are a reliable predictor of help-seeking behaviors (Rogers et al, 2018).…”

“…Thus, improving public awareness of CRC-related signs and symptoms, particularly among high-risk populations, is important (Center et al, 2009). However, a previous study conducted in Oman found that the majority of members of the public were not aware of CRC symptoms (Al-Azri et al, 2019). Alarmingly, they also reported several emotional barriers to seeking early medical help, including being worried about what the doctor might find or for wasting the doctor's time, feeling too scared or embarrassed to seek help and not feeling confident when talking about their symptoms (Al-Azri et al, 2019).…”

Knowledge of Cancer Risk Factors, Symptoms, and Barriers to Seeking Medical Help among Omani Adolescents

“…Furthermore, there are currently no screening programs available for cancer, except for breast cancer, as a program was introduced in 2010 (Ministry of Health, 2010). Previous studies among the adult Omani population have shown that the majority of the public were not aware of the risk factors and symptoms for most types of cancer (Al-Azri et al, 2017;Al-Azri et al, 2016;Al-Azri et al, 2014). There are also several notable social and cultural barriers contributing to the delays in cancer diagnosis, particularly among vulnerable groups (Al-Azri et al, 2016).…”

Retracted: CBP‐triggered KDM2B acetylation accelerates the carcinogenesis of colon cancer

“…Colon cancer is a usually malignant tumor of the digestive tract, which occurs in the colon, most commonly at the junction of the rectum and sigmoid colon (Yang et al, ). Aging of population, heredity, lifestyle, and environmental changes are the primary reasons for the high incidence of colon cancer (Al‐Azri et al, ; Fumery et al, ). The curative operation has dramatically increased the 5‐year survival rate of patients with colon cancer, whereas this cancer is a malignant tumor with highly specific, the clinical features, texture, immunophenotype, therapeutic effect, and biological course exist significant difference (Ha, Kim, Choi, & Kim, ; Tang et al, ).…”