Investigation of Iranian Family Physicians’ Knowledge Toward Colorectal Cancer Screening, Risk Factors, and Sings and Symptoms

Abstract

Background: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths with high mortality rates worldwide. Accessible screening methods have facilitated its early diagnosis. In Iran, as in many Asian countries, an important barrier to CRC screening is the insufficient knowledge of healthcare providers, including physicians, and the lack of advice from them. Available data on this subject are insufficient, and more surveys are needed in this country. Objectives: This study aimed to investigate Iranian physicians' knowledge about CRC signs and symptoms, risk factors, and screening. Additionally, the association between their knowledge and their characteristics was assessed to provide more data for further interventions. Methods: This cross-sectional study was conducted on 150 family physicians selected by convenience sampling from rural areas in Hamadan province, Iran, from June to September 2017. A self-administered, semi-structured questionnaire was used. Data were analyzed using SPSS 21, with a significance level set at P < 0.05. Results: The mean total knowledge score about CRC was 25.11 ± 4.64 (64.3%) out of 38 questions. The average scores for knowledge about CRC signs and symptoms, risk factors, and the screening program were 7.1 ± 0.81 (out of 8), 10.29 ± 1.83 (out of 13), and 7.77 ± 3.43 (out of 18), respectively. Family physicians had the highest accuracy in answering questions about CRC signs and symptoms (88.7%) and the lowest accuracy in answering questions about the screening program (43%). Since the Kolmogorov-Smirnov test rejected the normal distribution of the data, nonparametric tests were used to compare physicians' knowledge scores according to different variables. The study revealed a statistically significant reverse correlation between physicians’ knowledge of CRC and their age (r = -0.342, P < 0.001), years since graduation (r = -0.228, P = 0.005), and work experience (r = -0.247, P = 0.002). However, after multiple regression analysis, only higher age significantly predicted lower total knowledge scores (P = 0.002). No significant relationship was found between participants' knowledge scores and their gender (P = 0.929) or place of employment (P = 0.399). Conclusions: Family doctors had insufficient knowledge regarding CRC screening programs. To address this issue, health education programs should be designed to enhance their knowledge of CRC screening guidelines.