Perceived barriers to early presentation and symptom-specific time to seek medical advice for possible colorectal cancer symptoms among Palestinians

Abstract

This study explored the anticipated time to seek medical advice for possible colorectal cancer (CRC) signs/symptoms and its association with CRC symptom awareness. In addition, it examined perceived barriers that may delay seeking medical advice. Palestinian adults were recruited from hospitals, primary healthcare centers, and public spaces in 11 governorates. A modified, translated-into-Arabic version of the validated Bowel Cancer Awareness Measure was used. The questionnaire comprised three sections: sociodemographics, assessment of CRC symptom awareness and time to seek medical advice, and barriers to early presentation. A total of 4623 participants were included. The proportion that reported seeking immediate medical advice for possible CRC signs/symptoms with blood or mass ranged from 47.1% for ‘blood in stools’ to 59.5% for ‘bleeding from back passage’. Less than half of the participants reported immediate seeking of medical advice for non-specific symptoms (ranging from 5.4% for ‘loss of appetite’ to 42.0% for ‘anemia’) and other gastrointestinal symptoms (ranging from 7.7% for ‘feeling persistently full’ to 35.7% for ‘change in bowel habits’). Good CRC symptom awareness was associated with higher likelihood of seeking medical advice within a week from recognizing a CRC symptom. About 13.0% reported a delay to visit their doctor after recognizing a CRC symptom. The most reported barriers were practical with ‘would try some herbs first’ (50.9%) as the leading barrier. CRC symptoms with blood or mass prompted earlier help seeking. Participants with good CRC awareness were more likely to seek medical advice within a week.

Differences in Colorectal Cancer Awareness Between Vegetarians and Nonvegetarians: A National Cross-Sectional Study From Palestine

“…6 Consequently, convenience sampling was used to recruit participants from government hospitals, primary health care centers, and public spaces across 11 governorates in Palestine (four in the Gaza Strip and seven in the West Bank and Jerusalem) consistent with previous studies. 7 - 9 Public spaces encompassed markets, places of worship (churches and mosques), malls, parks, downtown areas, and public transportation stations.…”

“…The awareness level of each of the CRC signs/symptoms, risk factors, and causation myths was assessed using a scoring system that had also been used in previous studies. 7 - 9 For each correctly recognized item, one point was given. The total awareness score of each domain was calculated and categorized into tertiles; the first tertile was considered poor awareness, the second tertile was considered fair awareness, and third tertile was considered good awareness.…”

Screening Perspectives: The Role of Colorectal Cancer Awareness in Shaping Attitudes Toward Colonoscopy in Palestine

“…18 To increase the potential of creating a comprehensive and representative study sample, we used a convenience sampling method to recruit participants from various settings. 15 , 16 , 19 These settings included government hospitals, primary health care centers, as well as public spaces across 11 governorates in Palestine (seven in the West Bank and Jerusalem and four in the Gaza Strip). Public spaces included churches and mosques, shopping malls, local markets, parks, city centers, and public transportation stations.…”

“…This approach was used to maximize the diversity and representativeness of the study cohort. 15 , 16 , 19 …”

Understanding the interplay of colorectal cancer awareness and attitudes among Palestinians: a national cross-sectional study

“…For example, asymptomatic presentation and lack of acute intolerable pain can often hinder presentation to primary care facilities [ 10 , 11 ]. Other barriers to help-seeking for possible CRC symptoms include the willingness to use herbs, fear of disease, distrust in medical professionals, lack of social support, and poor health literacy [ 12 – 14 ].…”