Knowledge, attitude, and practices of primary health care physicians toward colorectal cancer screening

Abstract

Background/Aim:Early diagnosis of chronic illnesses and cancers mainly occurs at primary health care centers (PHCs) by primary health care physicians (PHPs). The incidence of colorectal cancer (CRC) in the Kingdom of Saudi Arabia (KSA) is rising and this has been attributed to many factors. The increasing incidence of CRC is compounded by nonadherence to screening recommendations. Therefore, evaluating PHPs knowledge, attitudes, and practices of screening for CRC is clinically important. We aimed to evaluate the knowledge, attitudes, and practices of PHPs regarding CRC screening and to identify the factors associated with nonadherence of PHPs to screening recommendations.Materials and Methods:PHPs working at three tertiary care centers and PHCs across the city of Jeddah were randomly recruited. Participants were surveyed using a comprehensive questionnaire that recorded data on demographics, qualifications, and knowledge of various modalities and guidelines related to CRC screening. Perspectives about effectiveness of, or adherence to, factors that influence physicians' perspectives or recommendations for CRC screening were also assessed. Logistic regression analysis was used to identify physician characteristics associated with PHPs perspectives and nonadherence to CRC screening.Results:A total of 127 PHPs were recruited. The average age of participants was 34 (±8.4) years, 86.6% were native Saudi's and 56.7% were females. The majority of surveys (66.9%) were completed at 24 PHCs and the remaining at hospital-based family medicine clinics. Most of the PHPs (55%) had a bachelor's degree and 31.5% were board-certified or carried a PhD in family medicine; 95% of participants believed that CRC screening in general was effective, but as much as 55% reported that they did not practice screening. The male physicians [odds ratio (OR) = 0.44, 95% confidence interval (CI) = 0.19–0.99, P = 0.048)] and PHPs with only a bachelor degree or less (OR = 0.72, 95% CI = 0.55–0.93, P = 0.011) were less likely to recommend screening for CRC.Conclusions:A considerable proportion of PHPs do not adhere to CRC screening recommendations despite a wide belief that screening is effective. Male PHPs with lower qualifications appear to be less likely to recommend screening.

Knowledge, attitude and practice towards early screening of colorectal cancer in Riyadh

“…[ 47 ] Several reasons may explain this low uptake of CRC screening, including low awareness of screening existence and personal fears,[ 31 32 ] low physician adherence to recommend CRC screening or low expectation of help. [ 48 49 ] Moreover, there is a lack of national policy. [ 23 ] Nevertheless, 75.3% of them would undergo early screening for colon cancer if their doctor advised them to do so.…”

The gap between knowledge and undergoing colorectal cancer screening using the Health Belief Model: A national survey

“…The knowledge, behavior, and beliefs of the public are expected to predict the response to a national CRC screening program. A few attempts of identifying the obstacles and challenges in establishing a CRC screening program in Saudi Arabia have been made,[38] but most of these were limited to a number of cities,[1115] while some targeted healthcare professionals[13] or undergraduate students in universities[12] which might not necessarily reflect the target population. It has been demonstrated that the targeted population's perceived severity and susceptibility to CRC and knowledge of guidelines increased the odds of screening intention,[39] thus it would be pertinent to examine acceptance of the public to undergo CRC screening and to explore potential barriers.…”

“…[10] Although there is no validated translated version into Arabic, it was converted into an Arabic version and reviewed by two bilingual epidemiologists and a gastroenterologist and used in the original Arabic study that was used in Riyadh[11] and has been reproduced in other publications. [1213]…”

Colorectal cancer: A looming threat, opportunities, and challenges for the Saudi population and its healthcare system

“…[ 2 3 ] Despite this scenario, institution of CRC screening and early diagnosis remains a formidable challenge. [ 4 5 6 ] As a consequence, up to 24% of these patients have advanced disease with distant metastasis at initial diagnosis. [ 2 ] The disconnect between the magnitude of the problem and the necessary national action plan is obvious.…”