Knowledge, Attitudes, and Practices on Colorectal Cancer Screening in Jordan

Background

Screening campaigns can significantly improve the survival rate of patients with colorectal cancer (CRC), the second most prevalent cancer in Jordan. This study aims to evaluate the knowledge, attitudes and practices (KAP) of the Jordanian population and Syrian refugees regarding CRC and CRC screening.

Methods

Cross-sectional KAP survey including 897 individuals aged 50 years or older living in Jordan. Data were collected using a face-to-face questionnaire on sociodemographic characteristics and CRC-related KAP and health-seeking behaviours (HSB). Composite indices were constructed for knowledge (0-32 points), attitudes (0-6) and practices (0-14). Poisson regression models with robust variance were used to calculate adjusted prevalence ratios (aPR) for KAP indices, adjusting for socio-demographic, clinical and health factors.

Results

Knowledge of CRC was low: median (me) knowledge index (interquartile range, IQR): 6 (4) among Jordanians and 7(4) among Syrian refugees. Both groups showed positive attitudes: me(IQR) attitudes index: 5(1), and 62% of refugees and 57% of Jordanian participants had a positive attitude (p < 0.05). The me(IQR) practice index was 8 (2) in both groups, and healthy habits were reported by 72% of Jordanian participants and 75% of refugees. A better CRC knowledge was associated with urban residence (aPR=1.08; 1.02-1.14) and positive attitudes towards CRC screening (aPR=1.12; 1.06-1.19). Positive attitudes were associated with better healthy habits (aPR=1.08; 1.03-1.13) and HSB (aPR=1.12; 1.06–1.19); as well as older age. Healthy practices were associated with living in rural areas and being self-employed. HSB were more frequent in women (aPR=1.14; 1.04–1.25), and in those with positive attitudes (aPR= 1.10; 1.04 – 1.16).

Conclusions

Our findings suggest that improving the population’s knowledge about CRC, while addressing cultural and structural barriers, could help increase screening uptake in Jordan.

Key messages

• Taking the population’s needs into account can improve awareness and positive attitudes towards CRC screening

• KAP surveys can inform and guide culturally adapted and equitable public health interventions, particularly for vulnerable populations such as refugees