Prevalence of and barriers to colorectal cancer screening among adults aged 45–75 years attending primary health care centers in Taif, Saudi Arabia: An analytical cross-sectional study
Bader Alnefaie, Abdullah Muidh Alqethami
A
BSTRACT
Background:
Colorectal cancer (CRC) is the most commonly diagnosed cancer among males and the third most common among females in Saudi Arabia, with rising incidence and a high proportion of late-stage presentation. Despite the proven benefits of organized screening, national uptake remains low and current programs operate on an opportunistic basis driven primarily by physician initiation in primary care.
Objective:
To estimate the prevalence of CRC screening and to identify the sociodemographic, knowledge-based, and psychological barriers to screening among adults aged 45–75 years attending primary health care (PHC) centers in Taif, Saudi Arabia.
Methods:
An analytical cross-sectional study was conducted in eight randomly selected PHC centers in Taif (out of 19 operational centers) using a cluster sampling design. Eligible attendees aged 45–75 years were recruited through consecutive sampling and interviewed face-to-face using a structured questionnaire adapted from two previously validated instruments. The questionnaire assessed sociodemographic and clinical characteristics, baseline CRC awareness, prior screening history, and general, colonoscopy-specific, and fecal occult blood test (FOBT)-specific barriers to screening. Individuals with a prior diagnosis of CRC or any pre-existing gastrointestinal disease were excluded. Data were analyzed in SPSS version 26 using descriptive statistics, the Chi-square test, and Fisher’s exact test, with statistical significance set at
Results:
Of 450 adults approached, 411 were included (mean age 57.9 ± 7.2 years; 59.9% male). Although 91.0% of participants reported having heard of CRC, only 2.7% (
Conclusions:
Despite near-universal awareness of CRC and high engagement with PHC services, screening uptake in Taif is critically low. The principal barriers are systemic (absence of physician recommendation) rather than knowledge-related. National strategies should embed automated, age-based screening prompts within electronic health records, strengthen physician training on opportunistic counseling, and promote FOBT/fecal immunochemical test as a non-invasive entry point to overcome psychological resistance to colonoscopy.