Awareness of Colorectal Cancer and Attitudes Towards Its Screening Guidelines in Lebanon

Mohamad Ali Tfaily; Dana Naamani; Alaa Kassir; Sara Sleiman; Mamadou Ouattara; Munir Paul Moacdieh; Miran A. Jaffa

doi:10.5334/aogh.2437

Figures & Tables

Table 1

Demographics of study participants.

Characteristic	No.	%
Age groups
25 to 40	145	39
40 to 50	86	23.1
Above 50	134	36
Sex
Male	161	43.3
Female	181	48.7
Education
University degree level	206	56.6
Below university degree level	158	43.4
Job related to health care
No	301	83.6
Yes	59	16.4
Currently employed
No	123	33.1
Yes	244	65.6
Monthly Income
Below middle income ($2000 or less)	164	48.8
Above middle income (more than $2000)	71	21.1
Prefer not to say	101	30.1
Insurance
No	79	21.5
Yes	288	78.5
Regular physician check-ups
No	181	49.5
Yes	183	50.0
I don’t know	2	0.5
Family or close friends had CRC history
No	246	66.1
Yes	105	28.2
I don’t know	16	4.3

Table 2

Awareness of the risk factors of CRC as per the awareness module of the CAM questionnaire.

Risk Factors	No.	%
Age
20-year-old	4	1.1
40-year-old	55	15.1
60-year-old (correct answer)	115	31.6
Unrelated to age	186	51.1
I don’t know	4	1.1
Drinking alcohol
Yes	191	52.8
No	73	20.2
I don’t know	98	27.1
Not eating fruits and vegetables
Yes	157	42.7
No	130	35.3
I don’t know	81	22.0
Eating red meat
Yes	237	64.4
No	67	18.2
I don’t know	64	17.4
Low fiber diet
Yes	208	56.7
No	72	19.6
I don’t know	87	23.7
Having a family member with CRC
Yes	195	53.6
No	103	28.3
I don’t know	66	18.1
Being 70 years old
Yes	155	42.5
No	101	27.7
I don’t know	109	29.9
Absence of physical activity
Yes	131	36.5
No	139	38.7
I don’t know	89	24.8
Presence of bowel disease
Yes	221	62.1
No	49	13.8
I don’t know	86	24.2
Having diabetes
Yes	94	26.0
No	150	41.6
I don’t know	117	32.4
Smoking
Yes	217	60.8
No	75	21.0
I don’t know	65	18.2
Obesity
Yes	213	58.0
No	66	18.0
I don’t know	88	24.0

Table 3

Awareness of warning signs of CRC as per the CAM questionnaire.

Risk Factors	No	%
Anal bleed
Yes	249	68.2
No	36	9.8
I don’t know	80	22
Pain in abdomen
Yes	225	61.6
No	68	18.6
I don’t know	72	19.7
Change in bowel habits
Yes	205	56.3
No	74	20.3
I don’t know	85	23.3
Bowel not emptying
Yes	151	42.1
No	94	26.2
I don’t know	114	31.7
Blood in your stools
Yes	237	65.3
No	54	14.9
I don’t know	72	19.8
Pain in your back passage
Yes	167	46
No	83	22.9
I don’t know	113	31.1
Lump in anus
Yes	212	58.6
No	58	16
I don’t know	92	25.4
Anemia/fatigue
Yes	143	39.3
No	104	28.6
I don’t know	117	32.1
Unexplained weight loss
Yes	216	59.2
No	54	14.8
I don’t know	95	26

Table 4

Multiple logistic regression showing adjusted associations between below factors and awareness of necessity of CRC screening.

	95% Confidence Interval for Odds Ratio
Factors	Odds Ratio	Lower Limit	Upper Limit	P-value
Sex (Reference male)	1.607	0.934	2.765	0.087
Family or close friends had CRC history	1.454	0.938	2.253	0.095
Risk Factors Awareness	2.221	1.023	4.820	0.044
Warning Signs Awareness	1.196	0.670	2.134	0.545
Age above 50 years	2.376	1.362	4.147	0.002
Level of Education	0.777	0.454	1.332	0.359
Smoking Status	0.897	0.542	1.485	0.673
Regular Physician Check-Ups	3.167	1.884	5.323	0.000
Employment Status	1.640	0.885	3.041	0.116
Job related to healthcare	1.022	0.492	2.123	0.953
Method of awareness about cancer (family doctor)	2.384	1.209	4.700	0.012
Method of awareness about cancer (TV)	0.613	0.355	1.059	0.079

Table 5

Multiple logistic regression showing adjusted associations between below factors and undergoing past CRC screening.

	95% Confidence Interval for Odds Ratio
Factors	Odds Ratio	Lower Limit	Upper Limit	P-value
Lived in a different country	1.147	0.467	2.818	0.765
Sex (Reference male)	0.570	0.229	1.416	0.226
Marital Status	0.727	0.232	2.276	0.584
Job Related to Healthcare	1.097	0.341	3.536	0.876
Insurance or NSSF	2.586	0.765	8.742	0.126
Family or Close Friends Having CRC	3.364	1.452	7.795	0.005
Warning Sign Awareness	2.565	1.050	6.266	0.039
Risk Factor Awareness	0.556	0.203	1.523	0.254
Age above 50 years	4.223	1.708	10.442	0.002
Employment Status	0.403	0.152	1.070	0.068
Level of Education	0.651	0.263	1.611	0.353
Smoking Status	0.880	0.376	2.062	0.769
Regular Physician Check-Ups	2.059	0.762	5.563	0.155

Previously screened participants’ reasons for choosing a) FOBT over Colonoscopy and b) Colonoscopy over FOBT.

Table 6

Multiple logistic regression showing adjusted associations between below factors and willingness to undergo CRC screening in the future among those who have never been previously screened.

	95% Confidence Interval for Odds Ratio
Factors	Odds Ratio	Lower Limit	Upper Limit	P-value
Sex (Reference male)	0.960	0.548	1.682	0.886
Marital Status	1.329	0.693	2.548	0.393
Job related to healthcare	0.874	0.412	1.855	0.726
Insurance or NSSF	0.601	0.307	1.175	0.136
Regular Physician Check-Ups	2.477	1.430	4.291	0.001
Employment status	1.124	0.588	2.147	0.724
Level of Education	1.256	0.694	2.273	0.451
Smoking Status	0.827	0.482	1.419	0.490
Risk Factor Awareness	2.641	1.217	5.732	0.014
Warning Sign Awareness	0.889	0.472	1.676	0.717
Age above 50 years	0.891	0.484	1.639	0.710
Knowing family/friends with CRC	1.364	0.748	2.488	0.311
Lived in a different country	0.972	0.531	1.780	0.927

Reasons for choosing a) FOBT b) Colonoscopy among previously unscreened participants who are willing to undergo screening in the future.

Reasons for not choosing Colonoscopy among previously unscreened participants who are willing to undergo screening in the future.

Awareness of Colorectal Cancer and Attitudes Towards Its Screening Guidelines in Lebanon

Figures & Tables

Table 1

Table 2

Table 3

Table 4

Table 5

Figure 1

Table 6

Figure 2

Figure 3

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