Evaluation of information, attitudes and behaviors about cancer screening tests and use of primary health care of individuals between 30-70 years

Introduction and Objective: Cancer is the second most common cause of death both in the world and in our country, and it is a disease with high morbidity and mortality. With the implementation of national cancer screening programs in our country, the role of primary health care services in cancer screening has gained great importance. The aim of our study is to evaluate the use of primary health care services of individuals between the ages of 30-70 who applied to the Family Medicine Outpatient Clinic, their knowledge and attitudes about cervical, colorectal and breast cancer available in the national cancer screening program, the behaviors of people who meet the screening criteria, and is to raise awareness. Materials and Methods: Our study included 215 people between the ages of 30-70 who applied to the Family Medicine Polyclinic of our university for any reason between June and October 2021. A questionnaire form, which was created to evaluate about sociodemographic data, use of primary health care services, the knowledge, attitudes about cancer screening tests and behaviors of people who met the screening criteria, was applied to the participants by face-to-face interview method. Data analysis was performed using a package program called SPSS (IBM SPSS Statistics 24). "Fisher-Exact" or "Pearson-χ2" crosstabs were used to evaluate the relationship between two qualitative variables. Cases with p<0.05 were considered statistically significant. Results: Of the 215 participants, 112 (52.1%) were female and 103 (47.9%) were male. The mean age of the participants was 46.61±9.25. It was determined that 85.1% of the participants were married, 61.9% were high school/university graduates, 60.5% were working and 86.0% were living in the city center. It was determined that 70.2% did not have a chronic disease, 95.8% did not have a diagnosis of cancer, and 50.7% did not have a family history of cancer. It was determined that all of the participants were registered to family medicine, 94.4% of them knew/recognized the family physician, and 70.2% of them went to the family physician regularly. The rate of knowledge of HPV DNA/smear test in women was 87.5%, breast self-examination was 91.1%, and mammography was 98.2%, in all participants, the rate of knowing the stool occult blood test was 54.4%, and colonoscopy was 84.2%. The rates of have screening tests of people whose age and gender are suitable for the screening test are 63.4% for HPV DNA/smear test, 75.9% for BSE, 47.3% for CBE, 51.2% for mammography, 29.5% for stool occult blood test, 14.1% for colonoscopy. It was seen that the rate of knowing the screening tests was higher than the rate of having them done. It was observed that those who had the HPV DNA/Smear test were predominantly in the 40-49 age group, while those who did not have the HPV DNA/Smear test were predominantly in the 30-39 age group. It was determined that those who were single did not have HPV DNA/Smear test mostly. It was observed that those in the age group of 40-49 were not predominantly have a mammography, while those in the age group of 50-70 were predominantly have a mammography. It was determined that those who graduated from high school/university, those in the white-collar profession, and those with an income level of >8000 TL predominantly had knowledge of fecal occult blood test. It was determined that those who graduated from primary school, those who were in the blue-collar occupation group and those with an income level of ≤4000 TL did not have knowledge of fecal occult blood test. It was determined that those with colonoscopy knowledge were predominantly in the white-collar occupation group and had an income of >8000 TL. Among the reasons for not having cancer screening tests or having them done irregularly, the first place was "because I did not have any complaints", and the second was "because I was not recommended to have a cancer screening test". It was observed that people who were recommended HPV DNA/smear test, mammography, stool occult blood test or colonoscopy had the recommended tests mostly done (p>0.05). Conclusion: In our study, we saw that the awareness of cancer screening programs and the rate of having cancer screening tests in the participants were not yet at the desired levels. Physicians working in primary care have important duties in educating the public about cancer screenings, raising awareness, and conducting cancer secreening tests or directing to having them. Keywords: Cancer screenings, Family Medicine, National Cancer Screening Program