The determination of colorectal cancer (CRC) risk levels, crc screening rates and factors affecting the participation to screening of individuals working in the agriculture

The purpose of this study was to determine colorectal cancer (CRC) risk levels, status of participation in CRC screenings, and the factors affecting the participation to screenings among individuals aged between 50 and 70 working in agriculture. Data of this cross-sectional and analytic study were collected between July and October 2014 in Altınova region located within boundaries of Kepez district in Antalya province. The sample size was calculated based on formula used in case that "number of persons in the population is unknown" and the study was completed with data of 244 agricultural workers (96%). A questionnaire involving questions related to socio-demographic characteristics, risk level, knowledge level, health beliefs, symptoms, and CRC-related awareness status of individuals was filled out by using face-to-face interview method. While dependent variable of the study was status of participation in CRC screenings, its independent variables were socio-demographic characteristics, CRC risk level, knowledge level, health beliefs related to CRC screenings, presence of symptom, and awareness status. It was found that CRC risk level of 89.4% of individuals working in agriculture in the region of Altınova was above average and very above average. Rate of participation in CRC screenings was 7%. While knowledge level and susceptibility perception score of individuals was above the mean (7.66±1.37 and 3.93±0.42, respectively), their confidence-benefit-health motivation perception score was below the mean (2.46±0.51). Rate of participation in CRC screenings among those with high risk level was low. Knowledge level and health beliefs of individuals were not effective upon their participation in CRC screenings (p>0.05). As a result of logistic regression analysis; while status of having a friend or neighbor with CRC and knowing to which doctor to consult increased the participation in CRC screenings 10 times, having stomach-ache increased the participation in CRC screenings 4 times (p<0.05). Within the scope of the study, the immunochemical fecal occult blood test (iFOBT) was performed on 217 individuals (89%) and rate of participation in CRC screenings increased from 7% to 89%. As a result of first iFOBT test, result of 9% of individuals was found to be positive. One of individuals with positive iFOBT result was diagnosed with tubular adenoma after colonoscopy. Considering that rate of participation in CRC screenings is low, population-based screenings should be performed principally on individuals with high risk level. It is concluded that physicians and nurses working in Family Health Center, Community Health Center, and Cancer Early Diagnosis, Screening and Training Centers should give an advice to increase the participation in CRC screenings and should inform individuals about application institutions as well as screenings being accessible will contribute to increase the screenings.