Evaluation of colorectal cancer screening behaviors of individuals aged 50-70 years applying to a primary health care institution

Objective: Colorectal cancer (CRC) is one of the most common cancers worldwide and has a high mortality rate. In our country, it is the third most common cancer in both men and women. Although the incidence of CRC is rare under the age of 40 years, it shows a significant increase especially after the age range of 40-50 years. 85% of cases are diagnosed at the age of 50 years or older. Screening programmes play a critical role in detecting colorectal cancers at an early stage and reducing the associated mortality and morbidity. In this context, in this study, we aim to investigate the colorectal cancer screening behaviours of individuals aged 50-70 years who apply to primary health care services and the factors affecting these behaviours. Material and Method: Between July 2024 and August 2024, 276 individuals aged 50-70 years who applied to Demirkapı Family Health Centre and agreed to participate in the study were asked to fill out the 'Colorectal Cancer Screening Behaviours Benefits and Barriers Perception Scale' questionnaire consisting of 31 questions. The original scale was developed by Rawl in 2001, and the Turkish validity and reliability study was conducted by Temuçin and Nahcivan in 2016. The first part of the questionnaire form, which consists of two parts, includes sociodemographic characteristics such as age, gender, marital status, as well as questions aimed at understanding CRC risk status such as whether there is a CRC patient in the family, chronic disease, exercise, and eating habits. The participants answered the demographic information and questionnaire questions during a face-to-face interview with the researcher. Results: The mean age of the individuals was 56.97±5.38 years and 54.7% of them were female. It was found that 42.4% had cancer in their first-degree relatives and 13.4% had colorectal cancer in their first-degree relatives. Those with a family history of inflammatory bowel disease were 11.2%. Those who had previously had a faecal occult blood test (DGKT) were 22.5% and those who had previously had a colonoscopy were 22.5%. To the question 'Have you been advised to have colonoscopy and FGT before?' 37.0% of the individuals answered yes. The mean score of the individuals' perception of benefit of DGKT was 9.45±1.47, the mean score of perception of obstacle of DGKT was 18.05±4.35, the mean score of perception of benefit of colonoscopy was 12.35±1.98, and the mean score of perception of obstacle of colonoscopy was 31.54±7.41. There was no statistically significant difference between the perception of benefit, perception of obstacle, perception of colonoscopy benefit, perception of colonoscopy obstacle, perception of colonoscopy obstacle scores of the individuals according to gender, income status, marital status, social security status, body mass index (BMI), smoking status and some nutritional habits; red meat, sausage, salami consumption status, adequate consumption of vegetables, fruits, cereals and legumes (p>0.05). High school graduates had a higher perception of benefit perception compared to primary school graduates. The perception of benefit of colonoscopy was higher in those who had previously been recommended colonoscopy and colonoscopy and in those who had colonoscopy. Individuals with first-degree relatives with colorectal cancer had a higher perception of benefit of colonoscopy compared to those without. According to employment status; retired individuals had the highest perceived benefit of CRC screening compared to others, followed by employed individuals, then housewives, and lastly those who were unemployed. Individuals with chronic illnesses had a lower perceived barrier to CRC screening compared to those without chronic illnesses. Those with a first-degree relative diagnosed with inflammatory bowel disease had higher perceived barriers to CRC screening and colonoscopy. A statistically significant difference was found in income levels based on whether individuals had previously undergone a Fecal Occult Blood Test (FOBT) (χ2=8.023,p=0.018). Among those who had previously had an FOBT, 46.2% reported their income was less than their expenses. Similarly, a statistically significant difference in income levels was observed based on prior colonoscopy status (χ2=6.795,p=0.033). The majority of individuals who had undergone a colonoscopy, specifically 41.9%, reported their income was equal to their expenses. No statistically significant differences were found in other demographic characteristics (p>0.05) based on prior FOBT or colonoscopy status. Conclusion: In our study, we found that the rates of colorectal cancer screening and the level of knowledge about screening are very low in individuals aged 50-70 years. In order to increase these low rates, awareness-raising activities for both healthcare professionals and patients are of great importance. Increasing screening rates can significantly reduce disease-related mortality by increasing the chance of early diagnosis and treatment.