The effect of health literacy level on behaviors of participation in colorectal cancer screening

Objective: The aim of the present study is to investigate the effect of the health literacy level of the population between the ages of 40 and 70 living in Adana on participation behavior in colorectal cancer screening. Materials and Methods: The present study is type of cross-sectional. The population of the study was accepted as 727,647 people living in Adana between the ages of 40-70 according to TUIK 2019 and the sample size was calculated as 323. After obtaining the necessary permissions, between 01.08.2020 and 31.10.2020, the survey that consists of 4 parts, 116 questions was applied to the participants by using the face-to-face interview method. Health literacy levels of participants with Turkey Health Literacy Scale-32 (Tsoy-32) were assessed. Frequency analysis, chi-square test, student-t test, simple linear and logistic regression analysis were used in the analysis with the help of SPSS 20.0 package program. A p-value of <0.05 was accepted as significant. Results: The mean age of 323 participants in the present study is 51.73 ± 7.51. Participants of 53.3% (n = 172) are female, of 85.1% are married (n = 275), of 61.6% (n = 199) had high school or higher education. The participation rate in colorectal cancer screening for participants aged 50-70 is 16.6%. Participants of 77.1% had insufficient health literacy levels. According to the logistic regression analysis the presence of a recommendation of a physician for Fecal Occult Blood Testing (FOBT) (OR = 17.8 p <0.001) increases adherence to screening with FOBT. The presence of a recommendation physician for colonoscopy (OR = 60.6 p <0.001) and female gender (OR = 6.0 p = 0.009) significantly increase adherence to screening with colonoscopy. Although the level of health literacy positively increases the perception of screening, it does not lead to a significant increase in the behavior of having FOBT and colonoscopy. Conclusion: In the present study, it was seen that the current state of participation in colorectal cancer screening is not at the desired level and the effect of physician's recommendation on screening behavior is important. In order to increase the effectiveness of the colorectal cancer screening program, it is recommended to raise the awareness of both those risked groups and health professionals by doing studies in this field.