Relationship between health literacy and colorectal cancer screening behaviors in adults aged 50 years and over in pinarhisar

This cross-sectional study was conducted to determine the relationship between health literacy (HL) levels of adults aged 50 and over and their colorectal cancer (CRC) screening behaviors in line with the national screening program. The study was carried out with 408 people residing in Pinarhisar district of Kirklareli, a province in northwestern Turkey, between August 01, 2019 and November 15, 2019 using the proportional cluster sampling method. Data were collected using the Personal Information Form and Turkish Health Literacy Scale-32 (THLS-32) through face-to-face interviews. The mean age of the participants was 59.30 ± 5.05 (Min: 50, Max: 70) years and 67.9% were women. Of them, 21.1% participated in CRC screenings, 17.2% participated in fecal occult blood tests (FOBT) screenings, 7.6% participated in colonoscopy screenings. Of them, 53.9% had inadequate HL and 32.6% had limited-problematic HL. According to the multivariate logistic regression analysis, the likelihood of not participating in CRC screening was high in the participants who worked at a job (OR: 3.001, 95% CI: 1.018-8.850), who did not do physical activity (OR: 2.516, 95% CI: 1.251-5.060), who were not aware of the presence of an early diagnosis test for CRC (OR: 32.613, 95% CI: 13.338-79.742), and who did not have a person having had CRC screening in their immediate environment (OR: 3.562, 95% CI: 1.752-7.240), and who obtained sufficient or excellent HL score from the overall THLS (OR: 3.324, 95% CI: 1.128-9.796). When the multivariate logistic regression analysis was corrected according to some characteristics, the likelihood of not participating in FOBT screenings was higher in the participants who had sufficient or excellent HL compared to the participants who had inadequate and insufficient and problematic-limited HL in THLS-treatment and service sub-dimension (OR:3.717, 95% CI: 1.141-12.111). There was no significant correlation between participation in CRC screenings, FOBT screenings, and THLS-processes (p> 0.05). To encourage people to participate in screenings and to improve their HL, education and awareness-raising attempts for target groups should be increased.