Skip to main content

Advertisement

SpringerLink
Log in

Awareness of Stomach and Colorectal Cancer Risk Factors, Symptoms and Time Taken to Seek Medical Help Among Public Attending Primary Care Setting in Muscat Governorate, Oman

  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

Abstract

Colorectal and stomach cancers are the top ranking cancers in Oman. Most of the patients are diagnosed at advanced disease stages. The aim of this study is to explore the knowledge of risk factors, symptoms and the time needed to seek medical care for stomach cancer and colorectal cancer (CRC) among Omani participants attending 28 local health centres (LHCs) in the governorate of Muscat, the capital city of Oman. The Bowel Cancer/CRC Awareness Measure (CAM) questionnaire (translated into Arabic) was used to collect data from Omani adult participants (aged 18 years and above) who attended the LHCs during the study period. There was a total of 405 participants in the study out of the 500 who were invited (response rate = 81%). The most recognised risk factors were excessive drinking of alcohol (73.1%) and smoking (70.6%); the least recognised were doing less exercise (37.3%), eating food which was high in salt (26.8%) and a diagnosis of diabetes mellitus (24.9%). Multinomial logistic regression showed that young participants recognised more risk factors than older participants; highly educated participants recognised more risk factors than the less-educated and married participants recognised more risk factors than single participants. Participants with a high level of education were more likely to identify signs and symptoms of stomach cancer and CRC than less-educated participants. Multinomial logistic regression showed women were more likely than men to report barriers to seeking medical help (fear, difficulty in arranging transport, worried what the doctor might find). Also, participants with less education were more likely to report barriers than the highly educated (worried about wasting the doctor’s time, difficulty in arranging transport, did not feel confident talking about symptoms, embarrassed, scared, worried what doctor might find). The majority of participants (93.6%) were not aware of any CRC screening programme or had undergone any screening (98.3) for CRC. Only 52.6% of participants would have a colonoscopy if the doctors advised; the main reasons for refusal were embarrassment (40.0%), lack of trust in the doctors (33.3%) and religious or culture beliefs (21.3%). Around 39% of participants would prefer to have their colonoscopy examination abroad. There is an urgent need to increase the public’s awareness of stomach cancer and CRC in Oman, particularly with evidence emerging of an increase in the incidence. School curriculums could include sessions on cancer education and the information be reiterated to students periodically. A strategy to establish a CRC screening programme in Oman might be paramount as the incidence of CRC increased.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. World Health Organization. Cancer—fact sheet. 2015. http://www.who.int/mediacentre/factsheets/fs297/en/. Updated February 2017 (Accessed 30.5.2017)

  2. Center MM, Jemal A, Ward E (2009) International trends in colorectal cancer incidence rates. Cancer Epidemiol Biomark Prev 18(6):1688

    Article  Google Scholar 

  3. Marley AR, Nan H (2016) Epidemiology of colorectal cancer. Int J Mol Epidemiol Genet 7(3):105–114

    PubMed  PubMed Central  Google Scholar 

  4. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA A Cancer Journal for Clinicians 61(2):69–90

    Article  PubMed  Google Scholar 

  5. Niksic M, Rachet B, Duffy SW, Quaresma M, Moller H, Forbes LJ (2016) Is cancer survival associated with cancer symptom awareness and barriers to seeking medical help in England? An ecological study. Br J Cancer 115(7):876–886

    Article  PubMed  PubMed Central  Google Scholar 

  6. Al-Azri M, Al-Maskari A, Al-Matroushi S, Al-Awisi H, Davidson R, Panchatcharam SM et al (2016) Awareness of cancer symptoms and barriers to seeking medical help among adult people attending primary care settings in Oman. Health Services Research and Managerial Epidemiology 3:1–10

    Article  Google Scholar 

  7. Oberoi DV, Jiwa M, McManus A, Hodder R (2015) Men’s help-seeking behavior with regards to lower bowel symptoms. Am J Health Behav 39(2):212–221

    Article  PubMed  Google Scholar 

  8. Pedersen AF, Hansen RP, Vedsted P (2013) Patient delay in colorectal cancer patients: associations with rectal bleeding and thoughts about cancer. PLoS One 8(7):e69700

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Weller D (2006) Colorectal cancer in primary care: even with national screening, primary care can do more to cut mortality. BMJ 333(7558):54–55

    Article  PubMed  PubMed Central  Google Scholar 

  10. Esteva M, Leiva A, Ramos MÕ, Pita-Fern_Éndez S, Gonz_Élez-Luj_Én L, Casamitjana M et al (2013). Factors related with symptom duration until diagnosis and treatment of symptomatic colorectal cancer. BMC Cancer 13(1):1–13

  11. Adelstein BA, Macaskill P, Turner RM, Irwig L (2012) Patients who take their symptoms less seriously are more likely to have colorectal cancer. BMC Gastroenterol 12(1):1–9

    Article  Google Scholar 

  12. MacDonald S, Macleod U, Campbell NC, Weller D, Mitchell E (2006) Systematic review of factors influencing patient and practitioner delay in diagnosis of upper gastrointestinal cancer. Br J Cancer 94(9):1272–1280

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Simon AE, Waller J, Robb K, Wardle J (2010) Patient delay in presentation of possible cancer symptoms: the contribution of knowledge and attitudes in a population sample from the United Kingdom. Cancer Epidemiol Biomark Prev 19(9):2272–2277

    Article  Google Scholar 

  14. Przybyla AG, Crockett JA, Rex JC, Culumovic PJ (2014) Current screening guidelines overlook a significant number of patients treated for colorectal cancer. Am Surg 80(6):539–543

    PubMed  Google Scholar 

  15. Ministry of National Economy (2010). Oman census summary http://www.data.gov.om/ (Accessed 30.5.2017)

  16. Al-Lawati JA, Mabry R, Mohammed AJ (2008) Addressing the threat of chronic diseases in Oman. Prev Chronic Dis 5(3):A99

    PubMed  PubMed Central  Google Scholar 

  17. Ministry of Health (2013). Cancer incidence in Oman. Department of Non-Communicable Disease. Directorate General of Primary Health care. Ministry of Health, Sultanat of Oman

  18. Al-Madouj, Eldali A, Al-Zahrani A (2011). Ten-year cancer incidence among nationals of the GCC states 1998–2007 (prepared under the supervision of Executive Board Of Health Ministers’ Council For the Gulf Cooperation Council State

  19. Kumar S, Burney IA, Zahid KF, Souza D, Belushi MA, Mufti TD et al (2015) Colorectal cancer patient characteristics, treatment and survival in Oman: a single center study. Asian Pac J Cancer Prev 16(12):4853–4858

    Article  PubMed  Google Scholar 

  20. Cancer Research UK University College London, King’s College London, Oxford University. Bowel Cancer Awareness Measure (CAM) toolkit version 2.1. 2011. Cancer Research UK

  21. Power E, Simon A, Juszczyk D, Hiom S, Wardle J (2011) Assessing awareness of colorectal cancer symptoms: measure development and results from a population survey in the UK. BMC Cancer 11(1):366

    Article  PubMed  PubMed Central  Google Scholar 

  22. Al-Azri M, Al-Hamedi I, Al-Awisi H, Al-Hinai M, Davidson R (2015) Public awareness of warning signs and symptoms of cancer in Oman: a community-based survey of adults. Asian Pac J Cancer Prev 16(7):2731–2737

    Article  PubMed  Google Scholar 

  23. Rahim HF, Sibai A, Khader Y, Hwalla N, Fadhil I, Alsiyabi H et al (2014) Non-communicable diseases in the Arab world. Lancet 383(9914):356–367

    Article  PubMed  Google Scholar 

  24. Robb K, Stubbings S, Ramirez A, Macleod U, Austoker J, Waller J et al. Public awareness of cancer in Britain: a population-based survey of adults. Br J Cancer 101(S2):S18-S23

  25. Forbes LJL, Simon AE, Warburton F, Boniface D, Brain KE, Dessaix A et al (2013) Differences in cancer awareness and beliefs between Australia, Canada, Denmark, Norway, Sweden and the UK (the International Cancer Benchmarking Partnership): do they contribute to differences in cancer survival? Br J Cancer 108(2):292–300

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Al-Azri MH (2016) Delay in cancer diagnosis: causes and possible solutions. Oman Med J 31(5):325–326

    Article  PubMed  PubMed Central  Google Scholar 

  27. Lynes K, Kazmi SA, Robery JD, Wong S, Gilbert D, Thaha MA (2016). Public appreciation of lifestyle risk factors for colorectal cancer and awareness of bowel cancer screening: a cross-sectional study. International journal of surgery 36, part a:312-318

  28. Albano JD, Ward E, Jemal A, Anderson R, Cokkinides VE, Murray T et al (2007) Cancer mortality in the United States by education level and race. J Natl Cancer Inst 99(18):1384–1394

    Article  PubMed  Google Scholar 

  29. Mulligan CR, Meram AD, Proctor C, Wu H, Zhu K, Marrogi AJ (2006) Unlimited access to care: effect on racial disparity and prognostic factors in lung cancer. Cancer Epidemiol Biomark Prev 15(1):25

    Article  Google Scholar 

  30. Vu M, Azmat A, Radejko T, Padela AI (2016) Predictors of delayed healthcare seeking among American Muslim women. J Women's Health 25(6):586–593

    Article  Google Scholar 

  31. Al-Azri M, Al-Awisi H, Al-Rasbi S, El-Shafie K, Al-Hinai M, Al-Habsi H et al (2014) Psychosocial impact of breast cancer diagnosis among Omani women. Oman Medical Journal 29(6):437

    Article  PubMed  PubMed Central  Google Scholar 

  32. Smith LK, Pope C, Botha JL (2003) Patients’ help-seeking experiences and delay in cancer presentation: a qualitative synthesis. Lancet 366(9488):825–831

    Article  Google Scholar 

  33. Burgess C, Hunter MS, Ramirez AJ (2001) A qualitative study of delay among women reporting symptoms of breast cancer. Br J Gen Pract 51(473):967–971

    CAS  PubMed  PubMed Central  Google Scholar 

  34. Caring demands and delay in seeking care in African American women newly diagnosed with breast cancer: an ethnographic, photographic study. 2001

  35. Kumar S, Burney IA, Zahid KF, Souza PC, Belushi MA, Meki TDM et al (2015) Colorectal cancer patient characteristics, treatment and survival in Oman: a single center study. Asian Pac J Cancer Prev 16:4853–4858

    Article  PubMed  Google Scholar 

  36. Siegel R, DeSantis C, Jemal A (2014) Colorectal cancer statistics. CA A Cancer Journal for Clinicians 64(2):104–117

    Article  PubMed  Google Scholar 

  37. O'Connell JB, Maggard MA, Livingston EH, Yo CK (2004) Colorectal cancer in the young. Am J Surg 187(3):343–348

    Article  PubMed  Google Scholar 

  38. Macleod U, Mitchell ED, Burgess C, MacDonald S, Ramirez AJ. Risk factors for delayed presentation and referral of symptomatic cancer: evidence for common cancers. Br J Cancer 101(S2):S92-S101

  39. Quaife SL, Forbes LJL, Ramirez AJ, Brain KE, Donnelly C, Simon AE et al (2014) Recognition of cancer warning signs and anticipated delay in help-seeking in a population sample of adults in the UK. Br J Cancer 110(1):12–18

    Article  CAS  PubMed  Google Scholar 

  40. McCaffery K, Wardle J, Waller J (2003) Knowledge, attitudes, and behavioral intentions in relation to the early detection of colorectal cancer in the United Kingdom. Prev Med 36(5):525–535

    Article  PubMed  Google Scholar 

  41. Vernon SW (1997) Participation in colorectal cancer screening. A review 89(19):1406–1422

    CAS  Google Scholar 

  42. Lansdorp-Vogelaar I, Knudsen AB, Brenner H (2010) Cost-effectiveness of colorectal cancer screening: an overview. Best Pract Res Clin Gastroenterol 24(4):439–449

    Article  PubMed  PubMed Central  Google Scholar 

  43. Bastani R, Gallardo NV, Maxwell AE (2001) Barriers to colorectal cancer screening among ethnically diverse high-and average-risk individuals. J Psychosoc Oncol 19(3–4):65–84

    Article  Google Scholar 

  44. Qumseya BJ, Tayem YI, Dasa OY, Nahhal KW, Abu Limon IM, Hmidat AM et al (2014) Barriers to colorectal cancer screening in Palestine: a national study in a medically underserved population. Clin Gastroenterol Hepatol 12(3):463–469

    Article  PubMed  Google Scholar 

  45. Hasnain M, Connell KJ, Menon U, Tranmer PA (2010) Patient-centered care for Muslim women: provider and patient perspectives. J Women's Health 20(1):73–83

    Article  Google Scholar 

  46. McLean M, Al Ahbabi S, Al Ameri M, Al Mansoori M, Al Yahyaei F, Bernsen R (2010) Muslim women and medical students in the clinical encounter. Med Educ 44(3):306–315

    Article  PubMed  Google Scholar 

  47. Alharbi NS, Almutari R, Jones S, Al-Daghri N, Khunti K, de Lusignan S (2014) Trends in the prevalence of type 2 diabetes mellitus and obesity in the Arabian gulf states: systematic review and meta-analysis. Diabetes Res Clin Pract 106(2):e30–e33

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank the participants and the Directorate General of Health Services of Muscat governorate for allowing this study to be conducted in the LHCs.

Author information

Authors and Affiliations

  1. Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman

    Mohammed Al-Azri

  2. Oman Medical Specialty Board, Al Dakhilya Region Ministry of health, Muscat, Oman

    Jamila Al-Kindi

  3. Department of Non-communicable Diseases, Directorate General of Health Services, Ministry of health, Muscat, Oman

    Thuraiya Al-Harthi

  4. Oman Medical Specialty Board, North Al Batinah Region, Ministry of health, Muscat, Oman

    Manal Al-Dahri

  5. Research Department, Oman Medical Specialty Board, Muscat, Oman

    Sathiya Murthi Panchatcharam & Abdullah Al-Maniri

Authors
  1. Mohammed Al-Azri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jamila Al-Kindi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thuraiya Al-Harthi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Manal Al-Dahri
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sathiya Murthi Panchatcharam
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Abdullah Al-Maniri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mohammed Al-Azri.

Ethics declarations

The study has been approved by the Medical Research and Ethics Committee of the College of Medicine and Health Sciences at Sultan Qaboos University, Muscat, Oman (MREC #1088).

Conflict of Interest Statement

The authors declare that they have no conflict of interest.

Funding

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Al-Azri, M., Al-Kindi, J., Al-Harthi, T. et al. Awareness of Stomach and Colorectal Cancer Risk Factors, Symptoms and Time Taken to Seek Medical Help Among Public Attending Primary Care Setting in Muscat Governorate, Oman. J Canc Educ 34, 423–434 (2019). https://doi.org/10.1007/s13187-017-1266-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-017-1266-8

Keywords

Search

Navigation