A Cross-Sectional Assessment of Literacy and Awareness, Attitudes, and Beliefs About Colorectal Cancer and Its Screening in Riyadh Region

  • Khalid M. Almutairi
  • Wadi B. Alonazi
  • Abdulaziz Alodhayani
  • Jason M. Vinluan
  • Mohammad Ahmad
  • Sultana Abdulaziz Alhurishi
  • Nourah Alsadhan
  • Majed Mohammed Alsalem
  • Nader Eqaab Alotaibi
  • Alaa Mustafa Alaqeel
Article
First Online:

Abstract

This study aims to explore the association between functional health literacy and awareness for, beliefs, and attitudes of patients with colorectal cancer (CRC) and CRC screening test in Riyadh, Saudi Arabia. A total of 256 participants from two different tertiary level hospitals in Riyadh, Saudi Arabia were recruited in this study. The participants were interviewed by a trained researcher between October and December 2015. All respondents answered a three-part questionnaire which included demographic data, questions related to CRC awareness, attitude, behaviour, and short Test of Functional Health Literacy in Adults (STOFHLA). More than half of the participants had an inadequate awareness of functional health literacy skills (FHLS), 16.4 % had marginal of FHLS awareness and 17.6 % had adequate awareness about FHLS as assessed by the STOFHLA. Overall, the majority of the participants in both marginal and adequate aware groups showed a limited awareness about colorectal cancer screening and testing. A significant association was found on awareness of the patients about frequencies that they should have been tested for colorectal cancer and functional health literacy. No significant association was found between functional health literacy as assessed by STOFHLA and concerns of Faecal Occult Blood Test (FOBT) (p = 0.384) and sigmoidoscopy or colonoscopy might cause embarrassment (p = 0.089), harm (p = 0.917), and pain (p = 0.849). The present study revealed a low level of health literacy among Saudi adults in Riyadh region. Although the level of literacy was low, the bigger concern is that of the poor awareness and beliefs of Saudi adults about CRC and CRC screening.

Keywords

Literacy Colorectal cancer Cancer screening Attitude Behaviour Saudi Arabia 

Notes

Acknowledgments

The authors extend their appreciation to the Research Center at the College of Applied Medical Sciences and the Deanship of Scientific Research at King Saud University for funding this work.

Compliance with Ethical Standards

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    National Collaborating Centre for Cancer (UK) (2011) (NICE Clinical Guidelines, No. 131.) http://www.ncbi.nlm.nih.gov/books/NBK116638/. (accessed 8.02.2015) Colorectal cancer: the diagnosis and Management of Colorectal Cancer. National Collaborating Centre for Cancer (UK), CardiffGoogle Scholar
  2. 2.
    Mosli MH, Al-Ahwal MS (2012) Colorectal cancer in the Kingdom of Saudi Arabia: the need for screening. Asian Pac J Cancer Prev 13(8):3809–3813CrossRefPubMedGoogle Scholar
  3. 3.
    Guraya SY, Eltinay OE (2006) Higher prevalence in young population and rightward shift of colorectal carcinoma. Saudi Medical Journal 27(9):1391–1393PubMedGoogle Scholar
  4. 4.
    Aljebreen AM (2007) Clinico-pathological patterns of colorectal cancer in Saudi Arabia: younger with an advanced stage presentation. Saudi Journal of Gastroenteroly 13(2):84–87CrossRefGoogle Scholar
  5. 5.
    Ibrahim EM, Zeeneldin AA, El-Khodary TR, Al-Gahmi AM, Bin Sadiq BM (2008) Past, present and future of colorectal cancer in the Kingdom of Saudi Arabia. Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association 14(4):178–182. doi:10.4103/1319-3767.43275 CrossRefGoogle Scholar
  6. 6.
    Amin TT, Suleman W, Al Taissan AA, Al Joher AL, Al Mulhim O, Al Yousef AH (2012) Patients’ profile, clinical presentations and histopathological features of colorectal cancer in Al Hassa region, Saudi Arabia. Asian Pac J Cancer Prev 13(1):211–216CrossRefPubMedGoogle Scholar
  7. 7.
    Oldach BR, Katz ML (2014) Health literacy and cancer screening: a systematic review. Patient Educ Couns 94:149–157CrossRefPubMedGoogle Scholar
  8. 8.
    Joseph DA, King JB, Miller JW, Richardson LC (2012) Prevalence of colorectal cancer screening among adults—behavioral risk factor surveillance system, United States, 2010. Morb Mortal Wkly Rep 61:51–56Google Scholar
  9. 9.
    Swan J, Breen N, Graubard BI et al (2010) Data and trends in cancer screening in the United States: results from the 2005 National Health Interview Survey. Cancer 116(20):4872–4881CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Levin B, Lieberman DA, McFarland B, Smith RA, Brooks D, Andrews KS et al (2008) Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US multi-society task force on colorectal cancer, and the American College of Radiology. CA Cancer Journal for Clinician 58:130–160CrossRefGoogle Scholar
  11. 11.
    Australian Cancer Network (2005) http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp106_0.pdf. (accessed 12.10.2015) Clinical practice guidelines for the prevention, early detection and management of colorectal cancer. Australian Cancer Council and Australian Cancer Network, SydneyGoogle Scholar
  12. 12.
    U.S. Preventive Services Task Force (2008) Screening for colorectal cancer: U.S. preventive services task force recommendation statement. AHRQ publication 08–05124-EF-3. Agency for Healthcare Research and Quality, RockvilleGoogle Scholar
  13. 13.
    Hewitson P, Glasziou P, Irwig L, Towler B, Watson E (2007) Screening for colorectal cancer using the faecal occult blood test, hemoccult. Cochrane Database Syst Rev 24(1):CD001216Google Scholar
  14. 14.
    Amalraj S, Starkweather C, Nguyen C, Naeim A (2009) Health literacy, communication, and treatment decision-making in older cancer patients. Oncology (Williston Park) 23(4):369–375Google Scholar
  15. 15.
    Peterson NB, Dwyer KA, Mulvaney SA et al (2007) The influence of health literacy on colorectal cancer screening knowledge, beliefs, and behaviors. J Natl Med Assoc 99(10):1105–1112PubMedPubMedCentralGoogle Scholar
  16. 16.
    Miller DP, Brownlee CD, McCoy TP et al (2007) The effect of health literacy on knowledge and receipt of colorectal cancer screening: a survey study. BMC Fam Pract 8:16CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    US Department of Health and Human Services (2000) HP 2010, With understanding and improving health and objectives for improving health, vol 2, 2nd edn. US Government Printing Office, Washington DCGoogle Scholar
  18. 18.
    Institute of Medicine of the National Academies (2004) Health literacy: a prescription to end confusion. National Academies Press, Washington, DCGoogle Scholar
  19. 19.
    Baker DW, Williams MV, Parker RM, Gazmararian JA, Nurss JR (1999) Development of a brief test to measure functional health literacy. Patient Education Counseling 38:33–42CrossRefPubMedGoogle Scholar
  20. 20.
    Parker RM, Baker DW, Williams MV, Nurss JR (1995) The test of functional health literacy in adults: a new instrument for measuring patients’ literacy skills. J Gen Intern Med 10:537–541CrossRefPubMedGoogle Scholar
  21. 21.
    Davis TC, Crouch MA, Long SW, Jackson RH, Bates P, George RB et al (1991) Rapid assessment of literacy levels of adult primary care patients. Fam Med 23:433–435 [9]PubMedGoogle Scholar
  22. 22.
    Davis TC, Long SW, Jackson RH, Mayeaux EJ, George RB, Murphy PW et al (1993) Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med 25:391–395PubMedGoogle Scholar
  23. 23.
    National Center for Educational Statistics (2003) National Assessment of adult literacy. National Center for Education, Washington, DCGoogle Scholar
  24. 24.
    Bann CM, McCormack LA, Berkman ND, Squiers LB (2012) The health literacy skills instrument: a 10-item short form. J Health Commun 17(Suppl. 3):191–202CrossRefPubMedGoogle Scholar
  25. 25.
    McCormack L, Bann C, Squiers L, Berkman ND, Squire C, Schillinger D et al (2010) Measuring health literacy: a pilot study of a new skills-based instrument. J Health Commun 15:51–71CrossRefPubMedGoogle Scholar
  26. 26.
    US Preventive Services Task Force (2008) Screening for colorectal cancer. http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/colorectal-cancer-screening. (accessed 12.10.2015)
  27. 27.
    Alsanea N (2014) The dilemma of the threshold age to start screening for colorectal cancer in Saudi Arabia. Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association 20(3):141–142. doi:10.4103/1319-3767.132976 CrossRefGoogle Scholar
  28. 28.
    Guerra CE, Dominguez F, Shea JA (2005) Literacy and knowledge, attitudes, and behavior about colorectal cancer screening. J Health Commun 10(7):651–663CrossRefPubMedGoogle Scholar
  29. 29.
    Christou A, Thompson SC (2012) Colorectal cancer screening knowledge, attitudes and behavioural intention among indigenous western Australians. BMC Public Health 12:528. doi:10.1186/1471-2458-12-528 CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    McVeigh TP, Lowery AJ, Waldron RM, Mahmood A, Barry K (2013) Assessing awareness of colorectal cancer symptoms and screening in a peripheral colorectal surgical unit: a survey based study. BMC Surg 13:20. doi:10.1186/1471-2482-13-20 CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Schroy PC, Glick JT, Robinson PA, Lydotes MA, Evans SR, Emmons KM (2008) Has the surge in media attention increased public awareness about colorectal cancer and screening? J Community Health 33:1–9CrossRefPubMedGoogle Scholar
  32. 32.
    Ma GX, Wang MQ, Toubbeh J, Tan Y, Shive S, Wu D (2012) Factors associated with colorectal cancer screening among Cambodians, Vietnamese, Koreans and Chinese living in the United States. N Am J Med Sci 5:1–8CrossRefGoogle Scholar
  33. 33.
    Robb KA, Solarin I, Power E, Atkin W, Wardle J (2008) Attitudes to colorectal cancer screening among ethnic minority groups in the UK. BMC Public Health 8:34. doi:10.1186/1471-2458-8-34 CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Severino G, Wilson C, Turnbull D, Duncan A, Gregory T (2009) Attitudes towards and beliefs about colorectal cancer and screening using the faecal occult blood test within the Italian-Australian community. Asian Pac J Cancer Prev 10:387–394PubMedGoogle Scholar
  35. 35.
    Paddison JS, Yip MJ (2010) Exploratory study examining barriers to participation in colorectal cancer screening. Aust J Rural Health 18:11–15CrossRefPubMedGoogle Scholar
  36. 36.
    Gimeno-Garcia AZ, Quintero E, Nicolas-Perez D, Jimenez-Sosa A (2011) Public awareness of colorectal cancer and screening in a Spanish population. Public Health 125:609–615CrossRefPubMedGoogle Scholar
  37. 37.
    Cameron KA, Francis L, Wolf MS, Baker DW, Makoul G (2007) Investigating Hispanic/Latino perceptions about colorectal cancer screening: a community-based approach to effective message design. Patient Education Counseling 68:145–152CrossRefPubMedGoogle Scholar
  38. 38.
    Koo JH, Arasaratnam MM, Liu K, Redmond DM, Connor SJ, Sung JY, Leong RL (2010) Knowledge, perception and practices of colorectal cancer screening in an ethnically diverse population. Cancer Epidemiol 34(5):604–610CrossRefPubMedGoogle Scholar
  39. 39.
    Wong YN, Coups EJ (2011) Correlates of colorectal cancer screening adherence among men who have been screened for prostate cancer. Journal of cancer education : the official journal of the American Association for Cancer Education 26(2):301–307. doi:10.1007/s13187-011-0194-2 CrossRefGoogle Scholar
  40. 40.
    Sentell T, Braun KL, Davis J et al (2013) Colorectal cancer screening: low health literacy and limited English proficiency among Asians and whites in California. J Health Commun 18:242–255CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Kobayashi LC, Wardle J, von Wagner C (2014) Limited health literacy is a barrier to colorectal cancer screening in England: evidence from the English longitudinal study of ageing. Prev Med 61(100):100–105. doi:10.1016/j.ypmed.2013.11.012 CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Arnold CL, Rademaker A, Bailey SC et al (2012) Literacy barriers to colorectal cancer screening in community clinics. J Health Commun 17(3):252–264. doi:10.1080/10810730.2012.713441 CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Harewood GC, Murray F, Patchett S, Garcia L, Leong WL, Lim YT et al (2009) Assessment of colorectal cancer knowledge and patient attitudes towards screening: is Ireland ready to embrace colon cancer screening? Ir J Med Sci 178(1):7–12CrossRefPubMedGoogle Scholar
  44. 44.
    DeMarco J, Nystrom M (2010) The importance of health literacy in patient education. Journal of Consumer Health on the Internet 14(3):294–301. doi:10.1080/15398285.2010.502021 CrossRefGoogle Scholar

Copyright information

© American Association for Cancer Education 2016

Authors and Affiliations

  • Khalid M. Almutairi
    • 1
  • Wadi B. Alonazi
    • 2
  • Abdulaziz Alodhayani
    • 3
  • Jason M. Vinluan
    • 1
  • Mohammad Ahmad
    • 4
  • Sultana Abdulaziz Alhurishi
    • 5
  • Nourah Alsadhan
    • 5
  • Majed Mohammed Alsalem
    • 6
  • Nader Eqaab Alotaibi
    • 4
  • Alaa Mustafa Alaqeel
    • 7
  1. 1.Department of Community Health Science, College of Applied Medical ScienceKing Saud UniversityRiyadhSaudi Arabia
  2. 2.College of Business AdministrationKing Saud UniversityRiyadhSaudi Arabia
  3. 3.Department of Family and Community Medicine, College of MedicineKing Saud UniversityRiyadhSaudi Arabia
  4. 4.College of Nursing Saudi ArabiaKing Saud UniversityRiyadhSaudi Arabia
  5. 5.Community Health Sciences, College of Applied Medical SciencesKing Saud UniversityRiyadhSaudi Arabia
  6. 6.Security Forces Hospital, College of Business AdministrationKing Saud UniversityRiyadhSaudi Arabia
  7. 7.College of MedicineKing Saud UniversityRiyadhSaudi Arabia

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