Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China.
PLoS One. 2013;8(4):e60366. doi: 10.1371/journal.pone.0060366. Epub 2013 Apr 3.
We tested the a priori hypothesis that self-perceived and real presences of risks for colorectal cancer (CRC) are associated with better knowledge of the symptoms and risk factors for CRC, respectively.
One territory-wide invitation for free CRC screening between 2008 to 2012 recruited asymptomatic screening participants aged 50-70 years in Hong Kong. They completed survey items on self-perceived and real presences of risks for CRC (advanced age, male gender, positive family history and smoking) as predictors, and knowledge of CRC symptoms and risk factors as outcome measures, respectively. Their associations were evaluated by binary logistic regression analyses.
From 10,078 eligible participants (average age 59 years), the mean knowledge scores for symptoms and risk factors were 3.23 and 4.06, respectively (both score range 0-9). Male gender (adjusted odds ratio [AOR] = 1.34, 95% C.I. 1.20-1.50, p<0.01), self-perception as not having any risks for CRC (AOR = 1.12, 95% C.I. 1.01-1.24, p = 0.033) or uncertainty about having risks (AOR = 1.94, 95% C.I. 1.55-2.43, p<0.001), smoking (AOR 1.38, 95% C.I. 1.11-1.72, p = 0.004), and the absence of family history (AOR 0.61 to 0.78 for those with positive family history, p<0.001) were associated with poorer knowledge scores (≤ 4) of CRC symptoms. These factors remained significant for knowledge of risk factors.
Male and smokers were more likely to have poorer knowledge but family history of CRC was associated with better knowledge. Since screening of these higher risk individuals could lead to greater yield of colorectal neoplasm, educational interventions targeted to male smokers were recommended.
我们检验了一个先验假设，即自我感知和实际存在的结直肠癌（CRC）风险与对 CRC 症状和风险因素的更好认知分别相关。
在 2008 年至 2012 年间，香港进行了一次全港范围内的免费 CRC 筛查邀请，招募了年龄在 50-70 岁之间的无症状筛查参与者。他们完成了关于自我感知和实际存在的 CRC 风险（年龄较大、男性、阳性家族史和吸烟）的预测因子的调查项目，以及 CRC 症状和风险因素的知识作为结果测量指标。通过二元逻辑回归分析评估了它们之间的相关性。
在 10078 名合格参与者（平均年龄 59 岁）中，症状和风险因素的平均知识得分分别为 3.23 和 4.06（得分范围均为 0-9）。男性（调整后的优势比 [AOR] = 1.34，95%置信区间 [95%CI] 1.20-1.50，p<0.01）、自我感知没有任何 CRC 风险（AOR = 1.12，95%CI 1.01-1.24，p = 0.033）或不确定是否存在风险（AOR = 1.94，95%CI 1.55-2.43，p<0.001）、吸烟（AOR 1.38，95%CI 1.11-1.72，p = 0.004）以及家族史缺失（对于阳性家族史的人，AOR 0.61 至 0.78，p<0.001）与 CRC 症状的知识评分（≤4）较差相关。这些因素对于风险因素的知识仍然具有重要意义。
男性和吸烟者更有可能知识较差，但 CRC 家族史与更好的知识相关。由于对这些高风险个体进行筛查可能会导致更多的结直肠肿瘤，因此建议针对男性吸烟者进行教育干预。
