Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7100, Cleveland, OH, USA.
Ministry of Health, Gaza, Palestine.
BMC Public Health. 2022 Apr 30;22(1):866. doi: 10.1186/s12889-022-13285-8.
In low-resource settings, the awareness level of colorectal cancer (CRC) signs and symptoms plays a crucial role in early detection and treatment. This study examined the public awareness level of CRC signs and symptoms in Palestine and investigated the factors associated with good awareness.
This was a national cross-sectional study conducted at hospitals, primary healthcare centers, and public spaces in 11 governorates across Palestine between July 2019 and March 2020. A translated-into-Arabic version of the validated bowel cancer awareness measure (BoCAM) was utilized to assess the awareness level of CRC signs and symptoms. For each correctly identified CRC sign/symptom, one point was given. The total score (ranging from 0 to 12) was calculated and categorized into three categories based on the number of symptoms recognized: poor (0 to 4), fair (5 to 8), and good awareness (9 to 12).
Of 5254 approached, 4877 participants completed the questionnaire (response rate = 92.3%). A total of 4623 questionnaires were included in the analysis; 1923 were from the Gaza Strip and 2700 from the West Bank and Jerusalem (WBJ). Participants from the Gaza Strip were younger, gained lower monthly income, and had less chronic diseases than participants in the WBJ. The most frequently identified CRC sign/symptom was 'lump in the abdomen' while the least was 'pain in the back passage'. Only 1849 participants (40.0%, 95% CI: 39.0%-41.0%) had a good awareness level of CRC signs/symptoms. Participants living in the WBJ were more likely to have good awareness than participants living in the Gaza Strip (42.2% vs. 37.0%; p = 0.002). Knowing someone with cancer (OR = 1.37, 95% CI: 1.21-1.55; p < 0.001) and visiting hospitals (OR = 1.46, 95% CI: 1.25-1.70; p < 0.001) were both associated with higher likelihood of having good awareness. However, male gender (OR = 0.80, 95% CI: 0.68-0.94; p = 0.006) and following a vegetarian diet (OR = 0.59, 95% CI: 0.48-0.73; p < 0.001) were both associated with lower likelihood of having good awareness.
Less than half of the study participants had a good awareness level of CRC signs and symptoms. Future education interventions are needed to improve public awareness of CRC in Palestine.
在资源匮乏的环境下，对结直肠癌（CRC）症状的认知水平对于早期发现和治疗至关重要。本研究旨在调查巴勒斯坦公众对 CRC 症状的认知水平，并探讨与之相关的认知水平较好的因素。
这是一项全国性的横断面研究，于 2019 年 7 月至 2020 年 3 月在巴勒斯坦 11 个省的医院、初级保健中心和公共场所进行。采用经过验证的阿拉伯语版结直肠癌认知测量工具（BoCAM）评估 CRC 症状的认知水平。对于每个正确识别的 CRC 症状/体征，得 1 分。根据识别出的症状数量，将总分（0-12 分）分为三个类别：差（0-4 分）、一般（5-8 分）和较好（9-12 分）。
在 5254 名受访者中，有 4877 名完成了问卷调查（应答率为 92.3%）。共有 4623 份问卷纳入分析，其中 1923 份来自加沙地带，2700 份来自西岸和耶路撒冷（WBJ）。加沙地带的参与者比 WBJ 的参与者年龄更小，月收入更低，慢性病也更少。最常被识别的 CRC 症状是“腹部肿块”，而最少的是“后道疼痛”。只有 1849 名参与者（40.0%，95%CI：39.0%-41.0%）对 CRC 症状有较好的认知水平。与加沙地带的参与者相比，居住在 WBJ 的参与者更有可能具有较好的认知水平（42.2%比 37.0%；p=0.002）。认识患有癌症的人（OR=1.37，95%CI：1.21-1.55；p<0.001）和去医院就诊（OR=1.46，95%CI：1.25-1.70；p<0.001）都与较高的认知水平相关。然而，男性（OR=0.80，95%CI：0.68-0.94；p=0.006）和素食（OR=0.59，95%CI：0.48-0.73；p<0.001）与较高的认知水平相关。
研究参与者中不到一半对 CRC 症状有较好的认知水平。未来需要开展教育干预措施，以提高巴勒斯坦公众对 CRC 的认知水平。
