Alabed Ammer, Samha Raghad, Nahhat Fouad, Droubi Sami, Fawaz Hassan, Latifeh Youssef
Faculty of Medicine, Damascus University, Damascus, Syria.
Faculty of Medicine, Albaath University, Homs, Syria.
BMC Public Health. 2025 Mar 11;25(1):963. doi: 10.1186/s12889-025-22182-9.
Colorectal cancer (CRC) is the third most common cancer globally, with rising incidence in developing countries due to lifestyle and dietary shifts. CRC often presents with late-stage symptoms, leading to higher mortality. Early detection through screening can significantly improve survival rates. In Syria, CRC is the second most common cancer, but screening rates remain low, especially following the decade-long war. This study aims to assess the knowledge of CRC and evaluate the awareness of CRC screening among Syrians to guide prevention and detection strategies.
A cross-sectional online survey was conducted from September 27 to October 21, 2023, across six governorates: Damascus, Homs, Aleppo, Latakia, Hama, and Tartus, using a self-administered questionnaire distributed via social media. Statistical analysis was performed using SPSS v28.0, with a Chi-square test to explore differences in knowledge based on socio-demographical factors. Multicollinearity was assessed using the Variance Inflation Factor (VIF), and multinomial regression was performed to confirm relationships established by the Chi-square analysis.
The study included 772 participants, 42.6% of whom were aged 30-35 years. The majority were female (64.4%) and married (56.3%). Only 27.8% considered themselves informed about CRC. While 54.8% had heard of colonoscopy, only 15.4% had undergone the procedure. Significant knowledge gaps were identified, particularly regarding the link between adenocarcinoma polyps and CRC (29.9%), the role of diet (33.2%), and the protective effect of aspirin (17.7%). Individuals aged 50 and above demonstrated higher awareness levels, particularly in recognizing CRC's hereditary nature (p-value = 0.033) and the potential for cure (p-value = 0.012). Education and economic status were also strongly associated with better CRC knowledge, and males generally exhibited higher awareness than females.
This study highlights significant gaps in CRC knowledge and screening awareness among Syrians, emphasizing the need to integrate education and complimentary screening into national health policies. Targeted campaigns, nonprofit collaboration, and media engagement are essential to bridge these gaps. Future research should address limitations like sampling bias and the cross-sectional design through longitudinal and comparative studies to guide tailored interventions.
结直肠癌（CRC）是全球第三大常见癌症，由于生活方式和饮食结构的改变，其在发展中国家的发病率呈上升趋势。CRC通常在晚期才出现症状，导致死亡率较高。通过筛查进行早期检测可显著提高生存率。在叙利亚，CRC是第二大常见癌症，但筛查率仍然很低，尤其是在长达十年的战争之后。本研究旨在评估叙利亚人对CRC的了解情况，并评估他们对CRC筛查的认识，以指导预防和检测策略。
2023年9月27日至10月21日，在大马士革、霍姆斯、阿勒颇、拉塔基亚、哈马和塔尔图斯六个省份开展了一项横断面在线调查，使用通过社交媒体分发的自填式问卷。使用SPSS v28.0进行统计分析，采用卡方检验探讨基于社会人口学因素的知识差异。使用方差膨胀因子（VIF）评估多重共线性，并进行多项回归以确认卡方分析所建立的关系。
该研究纳入了772名参与者，其中42.6%的年龄在30 - 35岁之间。大多数为女性（64.4%）且已婚（56.3%）。只有27.8%的人认为自己了解CRC。虽然54.8%的人听说过结肠镜检查，但只有15.4%的人接受过该检查。研究发现了显著的知识差距，特别是在腺癌息肉与CRC的关联（29.9%）、饮食的作用（33.2%）以及阿司匹林的保护作用（17.7%）方面。50岁及以上的个体表现出更高的认知水平，特别是在认识到CRC的遗传性质（p值 = 0.033）和治愈可能性（p值 = 0.012）方面。教育程度和经济状况也与对CRC的更好了解密切相关，男性的认知通常高于女性。
本研究突出了叙利亚人在CRC知识和筛查意识方面的显著差距，强调有必要将教育和补充筛查纳入国家卫生政策。有针对性的宣传活动、非营利组织合作以及媒体参与对于弥合这些差距至关重要。未来的研究应通过纵向和比较研究解决抽样偏差和横断面设计等局限性，以指导量身定制的干预措施。
