Knowledge of Colorectal Cancer Among Syrians: A Cross-Sectional Study
Authors: Almoshantaf Mohammad Badr , Swed Sarya , Alibrahim Hidar , Bohsas Haidara , Nasif Mohmad Nour , Hafez Wael , Aldaas Ahmad 
Published: March 2023

Background: The incidence of colorectal cancer is the second highest among women and the third highest among males. Screening for the disease has resulted in a significant decrease in both the prevalence and death rate of colorectal cancer (CRC) during the last two decades. Research has indicated that people unaware of the dangers of colorectal cancer may not participate in diagnostic procedures, which delays detection and reduces the likelihood of survival.
Aim: This cross-sectional research seeks to examine the level of knowledge of CRC risk factors in Syria and the variables correlated with a greater level of awareness.
Methods: An online cross-sectional study was conducted from 1 to 25 August 2022 to assess the Syrians' degree of awareness of Colorectal Cancer risk factors in Syria and the characteristics associated with a high level of understanding. The survey is based on another study, and the sample inclusion criteria of study participants were Syrian nationals aged 18 or older from all Syrian governorates. The questionnaire included 35 questions divided into 3 sections, sociodemographic variables such as (age, sex, marital status, educational level, occupation…etc.), evaluation of participant knowledge of colorectal cancer risk factors such as (alcohol consumption, Red meat consumption, lack of fiber in the diet, obesity, and old age), and symptoms such as (blood in stool, abdominal pain, constipation, change in defecation habits, general tiredness, unexplained weight loss).
Results: Among 702 Syrian national participants, (n=430, 61.3%) were females, and (n=272, 38.7%) males. Only (n=67, 9.5%) participants have a chronic disease. Most participants have shown good knowledge of colorectal cancer symptoms (n=301, 42.9%), and (n=297, 42.3%) participants have shown moderate knowledge of colorectal cancer symptoms. Only (n=123, 17.6%) participants have shown a good understanding of colorectal cancer risk factors, whereas (n=293, 41.7%) have demonstrated poor knowledge. Educational level was related to greater knowledge of colorectal cancer risk factors (P-value 0.05). No correlation was found between other variables and a good awareness of colorectal cancer symptoms and risk factors (P-value > 0.05). Ph.D. degree of educational level (OR = 15.41, 95% CI: 1.211–196.16; P-value<0.05) was associated with good awareness of colorectal cancer symptoms and Widowers' marital status (OR = 7.351, 95% CI: 1.22–44.285; P-value<0.05) was associated with good awareness of colorectal cancer risk factors. Most participants were somewhat confident in their ability to recognize colorectal cancer symptoms (43.60%), whereas just 4.60 % of people were highly confident in their ability to recognize them. Only (24.10%) The participants were not confident in identifying colorectal cancer symptoms.
Conclusion: According to our findings, there is insufficient understanding of the colorectal cancer symptoms and risk factors that contribute to the disease's development in patients and its detection in its late stages. Consequently, there is a greater need to increase colorectal cancer awareness and education programs on the disease's signs and symptoms and its risk factors. It may be possible to minimize the frequency of advanced cases of colorectal cancer by increasing the number of screening programs for colorectal cancer in Syria.