title: Knowledge, attitudes, and behavioral intentions in relation to the early detection of colorectal cancer in the United Kingdom.
abstract: BACKGROUND
  Colorectal cancer (CRC) mortality is high. Understanding the social, psychological, and cognitive predictors of early detection practices such as screening may help improve CRC outcomes. This study examined knowledge of CRC and the relationship between knowledge, attitudes to cancer, and intentions to engage in early detection behaviors for CRC in a national representative population sample.
  
  
  METHODS
  An interview-based survey was carried out in a British population sample of adults ages 16 to 74 years (n = 1637), assessing knowledge, attitudes, and intention with regard to colorectal cancer.
  
  
  RESULTS
  Knowledge levels were very low; 58% (n = 995) of respondents could not list any colorectal cancer risk factors and 24% (n = 393) were unable to identify any warning signs for cancer. Knowledge was lower among men (chi(2)[2] = 52.8, P < 0.0001), younger respondents (chi(2)[10] = 79.9, P <.0001), and those with less education (chi(2)[4] = 73.9, P < 0.0001). Attitudes to cancer were more negative among women (chi(2) [2] = 7.4, P = 0.025), younger participants (chi(2)[10] = 22.4, P = 0.013), and those with less education (chi(2) [4] = 75.0, P < 0.0001). Low knowledge was associated with negative attitudes (P < 0.0001) and both factors were associated with lower intentions to participate in colorectal cancer screening (P < 0.0001). Multivariate analysis indicated that attitudes partially mediated the effect of knowledge on screening intentions.
  
  
  CONCLUSIONS
  Increasing knowledge may reduce negative public perceptions of cancer which may impact positively on intentions to participate in screening.
authors.affiliation: Health Behaviour Unit, Cancer Research UK, Department of Epidemiology and Public Health, Royal Free and University College Medical School, London, England, UK.
authors.forename: Kirsten
authors.initials: K
authors.lastname: McCaffery
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
authors.forename: Jo
authors.initials: J
authors.lastname: Waller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology