title: Sociodemographic predictors of recall and recognition of colorectal cancer symptoms and anticipated delay in help- seeking in a multiethnic Asian population.
abstract: BACKGROUND
  Colorectal cancer is the second most common cancer in Malaysia. The prognosis of the disease is excellent if detected at an early stage, but the majority of Malaysian patients present at late stages. We aimed to assess the awareness of cancer warning signs and anticipated delay in help-seeking as possible contributors to this phenomenon.
  
  
  METHODS
  A population-based cross-sectional survey using the Colorectal Cancer Awareness Measure was initiated in Perak, Malaysia. A total of 2,379 respondents aged 18 years and above were recruited using a multi-stage sampling in five locations. Analysis of covariance was used to examine independent sociodemographic predictors of scores for symptom awareness.
  
  
  RESULTS
  Younger age, being female, a higher education, and higher income were significantly associated with better scores for both recall and recognition of warning symptoms. Among the ethnic groups, Malays had better recognition of symptoms whereas Chinese recalled the most symptoms. Passing bloody stool was associated with the least anticipated delay and unexplained anal pain had the highest anticipated delay.
  
  
  CONCLUSIONS
  The level of awareness across all ethnicities in Malaysia is generally low, especially among minorities. Targeted public education, which is culturally and linguistically appropriate, should be developed to encourage early help-seeking and improve clinical outcomes.
authors.affiliation: Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Kwong Weng
authors.initials: KW
authors.lastname: Loh
authors.forename: Hazreen Abdul
authors.initials: HA
authors.lastname: Majid
authors.forename: Maznah
authors.initials: M
authors.lastname: Dahlui
authors.forename: April Camilla
authors.initials: AC
authors.lastname: Roslani
authors.forename: Tin Tin
authors.initials: TT
authors.lastname: Su
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001364:Awareness; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis; D055815:Young Adult