title: Effect of public knowledge, attitudes, and behavior on willingness to undergo colorectal cancer screening using the health belief model.
abstract: OBJECTIVE
  Success of colorectal cancer (CRC) screening is dependent in part on the proportion of uptake by the targeted population. We aimed in this study to identify factors that were associated with willingness to undergo CRC screening based on the health belief model (HBM).
  
  
  METHODS
  This was a cross-sectional study among citizens of Riyadh, Saudi Arabia. Demographic data collected included gender, age, education, marital status, employment status, a history of CRC in the family or knowing a friend with CRC, as well as income. A questionnaire was developed in Arabic based on the HBM and included enquiries on knowledge about CRC symptoms and risk factors, types of CRC screening tests, perceived risk of CRC, previously undergoing CRC screening, intent to undergo CRC screening, perceived barriers to CRC screening, perceived severity of CRC, as well as attitudes toward CRC and its screening.
  
  
  RESULTS
  Five hundred participants were included. The mean age was 41.0 years (SD 10.7). Males were 50% and only 6.7% of those between 50 and 55 years of age had undergone CRC screening. Of those surveyed, 70.7% were willing to undergo CRC screening. Also, 70.5% thought that CRC is curable, 73.3% believed it was preventable, whereas 56.7% thought it was a fatal disease. Neither gender, level of education, occupation, income, marital status, nor general knowledge about CRC was found to be associated with the willingness to undergo CRC screening. Recognizing that colonoscopy was a screening test (OR 1.55, 95% CI; 1.04-2.29) was associated with a strong desire to undergo CRC screening while choosing a stool-based test was associated with not willing to undergo CRC screening (OR 0.59, 95%CI; 0.38-0.91).
  
  
  CONCLUSIONS
  We found that the majority of those interviewed were willing to undergo CRC screening and identified a number of barriers as well as potential areas that could be targeted in the promotion of CRC screening uptake if such a national program were to be implemented.
authors.affiliation: Division of Gastroenterology, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia; Division of Gastroenterology, The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, .
authors.forename: Majid A
authors.initials: MA
authors.lastname: Almadi
authors.forename: Mahmoud H
authors.initials: MH
authors.lastname: Mosli
authors.forename: Mohamed S
authors.initials: MS
authors.lastname: Bohlega
authors.forename: Mohanned A
authors.initials: MA
authors.lastname: Al Essa
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: AlDohan
authors.forename: Turki A
authors.initials: TA
authors.lastname: Alabdallatif
authors.forename: Turki Y
authors.initials: TY
authors.lastname: AlSagri
authors.forename: Faleh A
authors.initials: FA
authors.lastname: Algahtani
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mandil
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D010342:Patient Acceptance of Health Care; D012529:Saudi Arabia / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
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