# Differences in colorectal cancer awareness between screening eligible vs. ineligible Palestinians: a national cross-sectional study

## TL;DR

This study compares colorectal cancer awareness in Palestine between people who are and are not eligible for screening, finding low awareness in both groups.

## Contribution

The study reveals that CRC awareness is low among eligible individuals and does not differ significantly between eligible and ineligible groups.

## Key findings

- The most recognized CRC sign/symptom was 'lump in the abdomen' in both groups.
- Awareness of CRC causation myths was notably low, with 'having a physical trauma' being the most reported myth.
- No significant associations were found between screening eligibility and CRC awareness levels.

## Abstract

This study aimed to compare colorectal cancer (CRC) awareness between screening-eligible and ineligible individuals in Palestine.

Convenience sampling was utilized to recruit Palestinian adults from diverse settings, including hospitals, primary healthcare centers and public spaces across 11 governorates. The evaluation of CRC awareness in terms of signs/symptoms, risk factors and causation myths was conducted using Arabic-translated, modified versions of the validated instruments, the Bowel Cancer Awareness Measure and the Cancer Awareness Measure-Mythical Causes Scale.

The final analysis included 2698 participants, with 2158 (80.9%) eligible for CRC screening and 540 (19.1%) ineligible for it. The most recognized CRC sign/symptom was ‘lump in the abdomen’ in both screening-eligible (n = 386, 71.5%) and ineligible (n = 1582, 73.3%) groups. ‘Lack of physical activity’ was the most recognized risk factor in both groups (eligible: n = 451, 83.5%; ineligible: n = 1766, 81.8%). The most reported causation myth in both groups was ‘having a physical trauma’ (eligible: n = 340, 63.0%; ineligible: n = 1353, 62.7%). In the screening-eligible group, only 210 participants (38.9%) demonstrated high awareness of CRC signs/symptoms, 213 participants (39.4%) showed high awareness of CRC risk factors and only 46 participants (8.5%) displayed high awareness of CRC causation myths. There were no significant associations between being eligible for screening colonoscopy and the awareness levels of CRC signs/symptoms, risk factors and causation myths.

Overall, awareness levels of CRC signs/symptoms, risk factors and causation myths were notably low among screening-eligible participants. There were no differences in awareness levels between individuals eligible for colonoscopy and those who were not.