The gap between knowledge and undergoing colorectal cancer screening using the Health Belief Model: A national survey

Background/Aims: Colorectal cancer (CRC) is a public health issue, and before the initiation of a national cancer screening program, there is a need to examine the acceptance of the public to undergo CRC screening and explore potential barriers. Materials and Methods: A nationwide survey was conducted using an electronic platform to collect demographic variables and using the Health Belief Model to assess attitudes and behavior of participants as well as the knowledge about and intent to undergo CRC screening. At the end of the survey, participants from Riyadh were invited to get screened for CRC. Results: Responses from 5720 individuals covering all the 13 jurisdictions of Saudi Arabia were collected. Males represented 71.53% of the respondents; the mean age was 43.28 years and 15.24% had already undergone CRC screening using various methods, mostly colonoscopy (72.73%). The mean knowledge score was 11.05 (standard deviation 4.4, range 1-23), with no difference between genders, jurisdictions of the Kingdom, between those who expressed interest in screening and those who did not, and between those who accepted the invitation to undergo CRC screening and those who did not. Participants displayed positive attitudes toward both CRC screening and colonoscopy as a screening tool, and 73% expressed willingness to undergo screening. On multivariate analysis, male gender was the only factor associated with a higher probability of accepting screening, whereas neither knowledge nor willingness to undergo screening predicted accepting the invitation to screening. Conclusion: Although the majority of participants were willing to undergo screening, no significant correlation between knowledge and willingness to undergo screening were predictors of screening uptake. Other areas that could be targeted in the promotion of CRC screening uptake to bridge the gap between 'knowing' and 'doing' should be explored.