Health Behaviors, Knowledge, Screening, and Attitudes Toward Colorectal Cancer among Iraqi Adults

Purpose: There has been a change in the incidence and mortality of Colorectal Cancer (CRC) in the last 20 years in Iraq. Understanding knowledge, screening, and attitudes toward CRC is vital to the design of effective health measures. This study aimed to determine the Iraqi population’s health behaviors, knowledge, screening, attitudes toward CRC, and possible predictors that may affect their knowledge level. Methods: This cross-sectional study design was conducted among 1361 adults between March 2020 and August 2021 in Sulaymaniyah/Iraq. The self-designed questionnaire was used to collect data. Descriptive analysis and linear logistic regression were carried out. Results: Among participants, 6.1% had a colonoscopy, 4.0% had a sigmoidoscopy and 60.8% heard CRC screening. Participants’ overall knowledge score was poor (13.60± 1.03, Min=0, Max=28). Half of them (51%) believed CRC screening is essential for early diagnosis, and less than half worried because of pain and embarrassment. Respondents who retired (OR=1.30; p=0.00) and who had graduated from university (OR=0.86; p=0.01) had a high knowledge of CRC, while those who were aged 70 and above (OR=-1.08; p=0.00) had a low knowledge of CRC. Furthermore, it was found that Iraqi adults who answered “no idea” to questions related to attitude and who answered incorrectly questions related to risk factors were likely to have low knowledge (p=0.00). Conclusions: We found a lack of knowledge, screening, and misconceptions about CRC and screening among Iraqi adults. Thus, education and screening programs should target Iraqi populations with the most limited knowledge.