Knowledge, Attitudes, and Practices Toward Colorectal Cancer Screening Among Adults in Urban and Rural Settings: A Cross-Sectional Study

Abstract

Background

Colorectal cancer (CRC) is a significant public health challenge worldwide, with disparities in screening uptake contributing to preventable morbidity and mortality. Understanding the knowledge, attitudes, and practices (KAP) toward CRC screening in urban and rural populations can inform targeted interventions to improve screening rates.

Objectives

This study aimed to assess and compare the KAP of adults in urban and rural settings of Hofuf City, Saudi Arabia, regarding CRC screening and to identify factors influencing screening behaviors.

Methods

A cross-sectional study was conducted from December 2020 to March 2021, involving 422 participants (211 urban and 211 rural). A structured questionnaire assessed KAP. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression to identify predictors of screening adherence.

 Results

Urban participants exhibited higher knowledge about CRC risk factors (52% vs. 35%) and screening methods (63% vs. 44%) than rural participants. Positive attitudes toward CRC screening were more prevalent in urban areas (70% vs. 55%), while rural participants reported greater barriers, such as fear (41%) and lack of trust (33%). Screening adherence was low overall but higher among urban participants (29% vs. 16%). Knowledge and attitudes were positively correlated with screening practices (r = 0.48, p < 0.001).

Conclusion

Significant disparities in CRC screening KAP exist between urban and rural populations. Tailored interventions addressing knowledge gaps, cultural attitudes, and financial barriers are critical to improving screening rates.