Public awareness of colorectal cancer in the Gaza Strip: A comparative cross-sectional study between adults and high school students

MohamedRaed Elshami, Tamer Abdalghafoor, Maha Alfaqawi, Ayoub AbuNemer, Mohammed Ghuneim, Hussien Lubbad, Batool Almahallawi, Mosab Samaan, Abdallah Alwali, Ahmad Alborno, Deyaa Al-Kafarna, Aseel Salah, Karam Shihada, Mohammed Abo Amona, Amira Al-Najjar, Rana Abu Subha, Basma Alhelu, Israa Abujayyab, Loai Albarqouni, Bettina Bottcher

Research output: Contribution to journalMeeting AbstractResearchpeer-review


Introduction: Colorectal cancer (CRC) is a major cause of cancer deaths worldwide. Raising the awareness of CRC symptoms for early recognition, prevention via reduction of lifestyle risk factors, and removing barriers to seek medical help could lower its mortality. This study aimed to assess the level of public awareness of CRC in the Gaza Strip, and compare it between adults and high-school students (HSS).

Methods: This is a cross-sectional study conducted at 3 major hospitals and 10 high schools (recruitment used stratified sampling) in the Gaza Strip between September and October 2017. A previously pilot-tested, Arabic version of the Bowel Cancer/CRC Awareness Measure (CAM) questionnaire, a validated standardized questionnaire to measure public CRC awareness, was used. It consists of four sections: sociodemographic data, awareness of CRC symptoms, awareness of CRC risk factors, and barriers to seek medical help. Adults (aged ≥18 years) visiting or admitted to any of the three hospitals, and high-school students (aged 15-17 years) in any of the ten schools were recruited for face-to-face interviews to complete the CAM. Patients and visitors to oncology departments were ineligible. Informed consent and ethical approval were obtained.

Results: A total of 3080 participants completed the CAM questionnaire (of 3236 approached; response rate was 97.3% in HSS and 92.8% in adults). 1502 (48.8%) were HSS (730 males; 48.6%) and 1578 (51.2%) adults (736 males; 46.6%). Overall, 1391 (45.2%) reported that the chance of getting CRC is not related to age. A persistent abdominal pain was the most commonly recognized cancer symptom (n=1899, 61.7%) while pain in back passage was the least (n=1056, 34.3%). 2177 (70.7%) reported that they are not confident in recognizing CRC symptom/sign. Having a bowel disease (e.g, ulcerative colitis) was the most frequently recognized CRC risk factor (n= 1456, 47.3%) and having diabetes was the least (n=591, 19.2%). In general, adults have better awareness than HSS in terms of: recognizing CRC symptoms (mean score = 20.8 vs 18.7 of 24 total score, p< 0.0001) and its risk factors (mean score= 27.2 vs 25.4 of 45 total score, p< 0.0001). Worry about what a doctor might find was the most reported barrier to seek medical help among adults (n= 773, 49%), whereas, lack of confidence to talk about symptoms with the doctor was the most commonly reported one in HSS (n= 777, 51.7%).

Conclusions:The public awareness of CRC is suboptimal in the Gaza Strip. Interventions to improve the public awareness of CRC (e.g., educational outreach) is warranted. School curriculums should include awareness sessions on cancer symptoms and risk factors, including CRC.
Original languageEnglish
Article number5284
Number of pages2
JournalCancer Research
Issue number13_Supplement
Publication statusPublished - Jul 2018
EventAmerican Association for Cancer Research Annual Meeting - Chicago, United States
Duration: 14 Apr 201818 Apr 2018 (Program)


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