Knowledge and awareness of colorectal cancer in central Uganda: a community cross-sectional survey

Background
Improving public knowledge and awareness of cancer aids prevention and early detection, yet limited data exist on this subject in low- and middle-income African countries. This study aimed to assess knowledge and awareness of colorectal cancer (CRC) in the general population of central Uganda.

Methods
A community-based, cross-sectional survey was conducted among a random sample of 428 individuals from the general population in 2 districts of central Uganda. Data were collected using a semi-structured questionnaire and a modified version of the validated bowel cancer awareness measure. Multiple linear regression analysis was performed to identify factors associated with CRC awareness.

Results
Just over half of respondents had good awareness of CRC warning signs (57.9%, ≥ 6/9 correct responses), and risk factors (55.8%, ≥ 7/10 correct responses). Participants scored higher for awareness (responses to prompted questions), than knowledge (responses to unprompted questions) in relation to CRC warning signs (mean: 5.60 vs 0.46, out of 9) and risk factors (mean: 6.46 vs 0.22, out of 10). Residing in an urban area, lacking awareness of screenable cancers and not having private health insurance were associated with lower awareness of CRC warning signs. Being female and having non-degree tertiary education were associated with lower awareness of CRC risk factors.

Conclusion
This study found very low CRC knowledge in central Uganda, despite good recognition of warning signs and risk factors, with notable rural–urban disparities. These findings highlight the need of reinforcing CRC prevention messages within ongoing cancer sensitization efforts to improve public understanding of CRC.