Knowledge, Attitudes, and Practices in Colorectal Cancer Screening in the Philippines

Joseff Karl U. Fernandez, MD, MCM (MO); Martin Augustine B.  Borlongan, MS; Michael Anthony A.  Baliton, MD; Dennis L.  Sacdalan, MD, MCM (MO); Florge Francis A.  Sy, MD, MCM (MO); Analigaya R. Agoncillo, MD, MCM (MO); Carl Lawrence C.  Arenos, MD; Vincent F.  Tatoy, MD; Timothy Joseph S.  Uy, MD; Isabela Andrea L.  Reveldez, MD; Steven Johnson L.  Lim, MD

doi:10.47895/amp.vi0.8608

Authors

Joseff Karl U. Fernandez, MD, MCM (MO) Division of Medical Oncology, Department of Medicine, Philippine General Hospital, University of the Philippines Manila https://orcid.org/0009-0009-2813-9964
Martin Augustine B. Borlongan, MS School of Statistics, University of the Philippines Diliman
Michael Anthony A. Baliton, MD University of Colorado School of Medicine
Dennis L. Sacdalan, MD, MCM (MO) Division of Medical Oncology, Department of Medicine, Philippine General Hospital, University of the Philippines Manila
Florge Francis A. Sy, MD, MCM (MO) Division of Medical Oncology, Department of Medicine, Philippine General Hospital, University of the Philippines Manila
Analigaya R. Agoncillo, MD, MCM (MO) Division of Medical Oncology, Department of Medicine, Philippine General Hospital, University of the Philippines Manila
Carl Lawrence C. Arenos, MD Division of Medical Oncology, Department of Medicine, Philippine General Hospital, University of the Philippines Manila
Vincent F. Tatoy, MD Division of Medical Oncology, Department of Medicine, Philippine General Hospital, University of the Philippines Manila
Timothy Joseph S. Uy, MD Division of Medical Oncology, Department of Medicine, Philippine General Hospital, University of the Philippines Manila
Isabela Andrea L. Reveldez, MD University of the Philippines - Philippine General Hospital
Steven Johnson L. Lim, MD Division of Medical Oncology, Department of Medicine, Philippine General Hospital, University of the Philippines Manila

DOI:

https://doi.org/10.47895/amp.vi0.8608

Keywords:

colorectal cancer screening, Knowledge Attitudes Practices (KAP), FOBT and colonoscopy, patient education

Abstract

Background and Objective. Colorectal cancer (CRC) has the third highest incidence in the Philippines. Currently, there is a paucity in literature that is focused on the knowledge, attitudes, and perceptions of Filipinos regarding CRC screening. This is the first study in the Philippines that describes this.

Methods. This is a cross-sectional study that validated a 52-item Filipino questionnaire on the knowledge on
colorectal cancer, willingness to undergo CRC screening, and perceived benefits and barriers to fecal occult blood test (FOBT) and colonoscopy. The study enrolled household heads more than 20 years of age residing in both urban and rural communities in the Philippines.

Results. The UP-PGH CRC KAP (University of the Philippines – Philippine General Hospital Colorectal Cancer
Knowledge, Attitudes, and Practices) and Rawl Questionnaire’s validity and internal consistency were established in a pilot study of 30 respondents. A total of 288 respondents were then enrolled to the main study group with a median age of 54.0. Knowledge scores for prognosis and utility of CRC screening were modest (6.3/12 and 8.4/20, respectively). Perceived benefit scores to FOBT and colonoscopy were high (9.9/12 and 13.9/16, respectively).Median scores to barriers to FOBT and colonoscopy were intermediate (22.5/36 and 35.8/60, respectively). Notably, a vast majority (86.1%) were willing to participate in CRC screening programs initiated by the government, and 46.9% agreed to undergo screening tests even as out-of-pocket expense.

Conclusion. The UP-PGH CRC KAP Questionnaire as well as the Filipino translation of the Rawl Questionnaire
are reliable and valid tools in extensively assessing the knowledge of Filipinos on CRC and willingness to undergo screening, as well as the benefits of and barriers to FOBT and colonoscopy. Knowledge scores were modest suggesting that directed educational campaigns and awareness programs can aid in increasing awareness about CRC and its screening. Household income and highest educational attainment were significantly positively correlated with knowledge scores, and perceived benefits of and barriers to CRC screening. Scores were generally comparable between urban and rural communities.

Knowledge, Attitudes, and Practices in Colorectal Cancer Screening in the Philippines

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