Predictors of stages of adoption of colorectal cancer screening among adults attending primary healthcare centers in Turkey

Abstract Background Despite the proven effectiveness of colorectal cancer (CRC) screening in reducing mortality, adherence rates for fecal occult blood testing (FOBT) and colonoscopy remain low among Turkish adults. This study aimed to assess the stages of adoption of CRC screening behaviors, identi...

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Main Authors: Elif Dönmez, Nadire Ercan Toptaner, Elvan E. Ata, Zeynep Dülger, Onur Acar
Format: Article
Language:English
Published: SpringerOpen 2025-03-01
Series:Journal of the Egyptian Public Health Association
Subjects:
Online Access:https://doi.org/10.1186/s42506-025-00185-z
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author Elif Dönmez
Nadire Ercan Toptaner
Elvan E. Ata
Zeynep Dülger
Onur Acar
author_facet Elif Dönmez
Nadire Ercan Toptaner
Elvan E. Ata
Zeynep Dülger
Onur Acar
author_sort Elif Dönmez
collection DOAJ
description Abstract Background Despite the proven effectiveness of colorectal cancer (CRC) screening in reducing mortality, adherence rates for fecal occult blood testing (FOBT) and colonoscopy remain low among Turkish adults. This study aimed to assess the stages of adoption of CRC screening behaviors, identify the factors influencing adoption, and examine the perceived benefits and barriers to screening. Methods A cross-sectional study was conducted in Istanbul’s Anatolian region from May to June 2022, involving 498 adults aged 50–70 years. Multistage cluster sampling was used to select 20 primary healthcare centers. A structured questionnaire was administered to assess sociodemographic characteristics, health perceptions, knowledge of colorectal cancer (CRC) screening, and readiness for screening based on the transtheoretical model. The benefits and barriers to screening were evaluated using the Turkish version of “The Instruments to Measure CRC Screening Benefits and Barriers.” Results The participants (mean age: 59.10 ± 5.71 years) showed greater recognition of colonoscopy (68.7%) than FOBT (39.8%). Most participants were in the precontemplation stage for FOBT (58.6%) and colonoscopy (63.9%). Perceptions of benefits were associated with education, employment, income, health status, familial CRC history, and screening knowledge (p < 0.05). Perceived barriers were linked to lack of knowledge and provider recommendations (p < 0.05). The participants in the precontemplation stage reported fewer benefits and more barriers compared to those in advanced stages (p < 0.05). Conclusions Colonoscopy is more widely recognized than FOBT among the Turkish adult population; however, a significant proportion remains in the precontemplation stage for screening. Perceptions of benefits and barriers are influenced by sociodemographic factors, health status, and CRC knowledge. Interventions addressing these barriers and raising awareness could improve CRC screening uptake and help reduce the disease burden.
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spelling doaj-art-d3feddd5b9ba40e491fd138edaae528d2025-08-20T02:59:19ZengSpringerOpenJournal of the Egyptian Public Health Association2090-262X2025-03-01100111110.1186/s42506-025-00185-zPredictors of stages of adoption of colorectal cancer screening among adults attending primary healthcare centers in TurkeyElif Dönmez0Nadire Ercan Toptaner1Elvan E. Ata2Zeynep Dülger3Onur Acar4Oncology Nursing Department, Hamidiye Faculty of Nursing, University of Health SciencesNursing Department, Faculty of Health Sciences, Istanbul Galata UniversityPsychiatric Nursing Department, Hamidiye Faculty of Nursing, University of Health SciencesChemotherapy Department, Avrasya HospitalBursa Orhangazi District Health Directorate, Ministry of HealthAbstract Background Despite the proven effectiveness of colorectal cancer (CRC) screening in reducing mortality, adherence rates for fecal occult blood testing (FOBT) and colonoscopy remain low among Turkish adults. This study aimed to assess the stages of adoption of CRC screening behaviors, identify the factors influencing adoption, and examine the perceived benefits and barriers to screening. Methods A cross-sectional study was conducted in Istanbul’s Anatolian region from May to June 2022, involving 498 adults aged 50–70 years. Multistage cluster sampling was used to select 20 primary healthcare centers. A structured questionnaire was administered to assess sociodemographic characteristics, health perceptions, knowledge of colorectal cancer (CRC) screening, and readiness for screening based on the transtheoretical model. The benefits and barriers to screening were evaluated using the Turkish version of “The Instruments to Measure CRC Screening Benefits and Barriers.” Results The participants (mean age: 59.10 ± 5.71 years) showed greater recognition of colonoscopy (68.7%) than FOBT (39.8%). Most participants were in the precontemplation stage for FOBT (58.6%) and colonoscopy (63.9%). Perceptions of benefits were associated with education, employment, income, health status, familial CRC history, and screening knowledge (p < 0.05). Perceived barriers were linked to lack of knowledge and provider recommendations (p < 0.05). The participants in the precontemplation stage reported fewer benefits and more barriers compared to those in advanced stages (p < 0.05). Conclusions Colonoscopy is more widely recognized than FOBT among the Turkish adult population; however, a significant proportion remains in the precontemplation stage for screening. Perceptions of benefits and barriers are influenced by sociodemographic factors, health status, and CRC knowledge. Interventions addressing these barriers and raising awareness could improve CRC screening uptake and help reduce the disease burden.https://doi.org/10.1186/s42506-025-00185-zColonoscopyPredictorsScreeningFecal occult bloodPrimary careColorectal cancer
spellingShingle Elif Dönmez
Nadire Ercan Toptaner
Elvan E. Ata
Zeynep Dülger
Onur Acar
Predictors of stages of adoption of colorectal cancer screening among adults attending primary healthcare centers in Turkey
Journal of the Egyptian Public Health Association
Colonoscopy
Predictors
Screening
Fecal occult blood
Primary care
Colorectal cancer
title Predictors of stages of adoption of colorectal cancer screening among adults attending primary healthcare centers in Turkey
title_full Predictors of stages of adoption of colorectal cancer screening among adults attending primary healthcare centers in Turkey
title_fullStr Predictors of stages of adoption of colorectal cancer screening among adults attending primary healthcare centers in Turkey
title_full_unstemmed Predictors of stages of adoption of colorectal cancer screening among adults attending primary healthcare centers in Turkey
title_short Predictors of stages of adoption of colorectal cancer screening among adults attending primary healthcare centers in Turkey
title_sort predictors of stages of adoption of colorectal cancer screening among adults attending primary healthcare centers in turkey
topic Colonoscopy
Predictors
Screening
Fecal occult blood
Primary care
Colorectal cancer
url https://doi.org/10.1186/s42506-025-00185-z
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