Negative Perception in Those at Highest Risk - PotentialChallenges in Colorectal Cancer Screening in an Urban AsianPopulation

Introduction: Colorectal carcinoma (CRC) is the second commonest malignancy in Malaysia, with thehighest incidence seen in the Chinese. The aim of this study is to examine the knowledge of CRC and to identifypotential barriers for screening, which has yet to be carried out on a nationwide scale.
Methods: Subjects wererecruited consecutively from friends and relatives accompanying patients to the general medical clinic in a tertiaryhospital in Kuala Lumpur. Interviews were carried out using a standardized questionnaire for the Asia PacificCRC working group based on the Health Belief Model (HBM).
Results: 991 subjects were interviewed. Fromour study, 414 (41.8%), 500 (50.5%) and 646 (65.2%) could not identify any of the symptoms, risk factors andscreening methods for CRC respectively. Only 384 (38.7%) were agreeable to undergo screening. Independentfactors associated with willingness to undergo screening were as follows; Malay and Indian race compared tothe Chinese [aOR 2.73 (1.87, 3.98) and 3.04 (2.02, 4.59) respectively], perceived susceptibility, perceived barriersto screening, doctor’s recommendation and personal contact with CRC.
Conclusions: Knowledge of CRC andCRC screening is low among the Malaysian population. The majority are not willing to undergo screening, theChinese paradoxically being the least willing despite being at greatest risk.