Sociodemographic Predictors of Recall and Recognition of Colorectal Cancer Symptoms and Anticipated Delay in Help- Seeking in a Multiethnic Asian Population

Abstract

<b>Background:</b> Colorectal cancer is the second most common cancer in Malaysia. The prognosis of the diseaseis excellent if detected at an early stage, but the majority of Malaysian patients present at late stages. We aimedto assess the awareness of cancer warning signs and anticipated delay in help-seeking as possible contributors tothis phenomenon. Materials and <br/><b>Methods</b>: A population-based cross-sectional survey using the Colorectal CancerAwareness Measure was initiated in Perak, Malaysia. A total of 2,379 respondents aged 18 years and above wererecruited using a multi-stage sampling in five locations. Analysis of covariance was used to examine independentsociodemographic predictors of scores for symptom awareness. <br/><b>Results</b>: Younger age, being female, a highereducation, and higher income were significantly associated with better scores for both recall and recognitionof warning symptoms. Among the ethnic groups, Malays had better recognition of symptoms whereas Chineserecalled the most symptoms. Passing bloody stool was associated with the least anticipated delay and unexplainedanal pain had the highest anticipated delay. <br/><b>Conclusions</b>: The level of awareness across all ethnicities in Malaysiais generally low, especially among minorities. Targeted public education, which is culturally and linguisticallyappropriate, should be developed to encourage early help-seeking and improve clinical outcomes.