Awareness, Knowledge, and Perceived Barriers toward Colorectal Cancer Screening among Outpatients in Southern Nigeria: An Exploratory Pilot Study

Abstract

Background: Colorectal cancer (CRC) poses an escalating public health challenge in Nigeria, characterised by late-stage clinical presentations and high mortality rates. While screening remains the most effective intervention for mitigating disease progression, national uptake remains disproportionately low.  Objective: This exploratory pilot study aimed to examine awareness of colorectal cancer, knowledge of preventive measures, and perceived barriers to screening uptake among outpatients in a tertiary healthcare setting, generating baseline data to inform future larger-scale research.  Methods: A descriptive cross-sectional design was employed at the Rivers State University Teaching Hospital in Port Harcourt, Nigeria. Data were collected from a convenience sample of 60 respondents using a structured, self-administered questionnaire. Descriptive statistics were used to summarise sociodemographic variables, awareness levels, and screening practices.  Results: The sample was predominantly female (81.7%) and highly educated (96.7% tertiary education), with a mean age of 35.4 years (SD = 12.1). Although baseline awareness of CRC was high (88.3% had heard of the disease and 93.3% correctly identified the colon or rectum), only 61.7% had heard of CRC screening and just 10.0% had ever been screened. Among the 54 unscreened respondents, the most common barrier was absence of symptoms (64.8%), followed by lack of awareness of screening locations (18.5%) and financial constraints (14.8%).  Conclusion: These preliminary findings suggest that high general awareness of colorectal cancer does not necessarily translate into screening behaviour, even among educated, health-literate populations. The misconception that screening is only required in the presence of symptoms appears to be a major barrier. Future public health strategies should explore ways to decouple screening from symptomatology and integrate subsidised testing into routine care.