Knowledge, Attitudes, and Practices Regarding Colorectal Cancer Screening Among Medical Residents: An Exploratory, Single-Center, Cross-Sectional Study from Egypt

Abstract

OBJECTIVE: Colorectal cancer (CRC) in Egypt has a high incidence of early-onset cases compared to Western countries. However, screening rates remain low, which may be attributed to a lack of physician awareness, as well as structural and logistical limitations. This study evaluated medical residents' knowledge, attitudes, and practices regarding CRC screening, their perceptions of patient barriers, and their awareness of the "100 Million Healthy Lives" national screening initiative. METHODS: A self-administered, cross-sectional survey was conducted between September 10, 2023, and January 3, 2024, at Alexandria Main University Hospital (AMUH), Egypt. The survey was administered either face-to-face or online. We assessed the face, content, and structural validity of the questionnaire used. Descriptive statistics and bivariate analyses were performed, with associations evaluated using correlation and effect sizes. A significance level of p < 0.10 was adopted, given the exploratory nature of the study. RESULTS: The study included 70 medical residents at AMUH. The majority were female (78.6%), with a mean age of 27.97 ± 1.3 years and an average of 2.6 ± 1.2 years of clinical experience. Only 55.7% were aware of the "100 Million Healthy Lives" CRC screening program. Overall, 72.9% of participants demonstrated adequate knowledge, 66.7% showed a positive attitude, and 51.4% exhibited good practice. A total of 15.7% recommended screening for asymptomatic patients "often/always," compared to 61.4% for symptomatic patients. Financial constraints (64.3%) and low patient awareness (60%) were the most frequently cited barriers. Adequate knowledge was significantly associated with a positive attitude (80.8% vs. 19.2%; p = 0.078; Phi = 0.282). CONCLUSION: Despite generally adequate knowledge, attitudes and practices regarding CRC screening among residents remain suboptimal, hindered by limited awareness of national resources and persistent structural barriers. Strengthening provider education, improving access to screening tools, and expanding awareness of national initiatives are essential to enhance early CRC detection in Egypt.