Colorectal Cancer Knowledge and Screening Awareness in Syria: A Cross-Sectional Study

Background: Colorectal cancer (CRC) ranks as the third most common cancer globally, with rising incidence in developing countries due to lifestyle and dietary shifts. CRC often presents with late-stage symptoms, leading to higher mortality. Early detection through screening significantly improves survival rates. In Syria, CRC is the second most common cancer, but screening rates remain low, especially following the decade-long war. This study aims to assess the knowledge of CRC among Syrians to guide prevention and detection strategies. Methods: A cross-sectional online survey was conducted from September 27 to October 21, 2023, across six Syrian governorates: Damascus, Homs, Aleppo, Lattakia, Hama, and Tartous. A self-administered questionnaire, distributed via social media, assessed socio-demographics, CRC knowledge, and perceptions of screening methods. A total of 772 participants completed the survey. Statistical analysis was performed using SPSS v28.0, with a Chi-square test to explore differences in knowledge based on socio-demographic factors. Results: The study included 772 participants, 42.6% of them aged 30–35 years. The majority were female (64.4%) and married (56.3%). Only 27.8% considered themselves informed about CRC. While 54.8% had heard of colonoscopy, only 15.4% had undergone the procedure. Significant knowledge gaps were identified, particularly regarding the link between adenocarcinoma polyps and CRC (29.9%), the role of diet (33.2%), and the protective effect of aspirin (17.7%). Older individuals demonstrated higher awareness levels, particularly in recognizing CRC's hereditary nature and the potential for cure. Education and economic status were also strongly associated with better CRC knowledge, and males generally exhibited higher awareness than females. Conclusion: This study reveals significant gaps in CRC knowledge among Syrians, influenced by factors such as age, gender, education, and economic status. The findings underscore the urgent need for targeted health education and accessible screening programs to improve CRC awareness and reduce its incidence and mortality in Syria. Further research should address the study's limitations, including sampling bias and the cross-sectional design, to develop more effective public health interventions.