Women’s Awareness of Colon Cancer Screening in Real-world Clinical Setting in Nagasaki, Japan: a descriptive cross-sectional study

Background: Colorectal cancer (CRC) is a global health concern and the first cause of cancer-related mortalities among women in Japan. Despite the effectiveness of fecal immunochemical tests (FITs), screening rates for colorectal cancer in Nagasaki, Japan remain suboptimal. Investigating the determinants of CRC screening rates and awareness among women in Nagasaki may improve screening. Methods: This study included female patients with CRC knowledge and screening questionnaires at facilities conducting colonoscopy in Nagasaki Prefecture, Japan. Participants were categorized into three age groups: young (20s-30s), middle-aged (40s-60s), and older (over 70 years), and two areas (Urban and Rural). Descriptive statistics were used for analysis. Results: Of 107 facilities surveyed, 72 responded. The analysis was conducted on 1210 cases after excluding 52 incomplete responses. Overall, 83% of those qualified for screening were over the age of 40 years. Moreover, 92% of respondents were from urban areas and 5% from rural areas. Although the awareness on FITs was 83%, only 48% underwent FITs within 2 years. Knowledge on CRC (regarding the existence of asymptomatic CRC and importance of early detection) was approximately 40%. Regarding the second screening, 36% of patients opted for another FITs. Gender preference for colonoscopy was observed at 24%, and common concerns about colonoscopy were “pain,” “laxatives,” and “embarrassment.” Conclusions: In Nagasaki Prefecture, knowledge on CRC and second colonoscopy screening remains low. It is crucial to disseminate accurate information about CRC, its screening, and address patients' concerns regarding colonoscopy screening. Trial registration : The study protocol was approved by the Ethics Committee of Nagasaki University Graduate School of Biomedical Sciences (approval number: 2412602, approval date: 8, February 2024).