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Impact of Colorectal Cancer Awareness on Early Screening Practices among Adults in Nigeria

Abstract

Colorectal cancer is an important public health concern and a growing cause of cancer-related morbidity and mortality worldwide, including in Nigeria. Early detection through appropriate screening can facilitate the identification of colorectal abnormalities and cancers at stages when treatment may be more effective. Colorectal cancer awareness involves knowledge of the disease, risk factors, warning signs and symptoms, family history, lifestyle-related risk factors, available screening methods, recommended screening considerations, and the importance of timely medical evaluation. Early screening practices refer to appropriate participation in colorectal cancer screening or risk assessment before the development of advanced disease, as recommended by qualified healthcare professionals. In Nigeria, limited awareness, misconceptions about colorectal cancer, fear of screening procedures, stigma, cost of healthcare, limited availability of screening services, and inadequate access to reliable cancer information may discourage adults from utilizing screening services. Improving colorectal cancer awareness may increase perceived risk, knowledge of available screening options, willingness to seek professional advice, and participation in appropriate early screening. Against this background, this study investigates the impact of colorectal cancer awareness on early screening practices among adults in Nigeria. The study is anchored on the Health Belief Model, Theory of Planned Behavior, and Knowledge-Attitude-Practice framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding adults' decisions to participate in colorectal cancer screening. The Theory of Planned Behavior proposes that attitudes, subjective norms, and perceived behavioural control influence behavioural intentions and subsequent screening practices. The Knowledge-Attitude-Practice framework provides a basis for examining how increased awareness and favourable attitudes toward early detection may influence screening practices. Collectively, these theoretical perspectives provide a suitable framework for explaining the relationship between colorectal cancer awareness and early screening practices among adults in Nigeria. The study will adopt a quantitative cross-sectional research design. Primary data will be collected from adults in selected communities and healthcare facilities in Nigeria using a structured interviewer-administered questionnaire. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, and eligible participants. Colorectal cancer awareness will be assessed using participants' knowledge of colorectal cancer risk factors, symptoms, family history, lifestyle-related risks, prevention, available screening methods, and the importance of early detection. Early screening practices will be assessed based on participants' history of discussing colorectal cancer screening with a healthcare professional, participation in appropriate screening or risk assessment where indicated, timing of screening, and follow-up of abnormal findings where applicable. Where feasible and ethically appropriate, self-reported screening information may be supported by available healthcare records. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, colorectal cancer awareness, and screening practices. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple logistic regression analysis, will be used to determine the impact of colorectal cancer awareness on early screening practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that higher levels of colorectal cancer awareness have a significant positive impact on early screening practices among adults in Nigeria. Adults with greater awareness are expected to demonstrate better knowledge of colorectal cancer risk factors and warning signs and greater willingness to discuss and utilize appropriate screening services. Increased awareness may improve perceived susceptibility and severity, reduce misconceptions and fear, and encourage timely consultation with healthcare professionals. However, awareness alone may not guarantee screening uptake because adults may continue to face barriers such as screening costs, limited availability of services, geographical distance, fear of invasive procedures, stigma, lack of trained healthcare professionals, and inadequate referral and follow-up systems. Therefore, colorectal cancer awareness programmes should be supported by accessible, affordable, confidential, and appropriately delivered screening and diagnostic services. The study is expected to contribute to the literature on colorectal cancer prevention, cancer screening, health education, early detection, adult health, and public health in Nigeria by providing empirical evidence on the impact of colorectal cancer awareness on early screening practices among adults. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, state ministries of health, hospitals, primary healthcare facilities, cancer-control programmes, gastroenterologists, medical practitioners, public health professionals, community health workers, development partners, and policymakers regarding strategies for improving colorectal cancer prevention and early detection. The study will also provide evidence-based recommendations for strengthening colorectal cancer education, integrating cancer screening awareness into routine healthcare services, expanding access to appropriate screening facilities, addressing misconceptions and stigma, improving referral and follow-up systems, and promoting informed participation in colorectal cancer screening among eligible adults across Nigeria.