Sociodemographic and Clinical Predictors of Colonoscopy Utilization in Oman: A Call to Action within a...

Colorectal cancer (CRC) is the second leading cause of cancer mortality in Oman, yet structured screening remains absent. Most cases are diagnosed at advanced stages, highlighting the need to understand predictors of colonoscopy uptake to inform national screening strategies. This study aimed to identify sociodemographic, perceptual, and healthcare-related factors associated with colonoscopy utilization-whether for screening or diagnostic purposes among Omani adults.

A nationwide, cross-sectional online survey was conducted using a structured questionnaire adapted from the Health Information National Trends Survey (HINTS) between March and August 2023. Recruitment was carried out using non-probability convenience sampling through digital platforms (Instagram, Facebook, Twitter, WhatsApp) and health networks. Data collected included sociodemographic factors, CRC risk perceptions, awareness, and healthcare interactions. Chi-square tests and multivariate regression analysis were used to identify predictors of colonoscopy uptake.

Of the 1,060 respondents, only 137 participants (12.9%) reported ever undergoing colonoscopy; the majority (67.2%) did so due to symptoms rather than for screening. Uptake was significantly higher among men, participants aged >40 years, those who were married, and those who were employed (P < 0.05). Colonoscopy recipients were more likely to perceive themselves at higher risk for CRC and report frequent worry about the disease (P < 0.001). Multivariable analysis identified three strong predictors of colonoscopy uptake: 1. Clinical indication (presence of symptoms; OR 63.9, 95% CI: 45.6-89.1); 2. Physician recommendation (OR 9.5, 95% CI: 2.9-30.0); 3. Perception of test effectiveness [trend-level association (P = 0.054)].

Colonoscopy utilization in Oman remains low and is largely symptom-driven. Uptake was higher among men aged over 40 years, those who were married, and those who were employed, indicating that socioeconomic and life-stage factors influence engagement with colorectal health services. Physician recommendation emerged as the strongest determinant of colonoscopy uptake. These findings highlight the urgent need for a national CRC screening program that integrates the Fecal Immunochemical Test (FIT) within physician-led pathways to promote early detection and prevention.