Knowledge, attitudes, and behaviors regarding cancer screening among adults in primary care

To assess adults' knowledge, attitudes, and behaviors about cancer screening in primary care, and to evaluate short-term changes in attitudes after brief written information.

This cross-sectional study was conducted from March to June 2019 in a family medicine outpatient clinic. Adults aged 20-70 years who agreed to participate were consecutively enrolled. Data were collected using a structured face-to-face questionnaire assessing sociodemographic characteristics, cancer screening awareness, prior screening behavior, barriers, and post-brochure attitudes. Because study participation age did not necessarily correspond to screening eligibility, a post hoc binary screening-eligibility variable was created according to the study-period age/sex framework reflected in the questionnaire and source dataset. Categorical variables were analysed using Pearson's chi-square test or Fisher's exact test, as appropriate, and paired pre/post willingness responses were analysed using McNemar's exact test. Exploratory multiple binary logistic regression was performed for prior screening uptake.

A total of 247 participants were included (mean age 43.4 ± 12.7 years; 68.4% female). Overall, 40.5% were aware of cancer screening tests and 37.0% reported having previously undergone at least one screening test. However, uptake differed markedly by screening eligibility: 89/169 (52.7%) eligible participants versus 2/77 (2.6%) non-eligible participants had ever been screened. Awareness distribution differed significantly between healthcare workers and non-healthcare participants, whereas crude prior screening uptake did not differ significantly by occupation. Willingness to undergo screening increased after the brochure, indicating a short-term positive change in intention.

Awareness of cancer screening did not consistently translate into screening participation. Crude non-screening rates should not be interpreted without considering screening eligibility structure and sample composition. Brief written information may improve short-term willingness, but these findings should be interpreted as intention rather than confirmed behavioral change.