Comfort Asante, MBChB1, Imelda K. Moise, PhD2, Jackson Chipaila, MBChB, PhD3, Lucky Banda, MBChB4, Ethan F. Pearlstein, MD5, Whitney Mutalemwa, 6, Abbas Rupawala, MD5, Seke M. Kazuma, Bsc HB, MBCHB, MMED (UNZA); FCS (ECSA); FZCMS (ZAVOMS); FACS1, Akwi W. Asombang, MD, MPH5 1Ndola Teaching Hospital, Ndola, Copperbelt, Zambia; 2University of Miami, Miami, FL; 3Levy Mwanawasa University Teaching Hospital, Lusaka, Lusaka, Zambia; 4Ndola Teaching Hospital, Kafue, Copperbelt, Zambia; 5Warren Alpert Medical School of Brown University, Providence, RI; 6Smith College, Northampton, MA
Introduction: Colorectal cancer (CRC) is a global public health problem that requires early diagnosis and management to decrease mortality and morbidity. Yet, despite the existence of international CRC screening guidelines and recommendations, CRC screening is rarely practiced in most African countries and Zambia is no exception. We conducted a survey to understand the knowledge, attitudes, and practices about colorectal cancer screening among medical doctors in Zambia and assessed treatment referral patterns.
Methods: A multi-institutional cross-sectional study of all registered medical doctors working in Zambia using a self-administered online structured survey was carried out. The survey comprised of 23 standardized qualitative and quantitative questions. Descriptive analysis was used to describe frequencies of the variables; chi square analysis was used to determine associations between knowledge, attitudes and practices and multiple logistic regression was used to describe associations between knowledge of CRC screening and referral patterns. Statistical significance was evaluated at P <0.05.
Results: Out of 243 medical doctors, 147 medical doctors completed the survey giving us a response rate of 61%. Of the respondents 93 (63.3%) were male, with mean years in clinical practice of 3 years (± 3.4 years). Most see about 60 patients per day. One-third (n=50, 34%) of respondents had good knowledge on the appropriate age of initiation of CRC screening, while almost all (n=138, 95.2%) had poor knowledge on the screening modalities of CRC. Three-fifths (n=84, 60%) exhibited poor attitudes towards CRC, while more than half (n=86, 58.5%) report having referred patients for some form of CRC treatment in past year. There was no association between the knowledge and attitude towards screening (p= 0.948) or knowledge of CRC screening practices (p= 0.414) and referral patterns (p=0.433). Provider factors associated with CRC screening include a reduced clinic patient volume (p= 0.0176), and patient factors include family history of ulcerative colitis (p= 0.0151), having at least one first degree relative with CRC younger than 50 (p=0.0542), and knowledge that screening impacts management (p= 0.0571).
Discussion: The poor colorectal cancer screening knowledge and attitudes among medical doctors in Zambia suggests a need for studies that explore the magnitude of association between knowledge and practices to help establish national screening guidelines.
Disclosures: Comfort Asante indicated no relevant financial relationships. Imelda Moise indicated no relevant financial relationships. Jackson Chipaila indicated no relevant financial relationships. Lucky Banda indicated no relevant financial relationships. Ethan Pearlstein indicated no relevant financial relationships. Whitney Mutalemwa indicated no relevant financial relationships. Abbas Rupawala indicated no relevant financial relationships. Seke Kazuma indicated no relevant financial relationships. Akwi Asombang indicated no relevant financial relationships.
Comfort Asante, MBChB1, Imelda K. Moise, PhD2, Jackson Chipaila, MBChB, PhD3, Lucky Banda, MBChB4, Ethan F. Pearlstein, MD5, Whitney Mutalemwa, 6, Abbas Rupawala, MD5, Seke M. Kazuma, Bsc HB, MBCHB, MMED (UNZA); FCS (ECSA); FZCMS (ZAVOMS); FACS1, Akwi W. Asombang, MD, MPH5. P2360 - Colorectal Cancer Screening in Zambia, Southern Africa: A Nationwide Survey on Knowledge, Attitudes, and Practices (KAP) Amongst Medical Doctors, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.