Association between health literacy and screening behavior on colorectal cancer among the adult population in sarawak, malaysia

Abstract

Introduction: Colorectal cancer screening is proven to reduce the mortality associated with colorectal cancer. However, currently, there is no well-established population-based colorectal cancer screening program in Malaysia. Objective: This study aims to determine the relationship between screening behaviour on colorectal cancer and health literacy among Sarawak’s adult population. Methods: This was a cross-sectional study done in Sarawak. Data collection was done via face-to-face interviews using a validated structured questionnaire. Descriptive analysis was done using IBM SPSS version 22.0 to describe the sociodemographic characteristics and determine the respondents’ health literacy level, colorectal cancer-related knowledge, belief, and screening behaviour. WarpPLS 7.0 stable version was performed to examine the relationship between screening behaviour on colorectal cancer and health literacy. Results: A total of 829 respondents participated in this study, with 50.5% males and 49.5% females. The mean (SD) age of the respondents was 55.78 (5.0) years. Structural path analysis revealed a non-significant relationship between health literacy and screening behaviour (p>0.05). The perceived threat has a positive effect on the screening behaviour (p<0.001), while perceived benefits and barriers did not have any impact on screening behaviour on colorectal cancer (p>0.05). Conclusion: Health literacy did not have any significant association with the screening behaviour of colorectal cancer. The perceived threats have a positive effect, while the perception of benefits and barriers did not significantly impact screening behaviour. This finding could guide the development and formulation of successful health promotion and education to adopt healthy behaviour by focusing on health belief component apart from health literacy, thus reducing the cancer disparities and ensuring health equity.