Awareness of Colorectal Cancer: Recognition of Symptoms and Risk Factors by Socio-demographic Characteristics

Background: Early recognition of symptoms of colorectal cancer enables prompt help-seeking and timely diagnosis that may save lives. We aimed to assess public awareness of symptoms of colorectal cancer, anticipated delay to help-seeking in relation to these symptoms, and knowledge of risk factors and most common types of cancer in the English population.

Methods: Cross-sectional surveys (n = 38,630), using the first validated measure of public cancer awareness—the Cancer Research UK Cancer Awareness Measure (CAM), were carried out in England during 2009/11. We examined the association of cancer symptom awareness, knowledge of risk factors for colorectal cancer and anticipated time to help-seeking with age, gender, marital status, educational attainment and socio-economic position. Data were analysed using Kruskal-Wallis tests and logistic regression models.

Results: Knowledge that colorectal cancer is the third most common type of cancer in men and women was poor, as only about 10% of participants were aware of this fact. Almost half of participants could not recall any symptom of (46%) or any risk factor (44%) for colorectal cancer. Participants who least frequently recalled and recognised the four cancer symptoms were men, the youngest, the socio-economically deprived, unemployed and single participants. Over a third of participants reported that they would delay help-seeking for more than 2 weeks for “unexplained weight loss” (38%), but only 5% reported this for “unexplained bleeding”. The elderly, the underprivileged and participants without a degree least frequently recognised risk factors, especially “eating red or processed meat each day” and “eating less than 5 of fruit and vegetables a day”.

Conclusions: Future campaigns should focus on increasing awareness about symptoms and risk factors of colorectal cancer, and ensuring that people know how common this cancer is. Further efforts are needed to encourage early presentation, particularly among population sub-groups with low cancer awareness.