Document Type : Original Article


1 Departments of Health Education and Promotion

2 Biostatistics and Epidemiology, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran


Background: Colorectal cancer is one of the most important and most common cancers and the
second leading cause of cancer deaths worldwide.Every year, nearly 1million new cases of colorectal
cancer are recognized around the world and nearly half of them lose their lives due to the disease.The
statistics reveal shocking incidence and mortality from colorectal cancer, therefore secondary
prevention of this cancer is important and research has shown that by early diagnosis 90% of patients
can be treated.Among the colorectal cancer screening tests, fecal occult blood test(FOBT)takes the
priority because of its convenience and also low cost. But due to various reasons, the participation of
people in this screening test is low. The goal of this study is to assess the factors that affect participation
of population at average risk in colorectal cancer screening programs, based on health belief model
structures. Materials and Methods: A cross‑sectional survey of 196 individuals, more than 50 years
old, was conducted in Isfahan. Ninety‑eight people of the target group were selected from laboratories
while they came there for doing FOBT test; the method of sampling in this group was random sampling.
The method of data collection in the other 98 individuals was by home interview and they were selected
by cluster sampling. The questionnaire used was based on health belief model to assess the factors
associated with performing FOBT. The data collected were analyzed using descriptive and inferential
statistical methods. Results: The mean score of knowledge in the first group was 48/5 ± 11/7 and in
the second group was 36/5 ± 19/3. Individuals in the first group were more likely to be married, had
more years of schooling, and better financial status. There were significant relationships between
knowledge (P<0.001), perceived susceptibility (P<0.001), perceived severity (P<0.001), perceived
barriers (P<0.001), and self‑efficacy (P<0.001) in the two groups. There was no significant association
between the perceived benefits in the two groups. Those people who have had FOBT test in last
year in each group reported better score of Health Belief Model model structures. Conclusion:
According to this study, it seems that there is an urgent need to pay more attention to this disease
and its prevention through screening. With a better understanding of factors affecting the test, it can
be a useful step to reduce the rate of death and costs, and improve the community health outcomes.


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