Knowledge, Attitudes, and Perceptions of the Physician's Role in Colorectal Cancer Screening Among Primary Care Patients in Msaken, Tunisia, 2026.

Abstract

Introduction: Colorectal cancer (CRC) is a major public health concern worldwide and an emerging health issue in Tunisia. Early screening is critical for prevention and early diagnosis. Our study aimed to assess knowledge, attitudes, and behaviors related to CRC screening among primary care patients and to examine factors associated with screening acceptance, including the perceived role of physicians, as well as the barriers to discussing CRC.

Methods: We conducted a cross-sectional study among adults consulting primary health care centers in Msaken, Tunisia, in January 2026. Data were collected by using a validated, structured questionnaire that assessed sociodemographic characteristics, knowledge of CRC and screening methods, sources of information, physician-patient communication, attitudes toward screening, and perceived barriers. Associations were analyzed by using univariate and multivariate logistic regression.

Results: The study sample consisted of 701 participants. Among them, 72.0% had heard of CRC, but only 5.8% correctly identified the recommended age for screening. Almost one-third (32.8%) reported awareness of the hemoccult test, and 64.6% expressed willingness to undergo the test if it was free. We identified several independently associated factors with acceptance of a hemoccult test, including prior awareness of CRC (odds ratio [OR] = 2.18; P < .001), family history of CRC (OR = 2.00; P < .001), exposure to medical internet sources (OR = 2.06; P < .001), and prior discussion with a physician (OR = 2.46; P < .001).

Conclusion: Although patient attitudes were generally positive, we found notable gaps in knowledge and screening practices. The strongest determinant of screening acceptance was doctor-patient communication, which shows the importance of the role primary care physicians in CRC prevention.