Tailoring colorectal cancer screening: Knowledge, CRC screening acceptability, and practices among Jordanian and refugee populations.

BACKGROUND: Colorectal cancer (CRC) is the second most prevalent cancer in Jordan and a leading cause of cancer-related mortality. Early detection through screening campaigns significantly improves survival. However, Jordan lacks a national screening program, and disparities in access persist, particularly among the refugee population. The aim of this study was to evaluate knowledge, attitudes, and practices (KAP) regarding CRC and CRC screening among Jordanian and Syrian refugee populations in Mafraq governorate and to determine the factors associated. METHODS: A cross-sectional survey was conducted between May and July 2024 to a sample of 897 individuals aged above 50 years old. Data were collected using a structured, interviewer-administered questionnaire. RESULTS: The findings revealed a limited level of CRC awareness overall, with a median knowledge score of 7 out of 32. Refugees showed a higher level of awareness regarding lifestyle-related risks, and lower awareness of CRC symptoms and screening methods. Both groups expressed high CRC screening acceptability, with refugees demonstrating higher willingness to participate if invited by the Ministry of Health. The screening facilitators identified included free treatment, dissemination of information by healthcare professionals, and accessibility of services. Preventive practices were moderate, though refugees reported lower physical activity, reduced fruit and vegetable intake, and greater economic constraints. Multivariate analysis identified urban residence and higher education as predictors of better CRC knowledge. Rural residence and the type of occupation were associated with healthy habits, while the age, being female, higher education and having a health insurance were associated with better health-seeking behaviors. CONCLUSION: These findings underscore the need for culturally adapted, equity-focused CRC education and screening initiatives in Jordan, taking into account the refugee populations.