Alarm symptoms, risk factors for digestive tract cancer and readiness to participate in an endoscopic screening program

Introduction: There are no data available on the prevalence of digestive tract alarm symptoms or reflecting the readiness of the Polish population to undergo endoscopic screening for colorectal and other gastrointestinal cancers.

Aim: To determine the prevalence of alarm symptoms, readiness levels to undergo endoscopic screening for cancer and to identify decision-making factors.

Material and methods: Demographic and anthropometric data, alarm symptoms, nutritional habits, alcohol use, smoking, concomitant diseases and a family history of cancer were studied in an interview in a random sample from a middle-sized city.

Results: A total of 850 people were interviewed between 2002 and 2009. Alarm symptoms (weight loss > 10 kg, abdominal pain waking the patient up at night, persistent vomiting, dysphagia, blood in stool, constipation < 12 months, diarrhea > 1 month, anemia) were present in 15% of participants. Fifty-two percent of those with alarm symptoms had not been diagnosed before the survey, 38% had never had and still refused diagnostic endoscopic procedures. Less than 20% of all respondents declared their willingness to be screened. Readiness was significantly higher in males, diabetics, respondents with previous endoscopy and those with a family history of neoplasm, and it increased with the level of education. Smokers more often refused screening procedures. There was no significant increase in readiness for screening over the period studied.

Conclusions: Considering how small a proportion of respondents declared themselves ready for endoscopic cancer screening, even those at increased risk, more efforts should be made to raise public awareness about the importance of early detection screening.