Patient perceptions and attitudes towards early onset colorectal cancer screening in Hong Kong: a cross-sectional study

Background: Early Onset Colorectal Cancer (EOCRC) is an emerging public health concern in Hong Kong, particularly among individuals aged 40 to 49. Understanding their perceptions and attitudes regarding colorectal cancer screening methods is essential for developing effective interventions to enhance participation rates. This study explores the perceptions and attitudes of Hong Kong residents concerning EOCRC screening methods, specifically faecal immunochemical testing (FIT) and colonoscopy. Method: A cross-sectional study was conducted in Hong Kong from April to June 2024, targeting residents aged 40 to 49. An anonymous survey based on the Health Belief Model (HBM) assessed participants' perceptions and attitudes toward EOCRC screening methods. Multivariable logistic regression was employed to evaluate factors associated with attitudes toward EOCRC screening. Findings: Of the 1,029 responses analysed, 785 individuals (76.29%) indicated a willingness to undergo EOCRC screening. Multivariable logistic regression revealed that married individuals (Adjusted odds ratio [AOR]: 1.414, 95% CI: 1.003-1.993, p=0.048), full-time employees (AOR: 1.720, 95% CI: 1.024-2.888, p=0.040), those from higher-income families (AOR: 1.892, 95% CI: 1.066-3.355, p=0.029), and individuals with chronic diseases (AOR: 1.627, 95% CI: 1.147-2.308, p=0.006) were more likely to participate. Conversely, individuals with poorer self-perceived health (AOR: 0.621, 95% CI: 0.434-0.889, p=0.009), lower health and psychological barriers toward FIT (AOR: 0.637, 95% CI: 0.446-0.910, p=0.013), lower self-efficacy (AOR: 0.314, 95% CI: 0.220-0.448, p<0.001), and fewer cues for action (AOR: 0.646, 95% CI: 0.457-0.913, p=0.013) were less likely to participate in EOCRC screening. Interpretation: The findings highlight the importance of targeting specific sociodemographic groups to enhance participation in EOCRC screening among Hong Kong residents aged 40 to 49. Addressing health perceptions and increasing awareness of screening benefits could further improve screening uptake in this population.