Determinants of Colorectal Cancer: Risk Factors, Knowledge, and Diagnosis in a Cross-Sectional Study of Saudi Adults

IntroductionColorectal cancer (CRC) is the second most prevalent cancer in Saudi Arabia, with a rising incidence among younger adults. Despite the known benefits of early detection and screening, public awareness and screening uptake remain limited. Understanding knowledge, attitudes, and determinants of screening and diagnosis is essential to guide public health interventions and policies.MethodsThis cross-sectional study was conducted between August 2024 and January 2025 among adults aged 18 years and older across Saudi Arabia using a validated Arabic-language self-administered questionnaire. Data were analyzed to assess CRC knowledge, screening practices, and diagnostic patterns, as well as their sociodemographic determinants.ResultsA total of 2113 participants (mean age: 34 ± 9.6 years; 74% female) completed the survey. Overall, 53% demonstrated good CRC knowledge, while screening prevalence was notably low (2%), and 2.1% reported a prior diagnosis. Higher knowledge was observed among males, participants with higher income, and those reporting frequent fiber intake. Higher BMI was associated with lower screening uptake, whereas education level and income influenced diagnosis likelihood. Age was significantly associated with both screening and diagnosis outcomes.ConclusionsThis study highlights moderate CRC knowledge and low screening participation among Saudi adults. Targeted national awareness campaigns, integration of CRC screening into primary healthcare, and digital outreach for younger populations are recommended to enhance early detection, promote preventive practices, and reduce the national CRC burden.