Assessing Awareness on the Role of Diet in Colorectal Cancer Prevention: A Pilot Study ^†

Abstract

Colorectal cancer (CRC) incidence can be reduced through various modifiable lifestyle factors, including diet and physical activity. Awareness of the risk factors for CRC can encourage individuals to follow cancer prevention recommendations and reduce their risk of developing the disease. The aim of this study was to assess the awareness of the role of diet in CRC development in Malta. The researcher specifically designed a questionnaire that was used to assess knowledge of CRC risk and awareness of dietary factors that affect CRC development. This research tool was validated through a pilot study and ethically approved. Convenience sampling was used to recruit Maltese adults from eight different public places around Malta over a period of three months. The questionnaires were distributed by the researcher, and participants filled in the questionnaire in the presence of the researcher. Data were analyzed statistically using the Chi-squared test, the Kruskal–Wallis test, and the Spearman correlation coefficient. Sample participants (n = 150) were mostly female, well-educated, and employed. Less than half (44%) of the participants were aware that CRC risk can be reduced, but when asked about the link between diet and CRC, 83% of the participants acknowledged that diet affects CRC risk. However, there was poor awareness of how specific dietary factors, including alcohol, calcium supplements, dairy products, processed meat, and fiber, may affect CRC risk. Participants performed better in closed-ended questions than in open-ended ones. They also performed well in questions that asked about sources of fiber, whole grains, and processed meat, although 47.3% of participants failed to recognize bacon as processed meat. Participants were aware that diet affects CRC development, but awareness of the association with specific food groups and nutrients was poor. Public health strategies should be targeted towards raising awareness of cancer prevention recommendations, especially in younger generations. Despite its limited sample size, this pilot study is the first to investigate awareness of this association in Malta, thus paving the way for a study looking at a representative sample of the Maltese population.