Association between health literacy and colorectal cancer screening behaviors in adults in Northwestern Turkey

Background: In this study, aimed to determine the frequency of participation in colorectal cancer (CRC) screenings, the factors affecting participation and the association between CRC screening behaviors and health literacy (HL). Methods: This community-based cross-sectional study was carried out with 408 people residing in Kirklareli, a province in Northwestern Turkey, between August and November 2019. Results: CRC screenings participation prevalence was 21.1%. Of them, 17.2% participated in fecal occult blood tests (FOBT) screenings, 7.6% participated in colonoscopy screenings, and 86.5% had inadequate or limited-problematic HL. According to the multivariate logistic regression analysis, the likelihood of not participating in CRC screenings was high in the participants who worked at a paid job (OR: 3.001, 95% CI: 1.018-8.850), who did not do any physical activity regularly (OR: 2.516, 95% CI: 1.251-5.060), who were not aware of the presence of an early diagnosis test for CRC (OR: 32.613, 95% CI: 13.338-79.742), who did not have a person having had CRC screening in their immediate environment (OR: 3.562, 95% CI: 1.752-7.240) and who had sufficient or excellent HL (OR: 3.324, 95% CI: 1.128-9.796). According to adjusted for some characteristics, there was no significant association between participation in CRC screenings and THLS-sub-dimensions and THLS-processes (P>0.05). Conclusions: Participation in CRC screenings was low, and those with a high HL level were more likely not to participate in CRC screenings. Working status, knowledge and awareness levels affected the participation to CRC screenings. To encourage people to participate in screenings and to improve their HL, awareness-raising attempts for target groups should be increased