• Amrizal Muhammad Nur Department of Health Policy and Management, College of Public Health, Kuwait University, Shadadiya, Kuwait
  • Eleni L Tolma Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
  • Syed Mohamed Aljunid Department of Public Health and Community Medicine, International Medical University, Kuala Lumpur, Malaysia
  • Joseph C Longenecker Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, USA
  • Dina Zein Department of Health Policy and Management, College of Public Health, Kuwait University, Shadadiya, Kuwait
  • Mahmoud Annaka Department of International Health Relations, Kuwait Ministry of Health, Kuwait
  • Rihab AlWotayan Department of International Health Relations, Kuwait Ministry of Health, Kuwait
  • Amany ElBasmi Kuwait Cancer Control Center, Kuwait Ministry of Health, Kuwait


Colorectal cancer screening, Primary Care Physicians, Colonoscopy, Arab World, Kuwait


Colorectal cancer (CRC) poses a significant public health challenge in Kuwait, ranking as the second most common cancer. Despite its prevalence, Kuwait lacks established CRC screening guidelines, and public awareness remains low. The study, conducted as a cross-sectional survey in 2017, aimed to assess Primary Care Physicians' (PCPs') practices, attitudes, and perceived barriers to CRC screening. It involved 564 PCPs from Kuwaiti governmental primary care facilities who completed 14-page self-administered questionnaires. The response rate was 45%, with most respondents were female (52%), non-Kuwaitis (90%), and registrars (62.7%), with an average age of 43.3 years. All PCPs endorsed CRC screening, with colonoscopy (88%) and fecal occult blood tests (FOBT) (52%) being the preferred methods. Around 44% recommended both tests in the past year. Most PCPs (92%) had positive attitudes toward CRC screening effectiveness and claimed to have adequate time for patient discussions, despite citing patient non-compliance as an issue. PCPs noted encountering health system-related barriers. Female PCPs were more likely to recommend FOBT and colonoscopy screenings compared to males [OR: 2.1, CI (1.2-3.7), p=0.011], and PCPs from specific governorates were less inclined to order screenings compared to others [OR: 0.5, CI (0.3-0.9), p=0.028]. Public primary health clinic PCPs predominantly endorsed colonoscopy and FOBT. Further investigation is needed to understand why certain subgroups are less likely to refer patients for CRC screening. These findings emphasize the importance of promoting shared decision-making and addressing healthcare-related barriers to CRC screening in Kuwait.


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How to Cite

Nur, A. M., Tolma, E. L., Aljunid, S. M., Longenecker, J. C., Zein, D., Annaka, M., … ElBasmi, A. (2024). PRACTICES, ATTITUDES AND PERCEIVED BARRIERS IN COLORECTAL CANCER SCREENING AMONG PRIMARY CARE PHYSICIANS IN KUWAIT: INSIGHTS FROM A CROSS SECTIONAL STUDY. Malaysian Journal of Public Health Medicine, 24(1), 268–279. Retrieved from