University Students in the Middle East Show Alarming Gaps in Colorectal Cancer Knowledge

Colorectal cancer is one of the most common and most preventable malignancies in the world, yet a new multicountry survey suggests that many young adults across the Middle East know remarkably little about how to detect it early. A cross-sectional study published in BMC Public Health assessed colorectal cancer awareness among university students in Jordan, Egypt, and Saudi Arabia, and found only moderate knowledge overall, with a striking blind spot around screening. Nearly half of the more than one thousand students surveyed had never even heard of cancer screening tests, despite the fact that most believed the disease is preventable. The findings, researchers say, point to a missed opportunity to embed cancer literacy early, long before the age at which screening typically begins.

The research team, led by Khulud Ahmad Rezq of the University of Tabuk in Saudi Arabia together with colleagues from nursing faculties in Jordan and Egypt, recruited participants through an online questionnaire distributed on social media platforms between February 2023 and February 2024. Eligible respondents were university students aged 18 or older residing in one of the three countries who had never been diagnosed with colorectal cancer. The investigators calculated a required sample size of 366 participants, but the final dataset was far larger: 1,031 students completed the survey. Data were analyzed using Jamovi, an open-source statistical platform, with awareness measured on a scale ranging from 0 to 33.

The demographic profile of the sample is important for interpreting the results. Most respondents were between 18 and 21 years old, 71.3 percent were female, and a substantial majority, 80.7 percent, were medical students. That skew matters because students training in health sciences would be expected to know more about cancer prevention than their peers in other disciplines. Even so, the median awareness score across the entire sample was 19, with an interquartile range of 14 to 24 on the 33-point scale, a level the authors characterize as moderate rather than strong. If future healthcare workers are only moderately informed, the researchers suggest, awareness among the general student population may be considerably lower.

The single most alarming statistic concerns screening. Colorectal cancer is unusual among cancers in that screening can detect precancerous polyps and remove them before they ever become malignant, which is why stool-based tests and colonoscopy programs have driven falling incidence rates in countries with organized screening. Yet 46.3 percent of the students surveyed reported that they had not heard of cancer screening tests at all. At the same time, 61 percent believed colorectal cancer is preventable. The combination reveals a conceptual gap: young adults accept the principle of prevention but lack knowledge of the concrete tools, from fecal occult blood testing to colonoscopy, that make prevention and early detection possible in practice.

Statistical analysis showed that awareness was not distributed evenly across the sample. Age, education level, nationality, and being a medical student all significantly influenced awareness scores. Older students and those further along in their education tended to know more, and medical students outperformed their non-medical peers, as expected. Differences between the three countries also emerged, suggesting that national curricula, public health campaigns, and healthcare system characteristics may shape how much young people absorb about colorectal cancer even before they enter university. The authors caution, however, that the convenience sampling approach limits how far these comparisons can be generalized to each country’s broader student population.

Perhaps the most actionable finding concerns where students get their information. Social media was the dominant source, cited by 67.1 percent of respondents, followed by doctors and nurses at 43.5 percent. That hierarchy carries a double message. On one hand, it confirms that platforms like Instagram, TikTok, and Facebook have become the primary health information channels for this generation, for better and for worse, since misinformation circulates as freely as accurate content. On the other hand, it identifies healthcare professionals as a trusted secondary source whose preventive messaging could be amplified. The authors argue that educational interventions delivered through universities, healthcare professionals, and social media together may be the most effective way to raise awareness and encourage early detection practices.

The study’s methodology deserves scrutiny when weighing its conclusions. As a descriptive cross-sectional survey using convenience sampling, it captures a snapshot of a self-selected group rather than a nationally representative sample. Online recruitment through social media naturally favors students who are already active on those platforms, and the overwhelming proportion of medical students means the aggregate scores likely overestimate awareness among young adults in general. The authors explicitly ask readers to interpret the findings with caution for these reasons. Still, the sample size of 1,031 far exceeds the minimum requirement of 366, lending statistical weight to the observed patterns, and the multicountry design offers a regional perspective that single-nation surveys cannot provide.

The ethical scaffolding of the research was thorough. The study was conducted in accordance with the Declaration of Helsinki and approved by three separate ethics bodies: the Local Research Ethics Committee of the University of Tabuk in Saudi Arabia, the Scientific Research Committee of the Faculty of Nursing at Applied Science Private University in Jordan, and the Research Ethics Committee of the Faculty of Nursing at Suez Canal University in Egypt. All participants gave informed consent, were told participation was voluntary with the right to withdraw at any time, and were assured of anonymity and privacy protection. The work was funded by the Princess Nourah bint Abdulrahman University Researchers Supporting Project in Riyadh, and the authors declare no competing interests.

Why does awareness among university students matter for a cancer that typically strikes decades later? The answer lies in the trajectory of the disease and the shifting epidemiology of the region. Colorectal cancer incidence has been rising in many middle-income countries as diets shift toward processed foods and red meat, physical activity declines, and obesity rates climb, and several nations in the Middle East have reported diagnoses at younger ages than the historical norm. Lifestyle habits that influence colorectal cancer risk, including diet, exercise, smoking, and alcohol consumption, are largely established during young adulthood. Students who understand that these behaviors modulate their future risk, and that screening exists and works, are better positioned both to protect themselves and to carry accurate health information into their families and communities.

The study’s authors frame their results as a call to action for universities and public health authorities across the region. Embedding cancer awareness modules into general education curricula, not only medical programs, would reach the roughly one in five students in this sample who were not studying health sciences. Training physicians and nurses to discuss screening proactively with young patients and their families could leverage the trust reflected in the survey data. And because two thirds of students already turn to social media for health information, health agencies have a ready-made channel for campaigns, provided the content is accurate, engaging, and designed to counter the misinformation that inevitably shares the same feeds. The research, published open access under a Creative Commons license, was received in February 2026, accepted that October, and published on 19 October 2026, with the authors noting that the early-view version is citable and carries a permanent DOI pending final editorial edits.

Subject of Research: Colorectal cancer awareness levels among university students in Jordan, Egypt, and Saudi Arabia

Article Title: Colorectal cancer awareness among university students in Jordan, Egypt, and Saudi Arabia: a multicountry cross-sectional study

Article References: Rezq, K. A., Momani, A., Oleimat, B., Almegewly, W. H., & Gaballah, S. (2026). Colorectal cancer awareness among university students in Jordan, Egypt, and Saudi Arabia: a multicountry cross-sectional study. BMC Public Health. https://doi.org/10.1186/s12889-026-29986-3

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29986-3

Keywords: colorectal cancer, cancer awareness, cancer screening, university students, Jordan, Egypt, Saudi Arabia, cross-sectional study, public health, health education, social media, early detection