Background:In Türkiye,a total of 129,672 cancer-related deaths were recorded in 2022. The leading causes of cancer-related mortality were lung cancer(29.7%), followed by colorectal cancer(9.0%) and gastric cancer(8.1%).Gastric cancer(GC) and colorectal cancer(CRC) are among the major causes of cancer-related mortality in Türkiye.

Objectives:The aim of this study was to evaluate knowledge, attitudes, and perceptions regarding cancer screening among first-degree relatives of patients who underwent surgery for gastric or colorectal cancer and who are considered to be at higher risk than the general population in terms of environmental and genetic risk factors.

Methods:This descriptive cross-sectional study included relatives of patients who underwent surgery for gastric or colorectal cancer at Bezmialem Vak?f University Hospital between 2020-2024.Patient records were retrospectively reviewed from the hospital database.A total of 170 patient relatives who m were included.Data were collected using a 100-item questionnaire comprising a sociodemographic and cancer screening knowledge form, the Attitudes Toward Cancer Screenings Scale and the Cancer Screening Perception Scale.Questionnaires were administered by telephone or face-to-face at the General Surgery Clinic.Statistical analyses were performed,p<0.05 was considered statistically significant.

Results:Of the participants,29.4%(n=50) were first-degree relatives of patients operated on for GC and 70.6%(n=120) for CRC. The mean age was 46.6±10.6 years;50.6% were male, 75.9%were married, and 37.6%had a university-level education. Women demonstrated significantly higher knowledge regarding the National Cancer Screening Program(NCSP) than men, including awareness of Cancer Screening Center, perceived knowledge of screening,identification of screened cancer types,knowledge of screening ages and intervals, and familiarity with mammography and smear tests(allp<0.05). Women also had higher median perceived benefit and attitude scores toward cancer screening(p=0.023;p=0.007). Married participants had higher cue-to-action scores than single participants(p=0.045). Lower education and income levels were associated with higher perceived barriers(p<0.05);while higher education was associated with more positive screening attitudes(p=0.002).Participants not providing care for the operated patient had lower perceived severity scores(p<0.001).Relatives of CRC patients had higher perceived benefit and attitude scores than those of GC patients(p=0.028;p<0.001), with no differences in other perception domains.In our study, 84%of participants reported insufficient knowledge about cancer screening, while 51.2%had previously undergone at least one screening.Only 36.7%of relatives of patients operated on for CRC had undergone CRC screening. When screening participation was compared between relatives of gastric and colorectal cancer patients, no significant differences were found for breast or colorectal cancer screening(p=0.637;p=0.063);however, cervical cancer screening participation was significantly higher in the CRC group(p=0.002).

Conclusions:Female relatives demonstrated higher knowledge levels, perceived benefits, and more positive attitudes toward cancer screening than male relatives, likely reflecting the earlier implementation of breast and cervical cancer screening within the NCSP.Marriage, higher education and income, and caregiving were positively associated with screening perceptions and attitudes.Relatives of patients operated on for CRC showed more favorable screening-related perceptions and attitudes than those of GC patients, with significantly higher participation observed only for cervical cancer screening.Importantly, insufficient screening participation even among individuals with a family history of CRC underscores the need for targeted and effective strategies to improve screening awareness and knowledge, highlighting a critical screening gap in this high-risk population and supporting prevention-oriented screening interventions.