ABSTRACT AWARENESS OF COLORECTAL CANCER RISK FACTORS AMONG STUDENTS IN UDAYANA UNIVERSITY, BALI

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1 ABSTRACT AWARENESS OF COLORECTAL CANCER RISK FACTORS AMONG STUDENTS IN UDAYANA UNIVERSITY, BALI This study aimed to identify the awareness of colorectal cancer risk factors knowledge among medical undergraduates in Udayana University, Bali. Colorectal cancer has been increase significantly around the globe and also among the adults. A cross sectional study was conducted over a period of one month. In this study, 100 samples were chosen randomly from medicine faculty academic year 2013 till year The result of this study showed sample has good knowledge on his study and it was suggested education level play an important role.

2 CONTENTS Pages SAMPUL DEPAN... i SAMPUL DALAM...ii LEMBAR PERSETUJUAN... iii PENETAPAN PANITIA PENGUJI... iv PENYATAAN KEASLIAN PENELITIAN... v ABSTRACT vi ACKNOWLEDGEMENT... vii CONTENTS... viii-ix LIST OF TABLES... x LIST OF PICTURES... xi LIST OF ATTACHMENTS... xii LIST OF ABBREVIATIONS... xiii TABLE OF CONTENTS CHAPTER 1 INTRODUCTION 1.1 Background of the problem Problem identification Purpose of study Objective CHAPTER 2 LITERATURE REVIEW 2.1 Epidemiology Anatomy Risk Factors Sign and Symptoms Screening Staging Treatment Conclusion 27 CHAPTER 3 CONCEPTUAL FRAMEWORK 3.1 Concept. 28 CHAPTER 4 METHOD OF RESEARCH 4.1 Design of study Location and duration of study Location of study.29

3 4.2.2 Duration of study Population and sample Variable of population Criteria of sample Size of sample Method of sampling for study Research variable Operational Definition Things and instruments for study Analysis Data...32 CHAPTER 5 RESULT 5.1 Demographic Data Knowledge of Colorectal Cancer Risk Factor Among Students Understanding of Colorectal Cancer Screening and Prevention CHAPTER 6 DISCUSSION AND CONCLUSION 6.1 Discussion Conclusion...38 Reference Attachment

4 CHAPTER I INTRODUCTION 1.1Background of the problem Colorectal cancer is a major cause of morbidity and mortality throughout the world. Colorectal cancer cause approximately around 9% of all cancer incidence. It is the third most cancer worldwide and fourth most common cancer death 1. The mortality rate of colorectal cancer is higher in men compared to women throughout the world and also in South East Asia countries including Indonesia 2. Colorectal cancer is a cancer that starts either in the colon or the rectum or both in some cases. These cancer depending origin of the cancer. Colorectal cancer starts as a result of growth of cells on the inner lining of the colon or rectum also known as polyp 3. Colorectal cancer also can spread to distant organs and mainly attacks liver. Colorectal can be caused by either modifiable factor or nonmodifiable factors. Modifiable factors are more related an individual s living style and habits. These includes smoking, diet, heavy alcohol consumption and also inactive or unhealthy lifestyle. The non-modifiable risk factors are more related to family history or disease and also personal disease. The risk of colorectal cancer can be lessen if a person s habit is changed 4.Coorectal cancer symptoms are only recognized after the cancer cells or polyps has developed. The common symptoms often recognized are blood in stool. Other symptoms also may present such as change of bowel habit and also constant abdominal pain. Present of blood in stool can also other disease such as inflammatory bowel disease 5. To identify presence of colorectal cancer, few screening that are recommended can be carried out. Screening is an important process in every disease including colorectal cancer 3. Regular screening can prevent many cases of colorectal cancer and also find and remove polyps before turn into cancerous cells 1. Screening can be divided into two which are test to find both colorectal polyps and cancer and another test mainly to identify

5 colorectal cancer 6. Flexible sigmoidoscopy, colonoscopy and computed tomographic colonography are test that used to identify both polyp and cancerous cells. Meanwhile tests that find colorectal cancer are guaiacbased fecal occult blood test (gfobt), fecal immunochemical test (FIT) and stool DNA test 4. Once colorectal cancer or polyps presence has been confirmed, it is best to remove the cancerous as fast as possible. Treatment for both colon and rectal will be different because of the anatomical structure. Surgery is the main treatment for both early colon and rectal cancer. Surgery treatment can further divided into colectomy, lymphadenectomy and metastasectomy 3.another treatment choice for colorectal cancer are ablation. Ablation is a treatment that done to destroys small tumors with little harm to nearby tissue. These are most used to treat cancer that has spread to liver and distant organs. Radiation therapy also can be used. Radiation therapy is a treatment that uses high energy rays. The rays can cause damage to DNA cells. DNA is a chain of chemicals in cells that contain genes. This treatment either will kill the cancer cells or stop the cancer cells from being made 7. Chemotherapy or widely known as chemo is the use of drugs to fight cancer is the main choice of treatment in cancer treatment. The drugs may be assessed into a vein or given by mouth. These drugs will travel through the and easily reach the target cells. This treatment is useful for cancer that has spread to distant organs. Chemotherapy also can be used both before and after surgery. Not to forget the side effect, all this treatment has their own respective side effects 5. Staging of colorectal cancer has been assessed to aid in fighting and making treatment of colorectal easier. Cancer staging is a rating of how far the cancer has grown and spread in body. The staging of colorectal cancer are based on TNM system. The TNM is based on 3 key pieces of information, which are T(tumor), N (nodes) and M(metastasized) Colorectal cancer can spread over the body, but most common sites are liver and lungs 1.

6 Once TNM categories have been determined, this information will be combined in a process called stage grouping and an overall stage of 0, I, II, III and IV is assigned PROBLEM IDENTIFICATION Research has always been carried out regarding colorectal cancer. Physicians are wondering whether the community aware about colorectal cancer. Based on such speculation, the following problem is advanced for research: Is students aware about colorectal cancer risk factors. 1.3 PURPOSE OF STUDY 1. To evaluate the awareness of colorectal cancer risk factors among student. 2. To evaluate assertiveness of students towards colorectal cancer. 3. To study the exposure of colorectal cancer basic facts on students. 1.4 OBJECTIVES 1. Assess the understanding of colorectal cancer risk factors among undergraduates. 2. Determine the assertiveness of students towards colorectal cancer. 3. Recognize student s source information on colorectal cancer risk factors.

Colorectal Cancer: Preventable, Beatable, Treatable. American Cancer Society

Colorectal Cancer: Preventable, Beatable, Treatable American Cancer Society Reviewed/Revised May 2018 What we ll be talking about How common is colorectal cancer? What is colorectal cancer? What causes