Public knowledge, attitudes, and barriers to cancer screening in the UAE: a comprehensive assessment to inform screening practices.

Background and objectives: Despite the proven benefits of early cancer detection in reducing disease-related complications and deaths, participation in cancer screening programs varies across population and is influenced by multiple individual and systemic-level factors. Understanding knowledge, attitudes and practices regarding cancer screening is essential to inform effective public health strategies, Therefore, this study aimed to assess these factors among adults in the UAE. Methods: A cross-sectional study was conducted using a bilingual (English/Arabic), self-administered online questionnaire distributed via social media. The survey collected data on socio-demographic characteristics, lifestyle-related risk factors, and cancer screening practices. Cancer knowledge was assessed using 59 items covering general knowledge, screenable cancers, warning signs and symptoms, and environmental risk factors. Attitudes perceived facilitators and barriers to screening were measured using a 5-point Likert scale. Screening behavior was assessed as self-reported lifetime ("ever") participation in any cancer screening test. Binary logistic regression analysis was performed to identify factors associated with screening practices. Results: A total of 811 individuals completed the study questionnaire, of whom only 36.5% reported having ever undergone any cancer screening test. Higher knowledge (OR = 1.022; 95% CI: 1.007-1.037) and more positive attitudes (OR = 1.091; 95% CI: 1.062-1.120) were associated with increased screening uptake. Older age (OR = 0.970; 95% CI: 0.955-0.985) and lower income (OR = 0.689; 95% CI: 0.483-0.982) were associated with a reduced likelihood of screening. Physician recommendation (47.0%) and early detection (45.3%) were the main motivators, while fear of results (39.5%), lack of symptoms (38.6%), and unfamiliarity with screening sites (38.5%) were the most common barriers. Conclusion: The findings demonstrate moderate cancer knowledge, variable screening attitudes, and multiple behavioral and system-level barriers. Knowledge, attitudes, age, and income, were significantly associated with lifetime screening participation, while physician recommendation and early detection emerged as key motivators. Targeted educational interventions and improved healthcare system navigation may enhance screening uptake in similar populations. However, findings should be interpreted with caution due to cross-sectional design, convenience sampling, reliance on self-reported lifetime screening, and the relatively young age distribution, which may limit causal inference and generalizability.