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Alanzi TM, Alzahrani W, Albalawi NS, Allahyani T, Alghamdi A, Al-Zahrani H, Almutairi A, Alzahrani H, Almulhem L, Alanzi N, Al Moarfeg A, Farhah N. Public Awareness of Obesity as a Risk Factor for Cancer in Central Saudi Arabia: Feasibility of ChatGPT as an Educational Intervention. Cureus 2023; 15:e50781. [PMID: 38239542 PMCID: PMC10795720 DOI: 10.7759/cureus.50781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND While the link between obesity and chronic diseases such as diabetes and cardiovascular disorders is well-documented, there is a growing body of evidence connecting obesity with an increased risk of cancer. However, public awareness of this connection remains limited. STUDY PURPOSE To analyze public awareness of overweight/obesity as a risk factor for cancer and analyze public perceptions on the feasibility of ChatGPT, an artificial intelligence-based conversational agent, as an educational intervention tool. METHODS A mixed-methods approach including deductive quantitative cross-sectional approach to draw precise conclusions based on empirical evidence on public awareness of the link between obesity and cancer; and inductive qualitative approach to interpret public perceptions on using ChatGPT for creating awareness of obesity, cancer and its risk factors was used in this study. Participants included adult residents in Saudi Arabia. A total of 486 individuals and 21 individuals were included in the survey and semi-structured interviews respectively. RESULTS About 65% of the participants are not completely aware of cancer and its risk factors. Significant differences in awareness were observed concerning age groups (p < .0001), socio-economic status (p = .041), and regional distribution (p = .0351). A total of 10 themes were analyzed from the interview data, which included four positive factors (accessibility, personalization, cost-effectiveness, anonymity and privacy, multi-language support) and five negative factors (information inaccuracy, lack of emotional intelligence, dependency and overreliance, data privacy and security, and inability to provide physical support or diagnosis). CONCLUSION This study has underscored the potential of leveraging ChatGPT as a valuable public awareness tool for cancer in Saudi Arabia.
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Affiliation(s)
- Turki M Alanzi
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Wala Alzahrani
- Department of Clinical Nutrition, College of Applied Medical Sciences, King Abdulaziz University, Jeddah, SAU
| | | | - Taif Allahyani
- College of Applied Medical Sciences, Umm Al-Qura University, Makkah, SAU
| | | | - Haneen Al-Zahrani
- Department of Hematology, Armed Forces Hospital at King Abdulaziz Airbase Dhahran, Dhahran, SAU
| | - Awatif Almutairi
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Jouf University, Jouf, SAU
| | | | | | - Nouf Alanzi
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Jouf University, Jouf, SAU
| | | | - Nesren Farhah
- Department of Health Informatics, College of Health Sciences, Saudi Electronic University, Riyadh, SAU
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Martins T, Ukoumunne OC, Lyratzopoulos G, Hamilton W, Abel G. Are There Ethnic Differences in Recorded Features among Patients Subsequently Diagnosed with Cancer? An English Longitudinal Data-Linked Study. Cancers (Basel) 2023; 15:3100. [PMID: 37370710 PMCID: PMC10296232 DOI: 10.3390/cancers15123100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/02/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
We investigated ethnic differences in the presenting features recorded in primary care before cancer diagnosis. METHODS English population-based cancer-registry-linked primary care data were analysed. We identified the coded features of six cancers (breast, lung, prostate, colorectal, oesophagogastric, and myeloma) in the year pre-diagnosis. Logistic regression models investigated ethnic differences in first-incident cancer features, adjusted for age, sex, smoking status, deprivation, and comorbidity. RESULTS Of 130,944 patients, 92% were White. In total, 188,487 incident features were recorded in the year pre-diagnosis, with 48% (89,531) as sole features. Compared with White patients, Asian and Black patients with breast, colorectal, and prostate cancer were more likely than White patients to have multiple features; the opposite was seen for the Black and Other ethnic groups with lung or prostate cancer. The proportion with relevant recorded features was broadly similar by ethnicity, with notable cancer-specific exceptions. Asian and Black patients were more likely to have low-risk features (e.g., cough, upper abdominal pain) recorded. Non-White patients were less likely to have alarm features. CONCLUSION The degree to which these differences reflect disease, patient or healthcare factors is unclear. Further research examining the predictive value of cancer features in ethnic minority groups and their association with cancer outcomes is needed.
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Affiliation(s)
- Tanimola Martins
- Department of Health and Community Sciences, Faculty of Health and Life Sciences, College of Medicine and Health, University of Exeter St Luke’s Campus, Magdalen Road, Exeter EX1 2LU, UK; (W.H.); (G.A.)
| | - Obioha C. Ukoumunne
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) South West Peninsula (PenARC), Department of Health and Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter EX1 2LU, UK;
| | - Georgios Lyratzopoulos
- Epidemiology of Cancer Healthcare & Outcomes (ECHO) Group, University College London, 1-19 Torrington Place, London WC1E 7HB, UK;
| | - Willie Hamilton
- Department of Health and Community Sciences, Faculty of Health and Life Sciences, College of Medicine and Health, University of Exeter St Luke’s Campus, Magdalen Road, Exeter EX1 2LU, UK; (W.H.); (G.A.)
| | - Gary Abel
- Department of Health and Community Sciences, Faculty of Health and Life Sciences, College of Medicine and Health, University of Exeter St Luke’s Campus, Magdalen Road, Exeter EX1 2LU, UK; (W.H.); (G.A.)
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Fry A, White B, Nagarwalla D, Shelton J, Jack RH. Relationship between ethnicity and stage at diagnosis in England: a national analysis of six cancer sites. BMJ Open 2023; 13:e062079. [PMID: 36702581 PMCID: PMC9884890 DOI: 10.1136/bmjopen-2022-062079] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Cancer stage at diagnosis is a determinant of treatment options and survival. Previous research has shown differences in barriers to presentation with cancer between ethnic groups. The completeness and quality of cancer stage and ethnicity data has improved markedly over recent years in England, allowing for comparison of stage distributions at diagnosis between ethnic groups. This study aimed to assess relationships between ethnic group and two outcomes: unknown stage cancer and late stage (stages 3 and 4) cancer, after adjustment for confounders. DESIGN AND SETTING A retrospective secondary data analysis using data from NHS Digital's National Cancer Registration and Analysis Service and Hospital Episode Statistics records from 2012 to 2016. PARTICIPANTS This study analysed newly diagnosed breast, colon, non-small cell lung cancer (NSCLC), ovary, prostate and uterine cancers in white British, Caribbean, African, Chinese and Asian patients aged 15-99 in England. RESULTS Caribbean, African and Asian women with breast or ovarian cancer, Caribbean and African women with uterine or colon cancer, Caribbean women with NSCLC and Caribbean men with colon cancer had increased odds of late-stage disease at diagnosis compared with the white British cohort. In contrast, Caribbean and African men with prostate cancer had decreased odds of late-stage cancer. Where stage was known, there were variations in late-stage cancer by ethnic group. CONCLUSIONS Low symptom awareness and barriers to presentation can cause delays, resulting in later stage diagnosis. Targeted intervention campaigns to help raise awareness of cancer signs and symptoms and the benefits of early diagnosis, along with removing barriers to appropriate referrals, could help to improve these inequalities.
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Affiliation(s)
- Anna Fry
- National Cancer Registration and Analysis Service, NHS Digital, London, UK
- Cancer Intelligence, Cancer Research UK, London, UK
| | - Becky White
- Cancer Intelligence, Cancer Research UK, London, UK
- ECHO (Epidemiology of Cancer Healthcare & Outcomes), Department of Behavioural Science & Health, Institute of Epidemiology & Health Care, University College London, London, UK
| | | | - Jon Shelton
- Cancer Intelligence, Cancer Research UK, London, UK
| | - Ruth H Jack
- Centre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
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Martins T, Abel G, Ukoumunne OC, Price S, Lyratzopoulos G, Chinegwundoh F, Hamilton W. Assessing Ethnic Inequalities in Diagnostic Interval of Common Cancers: A Population-Based UK Cohort Study. Cancers (Basel) 2022; 14:3085. [PMID: 35804858 PMCID: PMC9264889 DOI: 10.3390/cancers14133085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND This study investigated ethnic differences in diagnostic interval (DI)-the period between initial primary care presentation and diagnosis. METHODS We analysed the primary care-linked data of patients who reported features of seven cancers (breast, lung, prostate, colorectal, oesophagogastric, myeloma, and ovarian) one year before diagnosis. Accelerated failure time (AFT) models investigated the association between DI and ethnicity, adjusting for age, sex, deprivation, and morbidity. RESULTS Of 126,627 eligible participants, 92.1% were White, 1.99% Black, 1.71% Asian, 1.83% Mixed, and 2.36% were of Other ethnic backgrounds. Considering all cancer sites combined, the median (interquartile range) DI was 55 (20-175) days, longest in lung [127, (42-265) days], and shortest in breast cancer [13 (13, 8-18) days]. DI for the Black and Asian groups was 10% (AFT ratio, 95%CI 1.10, 1.05-1.14) and 16% (1.16, 1.10-1.22), respectively, longer than for the White group. Site-specific analyses revealed evidence of longer DI in Asian and Black patients with prostate, colorectal, and oesophagogastric cancer, plus Black patients with breast cancer and myeloma, and the Mixed group with lung cancer compared with White patients. DI was shorter for the Other group with lung, prostate, myeloma, and oesophagogastric cancer than the White group. CONCLUSION We found limited and inconsistent evidence of ethnic differences in DI among patients who reported cancer features in primary care before diagnosis. Our findings suggest that inequalities in diagnostic intervals, where present, are unlikely to be the sole explanation for ethnic variations in cancer outcomes.
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Affiliation(s)
- Tanimola Martins
- College House St Luke’s Campus, College of Medicine and Health, University of Exeter, Magdalen Road, Exeter EX1 2LU, UK; (S.P.); (W.H.)
| | - Gary Abel
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration (ARC) South West Peninsula (PenARC), University of Exeter, Exeter EX1 2LU, UK; (G.A.); (O.C.U.)
| | - Obioha C. Ukoumunne
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration (ARC) South West Peninsula (PenARC), University of Exeter, Exeter EX1 2LU, UK; (G.A.); (O.C.U.)
| | - Sarah Price
- College House St Luke’s Campus, College of Medicine and Health, University of Exeter, Magdalen Road, Exeter EX1 2LU, UK; (S.P.); (W.H.)
| | - Georgios Lyratzopoulos
- Epidemiology of Cancer Healthcare & Outcomes (ECHO) Group, University College London, 1–19 Torrington Place, London WC1E 7HB, UK;
| | - Frank Chinegwundoh
- Barts Health NHS Trust & Department of Health Sciences, University of London, London WC1E 7HB, UK;
| | - William Hamilton
- College House St Luke’s Campus, College of Medicine and Health, University of Exeter, Magdalen Road, Exeter EX1 2LU, UK; (S.P.); (W.H.)
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Cancer Awareness Measure (CAM) and Cancer Awareness Measure MYthical Causes Scale (CAM-MY) scores in Pakistani population. Sci Rep 2022; 12:8887. [PMID: 35614124 PMCID: PMC9132919 DOI: 10.1038/s41598-022-13012-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 05/03/2022] [Indexed: 12/02/2022] Open
Abstract
Lifestyle modifications could prevent almost one-third to one-half of all cancer cases. The awareness of cancer risk factors could motivate people to make such changes in their behaviors and lifestyles. This work aims to investigate the cancer awareness level in the Pakistani population. Telephone interviews of 657 individuals in Pakistan were carried out using the Cancer Awareness Measure (CAM) and Cancer Awareness Measure–MYthical Causes Scale (CAM-MY). We observed that participants scored significantly better on the CAM scale than the CAM-MY scale, and CAM scores were negatively associated with CAM-MY scores. Years of formal education or a biology major at undergraduate or graduate level did not affect our population's cancer awareness levels. Age displayed a weak but statistically significant negative association with CAM scores. Most participants failed to identify modifiable cancer risk factors, e.g., low physical activity. Efforts should be made to improve awareness of modifiable risk factors. We observed that brief training sessions could markedly improve people's understanding of cancer risk factors and myths.
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Bantie GM, Aynie AA, Gelaw YM, Kasa AS, Alemayehu MA, Tamirat KS, Tsegaye GW, Wassie GT, Kassa TB, Dessie AA. Awareness regarding risk factors and determinants of cancers among Bahir Dar city residents, Northwest Ethiopia. PLoS One 2021; 16:e0248520. [PMID: 33891616 PMCID: PMC8064596 DOI: 10.1371/journal.pone.0248520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 02/27/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cancer is the second leading cause of death in the world. Knowing the cancer risk factors could help the policy-makers to design appropriate preventive and control strategies. OBJECTIVE To investigate the awareness regarding risk factors and determinants of cancers among Bahir Dar city residents, northwest, 2019. METHODS A community-based cross-sectional study was employed. A systematic random sampling technique was carried out to select 845 study participants from May 1 to June 30, 2019. A validated structured cancer awareness measuring tool was used to collect the data. The data were entered into the Epi-data version 3.1 and analyzed using SPSS version 21 software. A simple logistic regression was run, and AOR (adjusted odds ratio) at a 95% confidence interval was used to identify the determinants of awareness regarding risk factors of cancers. RESULTS Nearly twenty percent of the respondents had a good awareness regarding risk factors of cancers. An orthodox Christian (AOR = 3. 2; 95%CI: 1.8, 5.6), college graduated (AOR = 2. 3; 95%CI:1.1, 4.9), a family member with cancer (AOR = 2. 0; 95%CI: 1.3, 3.3), and living in a rental house (AOR = 0. 6; 95%CI: 0.4, 0.9) were significantly associated with awareness regarding risk factors of cancers. CONCLUSION The study revealed that awareness regarding risk factors of cancers was very low in the study area. Being Orthodox Christian, college graduated, a family member with cancer, and living in the rental house were the determinants of awareness regarding risk factors of cancers.
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Affiliation(s)
- Getasew Mulat Bantie
- Faculty of community Health, Alkan Health Sciences Business and Technology College, Bahir Dar, Ethiopia
| | - Amare Alamirew Aynie
- Faculty of Medical Health, Alkan Health Sciences Business and Technology College, Bahir Dar, Ethiopia
| | - Yared Mulu Gelaw
- Department of Health Economics and Health Service Management, Bahir Dar University, Bahir Dar, Ethiopia
| | | | | | - Koku Sisay Tamirat
- Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Gebiyaw Wudie Tsegaye
- Department of Epidemiology and Biostatistics, Bahir Dar University, Bahir Dar, Ethiopia
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Pham DX, Pham TTT, Pham TN, Bui TD. A Cross-Sectional Study about Knowledge, Awareness and Perception of Risk Factors for Cancer among Cancer-Patients Relatives and Healthy Adults in Ho Chi Minh City, Vietnam. Asian Pac J Cancer Prev 2021; 22:277-285. [PMID: 33507709 PMCID: PMC8184172 DOI: 10.31557/apjcp.2021.22.1.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Indexed: 11/26/2022] Open
Abstract
Background and Aims: Although cancer is common in Ho Chi Minh city, Vietnam, the community awareness is still unknown. The primary objective of this study was to examine and compare the knowledge and risk perceptions of cancer possessed by cancer patients - relatives and healthy adults in Ho Chi Minh City, Vietnam. Methods: A cross-sectional study was conducted from June to August 2019. Cancer patients and their relatives were drawn from those who were hospitalized in the Oncology Hospital, Ho Chi Minh City. Healthy individuals were those without a known diagnosis of cancer, and they were drawn from the participants of the Vietnam Osteoporosis Study. A total of 533 participants including 249 patients and relatives (cancerous group) and 284 healthy individuals (healthy group), were asked to respond to a structured questionnaire that was comprised of items concerning cancer knowledge, risk factor perception, and general attitude towards cancer, using Yes, No, or Likert Scale for response. Results: The findings showed that patients hold poorer knowledge of pathology, signs, symptoms, prevention, and treatment and lower awareness of risk factors but more positive attitude towards cancer as compared to their healthy counterparts. Overall, both groups varied in their cancer knowledge, with many areas remain to be improved. Conclusions: Knowledge about cancer and its risk factors should be improved among the general population as well as among those with direct experiences with cancer. Practical implications: The findings provided by this study has major implications for the design of an educational program for cancer patients in clinical settings and awareness programs for the general public as a primary preventive measure for mitigating the cancer burden. Future studies with larger and more diverse samples or qualitative studies exploring the personal narratives of people living with cancer could take advantage from the preliminary data provided by this study.
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Affiliation(s)
- Dung X Pham
- Ho Chi Minh City Oncology Hospital, Vietnam.,Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Tien T T Pham
- Department of Psychology, Hoa sen University, Ho Chi Minh City, Vietnam
| | - Thang N Pham
- Department of Psychology, Hoa sen University, Ho Chi Minh City, Vietnam
| | - Tung D Bui
- Ho Chi Minh City Oncology Hospital, Vietnam
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Tatari CR, Andersen B, Brogaard T, Badre-Esfahani SK, Jaafar N, Kirkegaard P. Perceptions about cancer and barriers towards cancer screening among ethnic minority women in a deprived area in Denmark - a qualitative study. BMC Public Health 2020; 20:921. [PMID: 32532227 PMCID: PMC7291658 DOI: 10.1186/s12889-020-09037-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 06/03/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Screening programmes for cervical cancer, breast cancer and colorectal cancer have been implemented in many Western countries to reduce cancer incidence and mortality. Ethnic minority women are less likely to participate in cancer screening than the majority population. In worst case this can result in higher incidence rates, later diagnosis and treatment and ultimately inferior survival. In this paper we explored the perceptions about cancer and perceived barriers towards cancer screening participation among ethnic minority women in a deprived area in Denmark. METHODS Interview study with ethnic minority women in a deprived area in Denmark. The interviews were transcribed verbatim followed by an inductive content analysis. RESULTS Cancer was perceived as a deadly disease that could not be treated. Cancer screening was perceived as only relevant if the women had symptoms. Knowledge about cancer screening was fragmented, often due to inadequate Danish language skills and there was a general mistrust in the Danish healthcare system due to perceived low medical competences in Danish doctors. There was, however, a very positive and curious attitude regarding information about the Danish cancer screening programmes and a want for more information. CONCLUSION Ethnic minority women did not have sufficient knowledge about cancer and the purpose of cancer screening. Perceptions about cancer screening were characterised by openness and the study showed positive and curious attitudes towards screening participation. The findings emphasise the importance of culturally adapted interventions for ethnic minority women in attempts to reduce inequality in screening participation.
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Affiliation(s)
- Camilla Rahr Tatari
- Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark.
| | - Berit Andersen
- Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Sara Koed Badre-Esfahani
- Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
| | - Negin Jaafar
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
| | - Pia Kirkegaard
- Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark
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Ahmed SB, Amer S, Hussein A, D. Kampani D, Al Hasham N, M. Assker M, Shawa N, Saleh D, Alfarouk KO. Assessing the Knowledge of Environmental Risk Factors for Cancer among the UAE Population: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17092984. [PMID: 32344867 PMCID: PMC7246594 DOI: 10.3390/ijerph17092984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/20/2020] [Accepted: 04/22/2020] [Indexed: 01/22/2023]
Abstract
The incidence of cancer is increasing worldwide as well as in the United Arab Emirates (UAE). Currently, researchers are advocating not only for prevention programs but also for early detection. In this study, we aimed to assess the general awareness of cancer among the UAE population, with a focus on environmental risk factors. A descriptive cross-sectional design was employed, and a structured questionnaire was used to collect data from 385 participants. A total of 91.2% of the study population identified cancer as the leading cause of death, while 64.6% of the subjects were able to identify the key causes of cancer. A total of 87.3% and 70.5% of the participants were able to define tobacco and alcohol, respectively, as cancer-causing agents. Most of the study population failed to identify cancer-related infectious agents and incense smoke as carcinogens. Respondents in the medical professions had the highest knowledge score when compared with respondents with a non-medical profession and unemployed participants (p < 0.0005). To fill the gaps in cancer-related knowledge, participants were asked about their preferred method for cancer education, and 83.9% of the participants favored the media as a source of information. Conclusively, our findings indicated a gap in cancer knowledge among UAE residents, which highlights the importance of educational campaigns by health authorities; a follow-up study evaluating the success of educational campaigns is also warranted.
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Affiliation(s)
- Samrein B.M. Ahmed
- College of medicine, University of Sharjah, Sharjah 27272, UAE; (S.A.); (A.H.); (D.D.K.); (N.A.H.); (M.M.A.); (D.S.)
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, UAE;
- Correspondence:
| | - Sara Amer
- College of medicine, University of Sharjah, Sharjah 27272, UAE; (S.A.); (A.H.); (D.D.K.); (N.A.H.); (M.M.A.); (D.S.)
| | - Amal Hussein
- College of medicine, University of Sharjah, Sharjah 27272, UAE; (S.A.); (A.H.); (D.D.K.); (N.A.H.); (M.M.A.); (D.S.)
| | - Drishti D. Kampani
- College of medicine, University of Sharjah, Sharjah 27272, UAE; (S.A.); (A.H.); (D.D.K.); (N.A.H.); (M.M.A.); (D.S.)
| | - Nour Al Hasham
- College of medicine, University of Sharjah, Sharjah 27272, UAE; (S.A.); (A.H.); (D.D.K.); (N.A.H.); (M.M.A.); (D.S.)
| | - Mohamed M. Assker
- College of medicine, University of Sharjah, Sharjah 27272, UAE; (S.A.); (A.H.); (D.D.K.); (N.A.H.); (M.M.A.); (D.S.)
| | - Nour Shawa
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, UAE;
| | - Dima Saleh
- College of medicine, University of Sharjah, Sharjah 27272, UAE; (S.A.); (A.H.); (D.D.K.); (N.A.H.); (M.M.A.); (D.S.)
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Connor K, Hudson B, Power E. Awareness of the Signs, Symptoms, and Risk Factors of Cancer and the Barriers to Seeking Help in the UK: Comparison of Survey Data Collected Online and Face-to-Face. JMIR Cancer 2020; 6:e14539. [PMID: 31951219 PMCID: PMC6996748 DOI: 10.2196/14539] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/29/2019] [Accepted: 09/20/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cancer is the second leading cause of death globally, causing an estimated 9.6 million deaths in 2018. Low cancer symptom awareness has been associated with poor cancer survival for all cancers combined. The Cancer Awareness Measure (CAM) is a validated, face-to-face survey used since 2008 to measure the UK public's awareness of the symptoms and risk factors of cancer as well as the barriers to seeking help. OBJECTIVE The aim of this study is to explore whether online data collection can produce a representative sample of the UK population, compare awareness of cancer signs and risk factors and the barriers to seeking help between data collected online and face-to-face, and examine the relationships between awareness and demographic variables. METHODS Differences in awareness of cancer signs, symptoms, and risk factors among samples were explored while adjusting for demographic differences (age, gender, ethnicity, educational level, marital status, and country of residence) to distinguish the effect of data collection method. Multivariate logistic regression models were used to calculate adjusted odds ratios for recall and recognition of signs and symptoms, risk factors, and barriers to seeking help. RESULTS A total of 4075 participants completed the CAM, 20% (n=819) via face-to-face interviews and 80% online (n=3256; agency A: n=1190; agency B: n=2066). Comparisons of data collected using face-to-face interviews and online surveys revealed minor differences between samples. Both methods provided representative samples of the UK population with slight differences in awareness of signs, symptoms, and risk factors and frequency of help-seeking barriers reported. CONCLUSIONS These findings support a move to online data collection for the CAM. The flexibility afforded will enable the CAM to explore a wider range of issues related to the prevention, early diagnosis, and treatment of cancer.
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Saranrittichai K, Ussavapark W, Thamrongwarangkoon A, Heangsorn T, Daoruang S, Teeranut A. Community- Based Approaches to Cancer Prevention in Rural Thailand Based on Experiences of Accredited Health Professionals. Asian Pac J Cancer Prev 2020; 21:7-12. [PMID: 31983156 PMCID: PMC7294034 DOI: 10.31557/apjcp.2020.21.1.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/01/2020] [Indexed: 12/24/2022] Open
Abstract
This qualitative research aimed to describe important components of community based approaches of cancer prevention from working experiences of accredited health professionals in Thai rural communities. METHODS Data were collected from 23 communities with 23 accredited health professionals as key participants using in-depth interview and focus group discussions (FGDs) in each community. Other informants were community leaders, community health volunteers and community people. Content analysis was applied for data analysis. RESULTS Community based approaches for cancer prevention from the experiences of accredited health professionals were composed of 2 themes: approaches for community-based cancer prevention and methods for cancer-based prevention in the community. The approaches for community-based cancer prevention was composed of 4 components: 1) primary prevention focusing on health education; 2) secondary prevention include: life style modification, vaccination, advocacy of cancer screening, early detection, and prompt refer; 3) tertiary prevention focusing on primary care, and 4) research collaboration focusing on net working. Methods for cancer-based prevention in the community were different based on types of cancer. The 3 factors determined to be associated with community based approaches for cancer prevention were: 1) primary care policy; 2) hometown workplace; and 3) health practice skill. CONCLUSION Community based approaches for cancer prevention should concentrate on building a literate community involvement to empower both health care providers and residents. From our evidence, dedicated community associates health professionals have a major role to play.
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Affiliation(s)
- Kesinee Saranrittichai
- Research and Training Center for Enhancing Quality of Life of Working Age People,
- Faculty of Public Health,
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Giri VN, Selvan P, Mohanty S, Lum R, Serrao S, Leader AE. Exploring Asian Indian views about cancer and participation in cancer research: an evaluation of a culturally tailored educational intervention. J Community Genet 2019; 11:193-203. [PMID: 31522341 DOI: 10.1007/s12687-019-00436-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 08/29/2019] [Indexed: 01/22/2023] Open
Abstract
Asian Indians (AIs) are a growing population in the United States (US) with increased cancer incidence and mortality. However, screening rates among this population are low, and the population has been underrepresented in clinical research. This pilot study aims to address gaps in the literature in order to understand if a culturally tailored educational intervention will improve knowledge, risk perceptions, and awareness of cancer risk assessments among AIs. We delivered an educational intervention comprised of culturally tailored case studies describing risk factors for developing cancer in both males and females. We assessed knowledge gaps about cancer risk and genetic testing, cancer risk perceptions, and willingness to participate in medical research studies, pre- and post-intervention. Among 23 participants, knowledge of genetic testing use and screening recommendations significantly improved post-intervention, with increased willingness to discuss cancer with family members, participate in medical research, and undergo genetic testing for cancer risk assessment. However, findings at the 1-month follow-up time did not show significant changes, except for one knowledge item. Culturally tailored educational interventions, delivered in a community setting, can influence knowledge and risk perceptions about cancer risk and genetics among AIs. Our findings lay the groundwork to continue educational efforts in the area of cancer risk and genetic testing in the AI population, a growing population that has been understudied in the US.
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Affiliation(s)
- Veda N Giri
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, 19107, USA.
| | - Preethi Selvan
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Salini Mohanty
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, 3141 Chestnut St, Philadelphia, PA, 19104, USA.,Department of Family and Community Health, University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Ray Lum
- Department of Management and Health Policy, Dornsife School of Public Health, Drexel University, 3141 Chestnut St, Philadelphia, PA, 19104, USA
| | - Samantha Serrao
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, 3141 Chestnut St, Philadelphia, PA, 19104, USA
| | - Amy E Leader
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, 19107, USA
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Smith SG, Beard E, McGowan JA, Fox E, Cook C, Pal R, Waller J, Shahab L. Development of a tool to assess beliefs about mythical causes of cancer: the Cancer Awareness Measure Mythical Causes Scale. BMJ Open 2018; 8:e022825. [PMID: 30552257 PMCID: PMC6303629 DOI: 10.1136/bmjopen-2018-022825] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 08/09/2018] [Accepted: 10/17/2018] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES We aimed to develop a reliable and valid measure to assess public beliefs in mythical causes of cancer: the Cancer Awareness Measure-MYthical Causes Scale (CAM-MYCS). DESIGN AND SETTING Cancer myth items were generated from a literature review, social media and interviews (n=16). The CAM-MYCS was prepared by reducing items using (a) an online sample (n=527) with exploratory factor analysis and (b) cancer experts with Delhpi methodology (n=13). To assess test-retest reliability and sensitivity to change, students (n=91) completed the CAM-MYCS at baseline and 1 week after exposure to information on lifestyle-related cancer causes or control information. Construct validity was tested by comparing CAM-MYCS scores between cancer experts (n=25) and students (n=91). Factor structure and internal reliability were investigated in a national sample (n=1993). RESULTS Out of 42 items generated, 12 were retained based on factor loadings, prevalence of endorsement and expert consensus. CAM-MYCS scores improved (fewer myths endorsed) among students exposed to information on cancer causes compared with the control group (p<0.001) and showed high test-retest reliability (r=0.90, p<0.001). Cancer experts reported higher CAM-MYCS scores (fewer myths endorsed) than students (p<0.001). The factor structure of the CAM-MYCS was confirmed in the national sample and internal reliability was high (α=0.86). Inclusion of the CAM-MYCS alongside items assessing knowledge of actual cancer causes did not affect responses. CONCLUSIONS The CAM-MYCS tool is a reliable and valid tool assessing beliefs in mythical causes of cancer, and it can be used alongside items assessing known causes of cancer.
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Affiliation(s)
- Samuel G Smith
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Emma Beard
- Research Department of Behavioural Science and Health, University College London, London, UK
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Jennifer A McGowan
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Emma Fox
- Division of General Internal Medicine, Northwestern University, Chicago, IL, USA
| | | | - Radhika Pal
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Jo Waller
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Lion Shahab
- Research Department of Behavioural Science and Health, University College London, London, UK
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Hooper L, Anderson AS, Birch J, Forster AS, Rosenberg G, Bauld L, Vohra J. Public awareness and healthcare professional advice for obesity as a risk factor for cancer in the UK: a cross-sectional survey. J Public Health (Oxf) 2018; 40:797-805. [PMID: 29155951 PMCID: PMC6306085 DOI: 10.1093/pubmed/fdx145] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/25/2017] [Indexed: 01/01/2023] Open
Abstract
Background Overweight and obesity is the second biggest preventable cause of cancer after smoking, causing ~3.4 million deaths worldwide. This study provides current UK data on awareness of the link between obesity and cancer by socio-demographic factors, including BMI, and explores to what degree healthcare professionals provide weight management advice to patients. Methods Cross-sectional survey of 3293 adults completed an online survey in February/March 2016, weighted to be representative of the UK population aged 18+. Results Public awareness of the link between obesity and cancer is low (25.4% unprompted and 57.5% prompted). Higher levels of awareness existed for least deprived groups (P < 0.001), compared to more deprived groups. Most respondents had seen a healthcare practitioner in the past 12 months (91.6%) and 17.4% had received advice about their weight, although 48.4% of the sample were overweight/obese. Conclusion Cancer is not at the forefront of people's minds when considering health conditions associated with overweight or obesity. Socio-economic disparities exist in health knowledge across the UK population, with adults from more affluent groups being most aware. Healthcare professionals are uniquely positioned to provide advice about weight, but opportunities for intervention are currently under-utilized in healthcare settings.
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Affiliation(s)
- Lucie Hooper
- Policy Research Centre for Cancer Prevention (PRCP), Cancer Research UK, Angel Building, 407 St. John Street, London, UK
| | - Annie S Anderson
- Centre for Research into Cancer Prevention and Screening, Level 7, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Jack Birch
- Policy Research Centre for Cancer Prevention (PRCP), Cancer Research UK, Angel Building, 407 St. John Street, London, UK
| | - Alice S Forster
- Department of Behavioural Science and Health, UCL, Gower Street, London, UK
| | - Gillian Rosenberg
- Policy Research Centre for Cancer Prevention (PRCP), Cancer Research UK, Angel Building, 407 St. John Street, London, UK
| | - Linda Bauld
- Cancer Research UK, Angel Building, 407 St. John Street, London, UK
- University of Stirling, Stirling, UK
| | - Jyotsna Vohra
- Policy Research Centre for Cancer Prevention (PRCP), Cancer Research UK, Angel Building, 407 St. John Street, London, UK
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Shahab L, McGowan JA, Waller J, Smith SG. Prevalence of beliefs about actual and mythical causes of cancer and their association with socio-demographic and health-related characteristics: Findings from a cross-sectional survey in England. Eur J Cancer 2018; 103:308-316. [PMID: 29705530 PMCID: PMC6202672 DOI: 10.1016/j.ejca.2018.03.029] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/21/2018] [Accepted: 03/23/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Literature on population awareness about actual causes of cancer is growing but comparatively little is known about the prevalence of people's belief concerning mythical causes of cancer. This study aimed to estimate the prevalence of these beliefs and their association with socio-demographic characteristics and health behaviours. METHODS A survey containing validated measures of beliefs about actual and mythical cancer causes and health behaviours (smoking, alcohol consumption, physical activity, fruit and vegetable consumption, overweight) was administered to a representative English population sample (N = 1330). RESULTS Awareness of actual causes of cancer (52% accurately identified; 95% confidence interval [CI] 51-54) was greater than awareness of mythical cancer causes (36% accurately identified; 95% CI 34-37; P < 0.01). The most commonly endorsed mythical cancer causes were exposure to stress (43%; 95% CI 40-45), food additives (42%; 95% CI 39-44) and non-ionizing electromagnetic frequencies (35%; 95% CI 33-38). In adjusted analysis, greater awareness of actual and mythical cancer causes was independently associated with younger age, higher social grade, being white and having post-16 qualifications. Awareness of actual but not mythical cancer causes was associated with not smoking and eating sufficient fruit and vegetables. CONCLUSIONS Awareness of actual and mythical cancer causes is poor in the general population. Only knowledge of established risk factors is associated with adherence to behavioural recommendations for reducing cancer risk.
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Affiliation(s)
- Lion Shahab
- Department of Behavioural Science and Health, University College London, London, WC1E 6BT, UK.
| | - Jennifer A McGowan
- Department of Behavioural Science and Health, University College London, London, WC1E 6BT, UK; Institute of Child Health, University College London, London, WC1E 6BT, UK
| | - Jo Waller
- Department of Behavioural Science and Health, University College London, London, WC1E 6BT, UK
| | - Samuel G Smith
- Department of Behavioural Science and Health, University College London, London, WC1E 6BT, UK; Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9NL, UK
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Hann KEJ, Ali N, Gessler S, Fraser LSM, Side L, Waller J, Sanderson SC, Lanceley A. Attitudes towards a programme of risk assessment and stratified management for ovarian cancer: a focus group study of UK South Asians' perspectives. BMJ Open 2018; 8:e021782. [PMID: 30021754 PMCID: PMC6059306 DOI: 10.1136/bmjopen-2018-021782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Population-based risk assessment, using genetic testing and the provision of appropriate risk management, could lead to prevention, early detection and improved clinical management of ovarian cancer (OC). Previous research with mostly white British participants found positive attitudes towards such a programme. The current study aimed to explore the attitudes of South Asian (SA) women and men in the UK with the aim of identifying how best to implement such a programme to minimise distress and maximise uptake. DESIGN Semistructured qualitative focus group discussions. SETTING Community centres across North London and Luton. PARTICIPANTS 49 women and 13 men who identified as SA (Indian, Pakistani or Bangladeshi), which constitutes the largest non-European ethnic minority group in the UK. METHODS Seven community-based focus groups were held. Group discussions were transcribed verbatim, coded and analysed thematically. RESULTS Awareness and knowledge of OC symptoms and specific risk factors was low. The programme was acceptable to most participants and attitudes to it were generally positive. Participants' main concerns related to receiving a high-risk result following the genetic test. Younger women may be more cautious of genetic testing, screening or risk-reducing surgery due to the importance of marriage and childbearing in their SA cultures. CONCLUSIONS A crucial first step to enable implementation of population-based genetic risk assessment and management in OC is to raise awareness of OC within SA communities. It will be important to engage with the SA community early on in programme implementation to address their specific concerns and to ensure culturally tailored decision support.
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Affiliation(s)
- Katie E J Hann
- Department of Women’s Cancer, EGA UCL Institute for Women’s Health, University College London, London, UK
- Health Psychology Research Unit, Royal Holloway, University of London, Egham, UK
| | - Nasreen Ali
- Institute for Health Research, University of Bedfordshire, Luton, UK
| | - Sue Gessler
- Department of Women’s Cancer, EGA UCL Institute for Women’s Health, University College London, London, UK
| | | | - Lucy Side
- Department of Women’s Cancer, EGA UCL Institute for Women’s Health, University College London, London, UK
- Department of Clinical Genetics, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jo Waller
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Saskia C Sanderson
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
- Department of Clinical Genetics, Great Ormond Street Hospital, London, UK
| | - Anne Lanceley
- Department of Women’s Cancer, EGA UCL Institute for Women’s Health, University College London, London, UK
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Kumarakulasingam P, McDermott H, Boutler L, Patel N, Tincello D, Moss EL. Knowledge of the risk factors and symptoms associated with endometrial cancer in British South Asian and British White women. Eur J Obstet Gynecol Reprod Biol 2018; 224:85-88. [PMID: 29567460 DOI: 10.1016/j.ejogrb.2018.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 02/27/2018] [Accepted: 03/01/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To explore differences in the background knowledge of Endometrial Cancer (EC), its risk factors, symptoms and prognosis of Endometrial Cancer (EC) between British White (BW) and British South Asian (BSA) women who had undergone treatment for stage I endometrial cancer within the past 3-years. STUDY DESIGN Face-to-face, semi-structured interviews exploring knowledge; diagnosis; treatment; follow-up; and survivorship were undertaken and analysed using Thematic Analysis. RESULTS Twenty-one women were interviewed (13 BW and 8 BSA). BW and BSA women reported similar views, experiences and concerns with regards to EC. Knowledge appeared to differ amongst the two groups with BSA women reporting being more aware that unscheduled vaginal bleeding could be associated with a malignancy but having lower levels of knowledge of the risk factors that can lead to EC, compared to BW women. There was a lack of understanding of the difference between cervical cancer and EC and as a result, many women reported taking reassurance from negative cervical cytology as excluding EC. There was also the misconception amongst some of the women that there was a link between sexual behaviour and EC. Women from both groups used the lay healthcare system to discuss their situation/symptoms, however BSA women reported to have specifically sought out women within their social network who had previously undergone treatment for EC. CONCLUSIONS Greater effort is needed to raise awareness in both the BW/BSA communities of the symptoms associated with EC that should prompt medical review. Educational efforts are required to overcome the reported perception that EC is synonymous with cervical cancer and cannot be detected by cervical screening.
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Affiliation(s)
- P Kumarakulasingam
- Leicester Cancer Research Centre, University of Leicester, Leicester, United Kingdom
| | - H McDermott
- National Centre of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | - L Boutler
- Department of Gynaecological Oncology, University Hospitals of Leicester, United Kingdom
| | - N Patel
- Department of Gynaecological Oncology, University Hospitals of Leicester, United Kingdom
| | - D Tincello
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - E L Moss
- Leicester Cancer Research Centre, University of Leicester, Leicester, United Kingdom; Department of Gynaecological Oncology, University Hospitals of Leicester, United Kingdom.
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Leader AE, Mohanty S, Selvan P, Lum R, Giri VN. Exploring Asian Indian and Pakistani views about cancer and participation in cancer genetics research: toward the development of a community genetics intervention. J Community Genet 2017; 9:27-35. [PMID: 28660599 DOI: 10.1007/s12687-017-0312-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 06/08/2017] [Indexed: 01/25/2023] Open
Abstract
Cancer is a leading cause of mortality among the three million Asian Indian/Pakistanis (AIPs) in the USA. AIPs have traditionally been underrepresented in cancer-related research, although reasons remain largely unexplored. We sought to understand AIP's awareness and perceptions of cancer to improve their participation in risk assessment and cancer genetics research. Four focus groups, stratified by gender and birthplace (US-born vs. foreign-born), were held at an AIP cultural center. Discussions focused on knowledge and awareness of cancer risk; how AIP culture influences cancer perceptions; access to health care services for cancer screening, diagnosis, or treatment; and willingness to or experiences with participating in cancer genetics research. Sessions were audio-recorded, transcribed verbatim, and content analyzed using NVivo®11 for dominant themes. Thirty-two AIP adults participated in a focus group. Information on family cancer history is challenging to obtain due to the desire for privacy, cancer stigma, and loss of medical records. Interest in genetic testing for cancer risk was mixed: some were in favor of knowing their personal risk, yet many noted that future generations in their family would benefit more by knowing their risk. Participants felt that the AIP community has largely been overlooked in recruitment efforts for research studies. Recommendations for improving recruitment efforts included partnering with community events and festivities, posting culturally and linguistically relevant recruitment materials, and focusing on population-wide health improvement. Understanding the culture and perceptions of AIPs, separate from Asian Americans at large, will allow for more tailored approaches for including this population in cancer genetics research.
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Affiliation(s)
- Amy E Leader
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Salini Mohanty
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Preethi Selvan
- College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ray Lum
- Department of Management and Health Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Veda N Giri
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
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Richards R, McNoe B, Iosua E, Reeder AI, Egan R, Marsh L, Robertson L, Maclennan B, Dawson A, Quigg R, Petersen AC. Changes in awareness of cancer risk factors among adult New Zealanders (CAANZ): 2001 to 2015. HEALTH EDUCATION RESEARCH 2017; 32:153-162. [PMID: 28334909 DOI: 10.1093/her/cyx036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 02/06/2017] [Indexed: 05/21/2023]
Abstract
Behaviour change, specifically that which decreases cancer risk, is an essential element of cancer control. Little information is available about how awareness of risk factors may be changing over time. This study describes the awareness of cancer risk behaviours among adult New Zealanders in two cross-sectional studies conducted in 2001 and 2014/5.Telephone interviews were conducted in 2001 (n = 436) and 2014/5 (n = 1064). Participants were asked to recall things they can do to reduce their risk of cancer. They were then presented with a list of potential risk behaviours and asked if these could increase or decrease cancer risk.Most New Zealand adults could identify at least one action they could take to reduce their risk of cancer. However, when asked to provide specific examples, less than a third (in the 2014/5 sample) recalled key cancer risk reduction behaviours such as adequate sun protection, physical activity, healthy weight, limiting alcohol and a diet high in fruit. There had been some promising changes since the 2001 survey, however, with significant increases in awareness that adequate sun protection, avoiding sunbeds/solaria, healthy weight, limiting red meat and alcohol, and diets high in fruit and vegetables decrease the risk of developing cancer.
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Affiliation(s)
- R Richards
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine
| | - B McNoe
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine
| | - E Iosua
- Department of Preventive and Social Medicine, Dunedin School of Medicine
| | - A I Reeder
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine
| | - R Egan
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine
| | - L Marsh
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine
| | - L Robertson
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine
| | - B Maclennan
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine
| | - A Dawson
- Kohatu - Centre for Hauora Maori, Division of Health Sciences, University of Otago, PO Box 56, Dunedin 9016, New Zealand
| | - R Quigg
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine
| | - A-C Petersen
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine
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Affiliation(s)
- Tanimola Martins
- College House St Luke's Campus, University of Exeter Medical School, Magdalen Road, Exeter EX1 2LU, UK.
| | - William Hamilton
- College House St Luke's Campus, University of Exeter Medical School, Magdalen Road, Exeter EX1 2LU, UK
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Smith SG, Osborne K, Tring S, George H, Power E. Evaluating the impact of a community-based cancer awareness roadshow on awareness, attitudes and behaviors. Prev Med 2016; 87:138-143. [PMID: 26921657 PMCID: PMC4893017 DOI: 10.1016/j.ypmed.2016.02.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 02/18/2016] [Accepted: 02/23/2016] [Indexed: 12/25/2022]
Abstract
Improving public awareness of cancer and encouraging health behavior change are important aspects of cancer control. We investigated whether a community-based roadshow was an effective way of communicating with the public about cancer and encouraging behavior change. Data were from 1196 people who completed questionnaires at a Cancer Research UK Cancer Awareness Roadshow in 2013. Of these, 511 (43%) completed questionnaires immediately before their visit (pre-visit group) and 685 (57%) completed questionnaires immediately after their visit (post-visit group). Among the post-visit sample, 217 (32%) were retained after two months. Self-reported data were available on risk factor and symptom awareness, help-seeking barriers, use of healthcare services and health behaviors. Compared with the pre-visit sample, the post-visit group had greater awareness of cancer risk factors and was more positive about aspects of help-seeking but awareness of potential symptoms was similar. Most effects were maintained over two months. Intentions to eat more fruit and vegetables and to exercise more were comparable between the groups but more people in the post-visit sample intended to quit smoking. At 2-month follow-up, smoking prevalence had significantly reduced but fruit and vegetable consumption decreased and there was no change to physical activity. User of weight loss services and general practitioner visits were high at follow-up and largely attributed to the Roadshow. The Cancer Research UK Roadshow appears to improve risk factor awareness, promote positive attitudes towards help-seeking and increase smoking cessation. This approach could be a useful building block for additional cancer prevention and control strategies.
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Affiliation(s)
- Samuel G Smith
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK; Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK.
| | - Kirstie Osborne
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK; Cancer Research UK, Angel Building, 407 St John Street, London EC1V 4AD, UK
| | - Sophie Tring
- Cancer Research UK, Angel Building, 407 St John Street, London EC1V 4AD, UK
| | - Helen George
- Cancer Research UK, Angel Building, 407 St John Street, London EC1V 4AD, UK
| | - Emily Power
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK; Cancer Research UK, Angel Building, 407 St John Street, London EC1V 4AD, UK
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Social Differentiation of Sun-Protection Behaviors: The Mediating Role of Cognitive Factors. Am J Prev Med 2016; 50:e81-e90. [PMID: 26526161 DOI: 10.1016/j.amepre.2015.07.040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 07/27/2015] [Accepted: 08/07/2015] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Adherence to sun-protection guidelines in developed countries is low, especially among people of low SES. Mechanisms underlying this social differentiation are poorly understood. This study aimed to examine the social differentiation of sun-protection behaviors and of two cognitive factors (knowledge about both sun health and behavioral risk factors for cancer) and to determine if these cognitive factors mediate the association between SES and sun-protection behaviors. METHODS Data came from the 2010 Baromètre Cancer survey (analyzed in 2014), a random cross-sectional telephone survey conducted among the French general population (n=3,359 individuals aged 15-75 years). First, bivariate associations between a composite individual SES indicator (based on education level, occupation, and income) and both sun-protection behaviors and cognitive factors were tested with chi-square tests and ANOVA. Then, confirmatory factor analysis and structural equation modeling were used to test the mediating role of cognitive factors with a multiple mediation model including four latent variables. RESULTS In bivariate analyses, the individual SES indicator was positively associated with sun-protection behaviors and both cognitive factors. Multiple mediation analyses showed that both cognitive factors partially mediated the effect of individual SES on sun-protection behaviors. The overall proportion of mediated effects was 48%. The direct effect of SES remained significant. CONCLUSIONS These results suggest that interventions aimed at modifying the knowledge and perceptions of people of low SES might help to reduce social differentiation of sun-protection behaviors. Further qualitative research is needed to better understand these cognitive factors and develop suitable prevention messages.
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Marlow LAV, Waller J, Wardle J. Barriers to cervical cancer screening among ethnic minority women: a qualitative study. JOURNAL OF FAMILY PLANNING AND REPRODUCTIVE HEALTH CARE 2015; 41:248-54. [PMID: 25583124 PMCID: PMC4621371 DOI: 10.1136/jfprhc-2014-101082] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 11/11/2014] [Accepted: 12/01/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Ethnic minority women are less likely to attend cervical screening. AIM To explore self-perceived barriers to cervical screening attendance among ethnic minority women compared to white British women. DESIGN Qualitative interview study. SETTING Community groups in ethnically diverse London boroughs. METHODS Interviews were carried out with 43 women from a range of ethnic minority backgrounds (Indian, Pakistani, Bangladeshi, Caribbean, African, Black British, Black other, White other) and 11 White British women. Interviews were recorded, transcribed verbatim and analysed using Framework analysis. RESULTS Fifteen women had delayed screening/had never been screened. Ethnic minority women felt that there was a lack of awareness about cervical cancer in their community, and several did not recognise the terms 'cervical screening' or 'smear test'. Barriers to cervical screening raised by all women were emotional (fear, embarrassment, shame), practical (lack of time) and cognitive (low perceived risk, absence of symptoms). Emotional barriers seemed to be more prominent among Asian women. Low perceived risk of cervical cancer was influenced by beliefs about having sex outside of marriage and some women felt a diagnosis of cervical cancer might be considered shameful. Negative experiences were well remembered by all women and could be a barrier to repeat attendance. CONCLUSIONS Emotional barriers (fear, embarrassment and anticipated shame) and low perceived risk might contribute to explaining lower cervical screening coverage for some ethnic groups. Interventions to improve knowledge and understanding of cervical cancer are needed in ethnic minority communities, and investment in training for health professionals may improve experiences and encourage repeat attendance for all women.
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Affiliation(s)
- Laura A V Marlow
- Senior Research Associate, Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
| | - Jo Waller
- Principal Research Associate, Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
| | - Jane Wardle
- Professor of Clinical Psychology, Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
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Piffer S, Gentilini M, Rizzello R, Mazzoleni G, Bellù F, Rossi S. Estimates of cancer burden in Trentino-Alto Adige. TUMORI JOURNAL 2013; 99:296-307. [DOI: 10.1177/030089161309900304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background The Trentino-Alto Adige region is composed of two autonomous provinces (Trento and Bolzano), each with its own cancer registry. The registries' total coverage is 100% of the regional population. The main difference between the two provinces in terms of cancer epidemiology is related to the prostate cancer incidence and survival, with higher values in Bolzano. This paper provides an update until 2015 of the basic epidemiological indicators for seven major cancers for the entire region. Methods The indicators were estimated by means of the MIAMOD method, a statistical back-calculation approach to derive incidence and prevalence figures starting from mortality and relative survival data. Mortality data were provided by ISTAT for the period 1970—2002 while survival was modeled on the basis of published data from the Italian cancer registries. Results The estimates for 2012 show that breast cancer was the most common cancer in women and prostate cancer was most common in men. Incidence and mortality were decreasing for cervix cancer and stomach cancer in both genders during the whole study period. The lung cancer incidence and mortality were decreasing in men but increasing in women. The colorectal cancer incidence rose in both genders while the mortality was decreasing in women. The incidence of skin melanoma increased in both sexes, while the mortality remained very low. The breast cancer incidence was increasing up to 2015 while the mortality was declining since 1986. The prostate cancer incidence increased up to 2006, thereafter the rates stabilized while mortality started to decrease in the early 2000s. The highest mortality rates were estimated for lung cancer in men and breast cancer in women. Conclusions Lifestyle plays an important role in cancer trends, as does organized screening for early detection of cervix, breast and colorectal cancer. The provincial data on risk factor distribution and adherence to and coverage of organized screening are satisfactory and their optimization may allow additional benefits in terms of public health.
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Affiliation(s)
- Silvano Piffer
- Servizio Epidemiologia Clinica e Valutativa, Registro Tumori, Azienda Provinciale per i Servizi Sanitari, Trento
| | - Maria Gentilini
- Servizio Epidemiologia Clinica e Valutativa, Registro Tumori, Azienda Provinciale per i Servizi Sanitari, Trento
| | - Roberto Rizzello
- Servizio Epidemiologia Clinica e Valutativa, Registro Tumori, Azienda Provinciale per i Servizi Sanitari, Trento
| | - Guido Mazzoleni
- UO Anatomia Patologica, Registro Tumori, Ospedale S Maurizio, Bolzano
| | - Francesco Bellù
- UO Anatomia Patologica, Registro Tumori, Ospedale S Maurizio, Bolzano
| | - Silvia Rossi
- Centro Nazionale di Epidemiologia, Istituto Superiore di Sanità, Rome, Italy
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