Levels and correlates of knowledge about cancer risk factors among 13,293 public school students in Morelos, Mexico

A Systematic Review on Reporting of Methods in National Surveys about Adults' Attitudes to Lifestyle and Environmental Risk Factors for Cancer

The risks of developing cancer are significantly affected by our lifestyle and environment. While there are several uncontrollable risk factors, we can modify our lifestyle and our environment to reduce the increased threat of cancer. This systematic review aims to evaluate the methodological assessment used to evaluate attitudes about cancer risk factors among the general population. Two researchers independently screened the articles for inclusion and Critical Appraisal Skills Programme (CASP) checklists were used to assess the methodology of the included studies. Thirty-one manuscripts met the inclusion criteria with a majority of them focusing on attitudes to several cancer risk factors and six on specific cancer location risk factors. This systematic review highlights the diversity of notions used around attitudes and methods used in the method of administering the survey, as well as the format of the questions and the response scales. It is thus difficult to compare data between different countries. However, cancer is a global problem. Harmonizing methods could allow a comparison of data between countries. Recommendations to this effect are suggested.

Cancer Education Interventions in Adolescents: A Systematic Review of Scope and Content

Given the long induction time of many cancers and the fact that modifiable risk factors (e.g., cigarette smoking) including preventive factors (e.g., human papillomavirus [HPV] vaccination, healthy dietary and physical activity patterns) are influenced in adolescence, educating adolescents about cancer causation and risk reduction may have a large impact on reducing the cancer burden. We conducted a systematic review of literature evaluating the impact of cancer education interventions on adolescent knowledge of cancer risk reduction. We searched for articles published from 2000 to 2019 and identified 33 studies meeting our criteria. Given the methodological heterogeneity across studies, we briefly assessed effectiveness but focused on examining the design of the intervention and study. The majority of studies took place outside of the United States (67%). Most studies solely addressed skin or cervical cancer (67%) with only 18% (n = 6) discussing multiple cancers. The majority of interventions were a single-session (55%), did not involve a control or comparison group (67%), and were evaluated using a pre-test and a single post-test (61%); some studies administered multiple post-tests. Few studies (12%) investigated adolescents' knowledge of lifestyle and environmental risk factors at both the individual and community level. Most studies (94%) reported improvement in knowledge following an intervention. Our review revealed wide methodological variation and a deficit in research evaluating interventions that address multiple cancer types and risk factors. Future research should robustly test whether comprehensive cancer education for adolescents can reduce the cancer burden, particularly in communities with major cancer health disparities.

What Children and Adolescents Know and Need to Learn about Cancer

Despite cancer's devastating effects on health and longevity, and the critical role of health habits formed during childhood and adolescence in its prevention, children's knowledge of contributors to cancer is understudied. In this paper, the first developmental analysis of the literature, we outline relevant theoretical perspectives and three early emerging intuitions about illness evident among preschool children-contagion/germ, contamination, and unhealthy lifestyle theories-and then review research on elementary and secondary school students' awareness of risk factors for cancer in light of these early intuitive theories. Our analysis centers on the 16 studies we could locate, done in seven countries, that allowed calculating the percentages of children of different age groups who mentioned various risk factors in response to open-ended questions or endorsed them in response to structured questions. Awareness of primary known risk factors (led by smoking), lifestyle contributors, and personal factors (genetics and old age) increased with age, while contact myths decreased with age until adolescents began to show awareness of sexual contact as a contributor to certain cancers. In addition, the analysis revealed higher levels of awareness in response to structured questions than in response to open-ended questions; a glaring need for research asking young school-aged children about key risk factors and exploring not only their knowledge but their causal understanding; a need for attention to sociocultural influences; and connections between preschool children's intuitive theories of disease and older children's patterns of belief about cancer that can help guide school-based cancer education.

Knowledge About Gastrointestinal Cancers in People Referred for Endoscopy and Colonoscopy During a Screening Program: a Cross-sectional Study in Guilan, North of Iran

PURPOSE

The most northern and northwestern regions of Iran are at a high risk for gastrointestinal cancers. In this study, we evaluated knowledge of gastrointestinal (GI) cancers in people referred for endoscopy and colonoscopy screening.

METHODS

This cross-sectional study was carried out among 461 people who were under the patronage of a local relief foundation and referred for endoscopy and colonoscopy to the Gastrointestinal and Liver Disease Research Center (GLDRC), Rasht, north of Iran, from March 2016 to March 2017. A well-defined two-sectioned questionnaire was carried out for each group.

RESULTS

Overall, 300 and 161 individuals were in the gastric and colon cancer knowledge group, respectively. The level of knowledge in various areas of gastric and colon cancer was desirable. In general, the average of different domains in gastric and colon cancer knowledge questions were 20.2 ± 6.6 and 19.2 ± 4.9, with the knowledge level higher than the mean in gastric cancer (58%) and colon cancer (67.1%). The mean score of knowledge of GI cancers in terms of risk factor indicated a significant relationship between BMI and alcohol consumption. Meanwhile, a meaningful relationship between symptoms and BMI with knowledge was declared. About domains of colon cancer, there was a significant relationship between younger age and knowledge in the risk factor.

CONCLUSIONS

The results of this study can provide an opportunity to formulate strategies to achieve goals, especially in the field of education, prevention, and control of the disease by raising knowledge for the general public and educating people who are responsible for providing and delivering health services to this community.

Cancer awareness among university students in Turkey

BACKGROUND

One of the most important reasons for the high mortality rates of cancer is the low level of awareness, which can lead to a late diagnosis and treatments starting too late. Therefore, it is necessary for individuals, especially at younger age, to gain awareness and integrate taking the necessary precautions into their lifestyle in order to prevent cancer and ensure early diagnosis. The aim of this study was to assess the levels of awareness of factors for major cancers among students studying in two different campuses of a university in the Western Black Sea Region.

MATERIALS AND METHODS

This descriptive/cross-sectional study was performed between January-March 2014. Students studying in the 2013-2014 academic year in a university in the Western Black Sea Region in two separate campuses were the subjects.

RESULTS

The mean age was 21.01 ± 3.63. While female students (51.2%) were the majority in the health sciences campus (74.8%), male students (48.8% ) were the majority in the social sciences campus (76.5%). Some 9.6% of the students from the health sciences campus and 12.4% of the students from the social sciences campus thought that cancer was communicable, while most of the students from both campuses knew that smoking caused cancer. It can also be seen that the rate of answering questions regarding cancer correctly was higher among students studying in the health sciences campus.

CONCLUSIONS

It was determined that students who do not study at the health sciences campus have insufficient information on cancer, cancer symptoms, and the possibility of breast cancer in males and approximately half of them regarded obesity as a risk factor for cancer.

[Perception of risk factors for cancer in the Spanish population]

OBJECTIVE

To analyze the perception of the Spanish population of risk factors for cancer.

METHODS

Data were extracted from the OncoBarometro 2010 survey. Multivariate logistic models were applied to analyze the perception of the population on the importance of various risk factors: smoking, alcohol, sun, food, weight, sexually transmitted diseases, family history, radiation exposure, exposure to toxic substances and air pollution. The answers were rated on a 0 to 10 scale and were converted to low (0-6) and high (7-10) categories. The measure of association used was the prevalence ratio (PR).

RESULTS

The greatest importance was assigned to smoking (high importance: 83.1%), whereas the least importance was assigned to weight (26.5%). In general, the probability of perceiving risk factors as important was lower among men (PR sun: 0.87; PR sexually transmitted diseases: 0.78) and increased among people who received professional advice on cancer prevention (PR alcohol: 1.11; PR sun: 1.18; PR food; 1.31; PR weight: 1.92). In particular, knowledge of symptoms and extreme fear of cancer were associated with perceiving smoking as an important risk factor, whereas a high perceived vulnerability to cancer was associated with perceiving exposure to toxic substances, pollution and smoking as important risk factors.

CONCLUSIONS

Greater awareness is required of the association of cancer with overweight and sexually transmitted diseases. The recommendations given by health professionals on cancer prevention are key to increasing the population's awareness of risk factors for cancer.

Cancer awareness changes after an educational intervention among undergraduate students

The objectives of this study are to assess undergraduate awareness of cancer risk factors, prevention strategies, and warning signs and to evaluate whether an educational intervention increases cancer awareness. This study adopts a nonequivalent control group pretest-posttest design. Of the 386 students who completed the pretest, only 35-39 % identified low fruit and vegetable intake, being overweight, and physical inactivity as cancer risk factors, and <30 % recognized persistent changes in bowel or bladder habits and persistent cough or hoarseness as cancer warning signs. After the educational intervention, the analysis of variance of changes from baseline (the pretest score) for all four experimental groups were all significantly higher than those of the two control groups (p ≤.001), except for the change of the retention test score from the pretest score for experimental group 3. This study highlights the need to improve undergraduates' cancer awareness and the effectiveness of educational intervention.

A systematic review of measures used in studies of human papillomavirus (HPV) vaccine acceptability

BACKGROUND

The recent proliferation of studies describing factors associated with HPV vaccine acceptability could inform health care providers in improving vaccine coverage and support future research. This review examined measures of HPV and HPV-vaccine knowledge, attitudes, beliefs and acceptability, described psychometric characteristics, and provided recommendations about their use.

METHODS

A systematic search of Medline, CINAHL, PsychoInfo, and ERIC through May 2008 for English language reports of quantitative data from parents, young adults or adolescents yielded 79 studies.

RESULTS

The majority of studies were cross-sectional surveys (87%), self-administered (67%), conducted before prophylactic vaccines were publicly available (67%) and utilized convenience samples (65%). Most measured knowledge (80%), general attitudes about HPV vaccination (40%), and willingness to vaccinate one's daughter (26%). Two-thirds did not report reliability or validity of measures. The majority did not specify a theoretical framework.

CONCLUSIONS

Use of a theoretical framework, consistent labeling of constructs, more rigorous validation of measures, and testing of measures in more diverse samples are needed to yield measurement instruments that will produce findings to guide practitioners in developing successful community and clinical interventions.

Public Awareness of Risk Factors for Cancer and Its Determinants in an Iranian Population

Cancer is increasingly being seen as a disease that is preventable and manageable. Knowledge often does constitute one element in the behavior change process. In addition, to promote the cancer prevention programs, data on level of knowledge among the target population are needed. The present research (as the first) aimed at providing information on level and correlates of awareness of cancer risk factors among the general public in Iran. The level of knowledge about 12 cancer risk factors (as a section of a multipart questionnaire) was assessed in a representative sample of 2500 adults (aged >18 years) in Tehran, Iran. The data were analyzed using latent class regression with the R statistical package. A small proportion of the respondents (12.2%) had high knowledge level and most of them had mixed (56.9%) and low level of awareness (30.9%). The most important determinants of knowledge level included level of education, gender, and family history. The results provided valuable clues and guidelines toward the formulation of relevant cancer prevention strategies, especially within the scope of health education. The applied statistical model presented a new descriptive and analytical perspective to evaluate the level of knowledge about the cancer risk factors and its determinants.