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Elshami M, Ayyad M, Alser M, Al-Slaibi I, Mohamad BM, Albandak M, Dwikat MF, Naji SA, Isleem WS, Shurrab A, Yaghi B, Qabaja YA, Hamdan FK, Sweity RR, Jneed RT, Assaf KA, Hmaid MM, Awwad II, Alhabil BK, Alarda MN, Alsattari AS, Aboyousef MS, Aljbour OA, AlSharif R, Giacaman CT, Alnaga AY, Abu Nemer RM, Almadhoun NM, Skaik SM, Albarqi SI, Bottcher B, Abu-El-Noor N. Attitudes toward colorectal cancer and colonoscopy in Palestine: a questionnaire-based study. Sci Rep 2024; 14:14563. [PMID: 38914664 PMCID: PMC11196673 DOI: 10.1038/s41598-024-65653-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/21/2024] [Indexed: 06/26/2024] Open
Abstract
Colorectal cancer (CRC) is a frequent cause of cancer-related mortality in the Palestinian population. This cross-sectional study was conducted from July 2019 to March 2020 and examined attitudes toward CRC and colonoscopy, as well as the interplay between both. Participants were recruited using convenience sampling from public spaces, governmental hospitals, and primary healthcare centers across 11 governorates in Palestine. Displaying a positive attitude was defined as agreeing on at least the median number of questions related to CRC (5 of 11 questions) or colonoscopy (6 of 10 questions). A total of 4623 participants were included. Most participants agreed that 'early detection of CRC increases the possibility of more effective treatment' (n = 4161, 89.7%). Similarly, the majority of participants agreed on 'preferring a physician with a gender similar to the participants to perform the colonoscopy' (n = 3738, 80.9%) and 'willingness to have colonoscopy even if the participant had to pay for it' (n = 3727, 80.6%). Furthermore, 3115 participants (67.4%) demonstrated positive attitudes toward CRC, while 2540 participants (55.0%) displayed similar attitudes toward colonoscopy. Participants from the West Bank and Jerusalem were more likely than those from the Gaza Strip to display positive attitudes toward colonoscopy (59.2% vs. 48.9%). Participants with positive attitudes toward CRC were more likely to also display positive attitudes toward colonoscopy and vice versa. About two thirds of study participants exhibited positive attitudes toward CRC, and 55.0% displayed positive attitudes toward colonoscopy. There was a reciprocal relationship between having positive attitudes toward CRC and colonoscopy.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7100, Cleveland, OH, 44106, USA.
- Ministry of Health, Gaza, Palestine.
| | - Mohammed Ayyad
- Department of Internal Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza, Palestine
| | | | - Balqees M Mohamad
- Doctors Without Borders (Médecins Sans Frontières), Hebron, Palestine
| | - Maram Albandak
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Mohammad F Dwikat
- Department of Internships, An-Najah National University Hospital, Nablus, Palestine
| | - Shoruq A Naji
- Faculty of Pharmacy, Al-Azhar University of Gaza, Gaza, Palestine
| | - Wejdan S Isleem
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Adela Shurrab
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Bashar Yaghi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Fatma K Hamdan
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Raneen R Sweity
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Remah T Jneed
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Khayria A Assaf
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Mohammed M Hmaid
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Iyas I Awwad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Marah N Alarda
- Faculty of Dentistry, Arab American University, Jenin, Palestine
| | | | | | - Omar A Aljbour
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Rinad AlSharif
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Ali Y Alnaga
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Ranin M Abu Nemer
- Faculty of Allied Medical Sciences, Arab American University, Jenin, Palestine
| | | | - Sondos M Skaik
- Faculty of Medicine, Al-Azhar University, Gaza, Palestine
| | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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2
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Elshami M, Dwikat MF, Al-Slaibi I, Alser M, Albandak ME, Ayyad M, Naji SA, Mohamad BM, Isleem WS, Shurrab A, Yaghi B, Qabaja YA, Hamdan FK, Sweity RR, Jneed RT, Assaf KA, Hmaid MM, Awwad II, Alhabil BK, Alarda MN, Alsattari AS, Aboyousef MS, Aljbour OA, AlSharif R, Giacaman CT, Alnaga AY, Nemer RMA, Almadhoun NM, Skaik SM, Albarqi SI, Abu-El-Noor N, Bottcher B. Understanding the interplay of colorectal cancer awareness and attitudes among Palestinians: a national cross-sectional study. BMC Cancer 2024; 24:590. [PMID: 38750448 PMCID: PMC11094844 DOI: 10.1186/s12885-024-12357-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/07/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND In Palestine, colorectal cancer (CRC) is the second most common cause of cancer-related mortality after lung cancer. No studies have examined the relationship between CRC awareness and attitudes. This study aimed to investigate the interplay between CRC awareness and attitudes among the Palestinian population. METHODS A nationwide cross-sectional survey was carried out between July 2019 and March 2020. Convenience sampling was used to collect data from hospitals, primary healthcare facilities, and public areas in 11 governorates. Modified, translated-into-Arabic versions of the validated Bowel Cancer Awareness Measure and Cancer Awareness Measure-Mythical Causes Scale were utilized to assess the awareness of CRC signs/symptoms, risk factors, and causation myths. The cumulative awareness score for each domain was computed and stratified into tertiles. The top tertile denoted 'high' awareness, while the remaining two tertiles denoted 'low' awareness. RESULTS The final analysis included 4,623 participants; of whom, 3115 (67.4%) reported positive attitudes toward CRC. In total, 1,849 participants (40.0%) had high awareness of CRC signs/symptoms. There was no association between displaying a high awareness of CRC signs/symptoms and having positive attitudes toward CRC. A total of 1,840 participants (38.9%) showed high awareness of CRC risk factors. Participants with high CRC risk factor awareness were more likely to display positive attitudes toward CRC (OR = 1.22, 95% CI: 1.07-1.39). Only 219 participants (4.7%) had high awareness of CRC causation myths. Participants with high awareness of CRC causation myths were more likely to exhibit positive attitudes toward CRC (OR = 2.48, 95% CI: 1.71-3.58). CONCLUSION A high awareness level of CRC risk factors and causation myths was associated with a greater likelihood of demonstrating positive attitudes toward CRC in terms of perceived susceptibility, importance of early detection, and consequences of developing the disease. Future educational interventions should focus on raising public awareness about CRC, with a particular emphasis on risk factors and causation myths, to maximize the potential for shaping favorable attitudes toward the disease.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside, Cleveland, OH, 7100, 44106, USA.
- Ministry of Health, Gaza, Palestine.
| | - Mohammad Fuad Dwikat
- Department of Internships, An-Najah National University Hospital, Nablus, Palestine
| | | | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza, Palestine
| | | | - Mohammed Ayyad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | - Bashar Yaghi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | - Khayria Ali Assaf
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | | | - Iyas Imad Awwad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | - Rinad AlSharif
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Elshami M, Albandak M, Alser M, Al-Slaibi I, Ayyad M, Dwikat MF, Naji SA, Mohamad BM, Isleem WS, Shurrab A, Yaghi B, Ayyash Qabaja Y, Hamdan FK, Sweity RR, Jneed RT, Assaf KA, Hmaid MM, Awwad II, Alhabil BK, Alarda MN, Alsattari AS, Aboyousef MS, Aljbour OA, AlSharif R, Giacaman CT, Alnaga AY, Abu Nemer RM, Almadhoun NM, Skaik SM, Albarqi SI, Abu-El-Noor N, Bottcher B. Differences in colorectal cancer awareness between screening eligible vs. ineligible Palestinians: a national cross-sectional study. Eur J Public Health 2024:ckae083. [PMID: 38745392 DOI: 10.1093/eurpub/ckae083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND This study aimed to compare colorectal cancer (CRC) awareness between screening-eligible and ineligible individuals in Palestine. METHODS Convenience sampling was utilized to recruit Palestinian adults from diverse settings, including hospitals, primary healthcare centers and public spaces across 11 governorates. The evaluation of CRC awareness in terms of signs/symptoms, risk factors and causation myths was conducted using Arabic-translated, modified versions of the validated instruments, the Bowel Cancer Awareness Measure and the Cancer Awareness Measure-Mythical Causes Scale. RESULTS The final analysis included 2698 participants, with 2158 (80.9%) eligible for CRC screening and 540 (19.1%) ineligible for it. The most recognized CRC sign/symptom was 'lump in the abdomen' in both screening-eligible (n = 386, 71.5%) and ineligible (n = 1582, 73.3%) groups. 'Lack of physical activity' was the most recognized risk factor in both groups (eligible: n = 451, 83.5%; ineligible: n = 1766, 81.8%). The most reported causation myth in both groups was 'having a physical trauma' (eligible: n = 340, 63.0%; ineligible: n = 1353, 62.7%). In the screening-eligible group, only 210 participants (38.9%) demonstrated high awareness of CRC signs/symptoms, 213 participants (39.4%) showed high awareness of CRC risk factors and only 46 participants (8.5%) displayed high awareness of CRC causation myths. There were no significant associations between being eligible for screening colonoscopy and the awareness levels of CRC signs/symptoms, risk factors and causation myths. CONCLUSION Overall, awareness levels of CRC signs/symptoms, risk factors and causation myths were notably low among screening-eligible participants. There were no differences in awareness levels between individuals eligible for colonoscopy and those who were not.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- Ministry of Health, Gaza, Palestine
| | - Maram Albandak
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza, Palestine
| | | | - Mohammed Ayyad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Mohammad F Dwikat
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Shoruq A Naji
- Faculty of Pharmacy, Al-Azhar University of Gaza, Gaza, Palestine
| | - Balqees M Mohamad
- Doctors Without Borders (Médecins Sans Frontières), Hebron, Palestine
| | - Wejdan S Isleem
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Bashar Yaghi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Fatma K Hamdan
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Raneen R Sweity
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Remah T Jneed
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Khayria A Assaf
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Mohammed M Hmaid
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Iyas I Awwad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Marah N Alarda
- Faculty of Dentistry, Arab American University, Jenin, Palestine
| | | | | | - Omar A Aljbour
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Rinad AlSharif
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Ali Y Alnaga
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Ranin M Abu Nemer
- Faculty of Allied Medical Sciences, Arab American University, Jenin, Palestine
| | | | - Sondos M Skaik
- Faculty of Medicine, Al-Azhar University, Gaza, Palestine
| | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Elshami M, Sawafta N, Mansour A, Alser M, Al-Slaibi I, Abukmail H, Shurrab H, Qassem S, Usrof FD, Alruzayqat M, Aqel W, Nairoukh R, Kittaneh R, Habes YMN, Ghanim O, Aabed WA, Omar O, Daraghma M, Aljbour J, Elian REM, Zuhour A, Habes H, Al-Dadah M, Albarqi SI, Bottcher B, Abu-El-Noor N. Anticipated time to seek medical advice for possible lung cancer symptoms and barriers to timely presentation in Palestine: a national cross-sectional study. BMC Cancer 2024; 24:183. [PMID: 38326766 PMCID: PMC10848550 DOI: 10.1186/s12885-024-11935-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/29/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Lung cancer (LC) has poor survival outcomes mainly due to diagnosis at late stages. This study explored the anticipated time to seek medical advice for possible LC symptoms and barriers to early presentation in Palestine. METHODS This cross-sectional study recruited adult participants from hospitals, primary healthcare centers, and public spaces of 11 governorates using convenience sampling. A modified, translated-into-Arabic version of the validated LC awareness measure was used to assess LC symptom awareness, the time needed to seek medical advice and barriers to early presentation. RESULTS A total of 4762 participants were included. The proportion that would immediately seek medical advice for possible LC symptoms varied according to the symptoms' nature. For respiratory symptoms, this ranged from 15.0% for 'painful cough' to 37.0% for 'coughing up blood'. For non-respiratory symptoms, this ranged from '4.2% for 'unexplained loss of appetite' to 13.8% for 'changes in the shape of fingers or nails'. Participants with good LC symptom awareness were more likely to seek medical advice within a week of recognizing most LC symptoms. About 13.0% would delay their visit to see a doctor after recognizing an LC symptom. The most reported barriers were emotional with 'disliking the visit to healthcare facilities' (59.8%) as the leading barrier. CONCLUSION LC respiratory symptoms were more likely to prompt early seeking of medical advice. Good LC symptom awareness was associated with a higher likelihood of help-seeking within a week. Educational interventions are needed to promote LC awareness and address the perceived barriers to early presentation in low-resource settings, such as Palestine.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7100, Cleveland, OH, 44106, USA.
- Ministry of Health, Gaza, Palestine.
| | - Nawras Sawafta
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Ahmad Mansour
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
- Ministry of Health, Ramallah, West Bank, Palestine
| | - Mohammed Alser
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza, Palestine
| | | | - Hanan Abukmail
- International Medical Corps, Gaza, Palestine
- Harvard Medical School, Boston, MA, USA
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Hanan Shurrab
- Faculty of Pharmacy, Al-Azhar University of Gaza, Gaza, Palestine
| | - Shahd Qassem
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Faten Darwish Usrof
- Department of a Medical Laboratory Sciences, Faculty of Health Sciences, Islamic University of Gaza, Gaza City, Palestine
| | | | - Wafa Aqel
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Roba Nairoukh
- Faculty of Dentistry, Al-Quds University, Jerusalem, Palestine
| | - Rahaf Kittaneh
- Faculty of Nursing, An Najah National University, Nablus, Palestine
| | | | - Obaida Ghanim
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Ola Omar
- Faculty of Medicine, Al Najah National University, Nablus, Palestine
| | - Motaz Daraghma
- Faculty of Medicine, Al Najah National University, Nablus, Palestine
| | - Jumana Aljbour
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Razan E M Elian
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Areen Zuhour
- Faculty of Medicine, Al Najah National University, Nablus, Palestine
| | - Haneen Habes
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Elshami M, Albandak M, Alser M, Al-Slaibi I, Ayyad M, Dwikat MF, Naji SA, Mohamad BM, Isleem WS, Shurrab A, Yaghi B, Qabaja YA, Hamdan FK, Sweity RR, Jneed RT, Assaf KA, Hmaid MM, Awwad II, Alhabil BK, Alarda MN, Alsattari AS, Aboyousef MS, Aljbour OA, AlSharif R, Giacaman CT, Alnaga AY, Abu Nemer RM, Almadhoun NM, Skaik SM, Albarqi SI, Abu-El-Noor N, Bottcher B. Screening Perspectives: The Role of Colorectal Cancer Awareness in Shaping Attitudes Toward Colonoscopy in Palestine. JCO Glob Oncol 2024; 10:e2300470. [PMID: 38386956 PMCID: PMC10898669 DOI: 10.1200/go.23.00470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 01/05/2024] [Indexed: 02/24/2024] Open
Abstract
PURPOSE To assess colorectal cancer (CRC) awareness and its influence on attitudes toward colonoscopy in Palestine. MATERIALS AND METHODS Convenience sampling was used to recruit Palestinian adults from hospitals, primary health care centers, and public spaces across 11 governorates. To evaluate the awareness of CRC signs/symptoms, risk factors, and mythical causes, the Bowel Cancer Awareness Measure and Cancer Awareness Measure-Mythical Causes Scale were used after translation into Arabic. For each correctly recognized item, one point was given. The total awareness score of each domain was calculated and categorized into tertiles; the top tertile was considered high awareness, and the other two tertiles were considered low awareness. RESULTS A total of 4,623 questionnaires were included. Only 1,849 participants (40.0%) exhibited high awareness of CRC signs/symptoms. High awareness of CRC symptoms was associated with higher likelihood of showing positive attitudes toward colonoscopy (odds ratio [OR], 1.21 [95% CI, 1.07 to 1.37]). A total of 1,840 participants (38.9%) demonstrated high awareness of CRC risk factors. Participants with high awareness of CRC risk factors were more likely to display positive attitudes toward colonoscopy (OR, 1.20 [95% CI, 1.07 to 1.37]). Only 219 participants (4.7%) demonstrated high awareness of CRC causation myths. There was no association between awareness of CRC causation myths and positive attitudes toward colonoscopy. CONCLUSION Awareness of CRC was poor with less than half of the study participants demonstrating high awareness of CRC signs/symptoms and risk factors, and a minority (<5%) displaying high awareness of CRC causation myths. High awareness of CRC signs/symptoms and risk factors was associated with greater likelihood of demonstrating positive attitudes toward colonoscopy. Educational initiatives are needed to address knowledge gaps and dispel misconceptions surrounding CRC.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH
- Ministry of Health, Gaza, Palestine
| | - Maram Albandak
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza, Palestine
| | | | - Mohammed Ayyad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Shoruq A. Naji
- Faculty of Pharmacy, Al-Azhar University of Gaza, Gaza, Palestine
| | | | - Wejdan S. Isleem
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Bashar Yaghi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Fatma K. Hamdan
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Remah T. Jneed
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Khayria A. Assaf
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | | | - Iyas I. Awwad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Marah N. Alarda
- Faculty of Dentistry, Arab American University, Jenin, Palestine
| | | | | | - Omar A. Aljbour
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Rinad AlSharif
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Ali Y. Alnaga
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Ranin M. Abu Nemer
- Faculty of Allied Medical Sciences, Arab American University, Jenin, Palestine
| | | | | | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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6
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Elshami M, Albandak M, Alser M, Al-Slaibi I, Ayyad M, Dwikat MF, Naji SA, Mohamad BM, Isleem WS, Shurrab A, Yaghi B, Ayyash Qabaja Y, Hamdan FK, Sweity RR, Jneed RT, Assaf KA, Hmaid MM, Awwad II, Alhabil BK, Alarda MN, Alsattari AS, Aboyousef MS, Aljbour OA, AlSharif R, Giacaman CT, Alnaga AY, Abu Nemer RM, Almadhoun NM, Skaik SM, Albarqi SI, Abu-El-Noor N, Bottcher B. Differences in Colorectal Cancer Awareness Between Vegetarians and Nonvegetarians: A National Cross-Sectional Study From Palestine. JCO Glob Oncol 2024; 10:e2300400. [PMID: 38386954 PMCID: PMC10898678 DOI: 10.1200/go.23.00400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/21/2023] [Accepted: 01/10/2024] [Indexed: 02/24/2024] Open
Abstract
PURPOSE To compare colorectal cancer (CRC) awareness between vegetarians and nonvegetarians in Palestine. MATERIALS AND METHODS The validated Bowel Cancer Awareness Measure and Cancer Awareness Measure-Mythical Causes Scale were translated into Arabic and used to assess awareness of CRC signs/symptoms, risk factors, and mythical causes. The total awareness score of each domain was calculated and categorized into tertiles; the top tertile was considered as good awareness. Multivariable logistic regression analysis was used to examine the association between being a vegetarian and displaying good awareness in each domain. RESULTS This study included 4,623 participants: 560 vegetarians (12.1%) and 4,063 nonvegetarians (87.9%). Lump in the abdomen was the most recognized CRC sign/symptom among both nonvegetarians (n = 2,969, 73.1%) and vegetarians (n = 452, 80.7%). Vegetarians were less likely than nonvegetarians to display good awareness of CRC signs/symptoms (odds ratio, 0.59 [95% CI, 0.48 to 0.72]). Lack of physical activity was the most identified modifiable CRC risk factor in both nonvegetarians (n = 3,368, 82.9%) and vegetarians (n = 478, 85.4%). Similarly, having a bowel disease was the most identified nonmodifiable risk factor among both nonvegetarians (n = 2,889, 71.1%) and vegetarians (n = 431, 77.0%). There were no associated differences between both groups in the awareness levels of CRC risk factors. The most recognized food-related CRC causation myth in nonvegetarians was drinking from plastic bottles (n = 1,023, 25.2%), whereas it was eating burnt food in vegetarians (n = 176, 31.4%). Having a physical trauma was the most recognized food-unrelated myth in both nonvegetarians (n = 2,356, 58.0%) and vegetarians (n = 396, 70.7%). There were no associated differences in the awareness of CRC causation myths between both groups. CONCLUSION Awareness of CRC was notably low in both Palestinian vegetarians and nonvegetarians. Particularly, vegetarians demonstrated lower awareness of CRC signs and symptoms.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH
- Ministry of Health, Gaza, Palestine
| | - Maram Albandak
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza, Palestine
| | | | - Mohammed Ayyad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Mohammad F Dwikat
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Shoruq A Naji
- Faculty of Pharmacy, Al-Azhar University of Gaza, Gaza, Palestine
| | - Balqees M Mohamad
- Doctors Without Borders (Médecins Sans Frontières), Hebron, Palestine
| | - Wejdan S Isleem
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Bashar Yaghi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Fatma K Hamdan
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Raneen R Sweity
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Remah T Jneed
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Khayria A Assaf
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Mohammed M Hmaid
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Iyas I Awwad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Marah N Alarda
- Faculty of Dentistry, Arab American University, Jenin, Palestine
| | | | | | - Omar A Aljbour
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Rinad AlSharif
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Ali Y Alnaga
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Ranin M Abu Nemer
- Faculty of Allied Medical Sciences, Arab American University, Jenin, Palestine
| | | | - Sondos M Skaik
- Faculty of Medicine, Al-Azhar University, Gaza, Palestine
| | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Elshami M, Naji SA, Dwikat MF, Al-Slaibi I, Alser M, Ayyad M, Mohamad BM, Isleem WS, Shurrab A, Yaghi B, Qabaja YA, Hamdan FK, Sweity RR, Jneed RT, Assaf KA, Albandak ME, Hmaid MM, Awwad II, Alhabil BK, Alarda MN, Alsattari AS, Aboyousef MS, Aljbour OA, AlSharif R, Giacaman CT, Alnaga AY, Abu Nemer RM, Almadhoun NM, Skaik SM, Bottcher B, Abu-El-Noor N. Myths and Common Misbeliefs About Colorectal Cancer Causation in Palestine: A National Cross-Sectional Study. JCO Glob Oncol 2024; 10:e2300295. [PMID: 38166235 PMCID: PMC10803036 DOI: 10.1200/go.23.00295] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 10/07/2023] [Accepted: 11/06/2023] [Indexed: 01/04/2024] Open
Abstract
PURPOSE To explore public awareness of myths around colorectal cancer (CRC) causation in Palestine and to examine factors associated with good awareness. MATERIALS AND METHODS Convenience sampling was used to recruit adult Palestinians from governmental hospitals, primary health care centers, and public spaces. Recognizing 13 myths around CRC causation was assessed using a translated-into-Arabic version of the Cancer Awareness Measure-Mythical Causes Scale. Awareness level was determined based on the number of CRC mythical causes recognized: poor (0-4), fair (5-9), and good (10-13). Multivariable logistic regression was used to examine the association between sociodemographic characteristics and displaying good awareness. It adjusted for age group, sex, education, occupation, monthly income, residence, marital status, having chronic diseases, being a vegetarian, knowing someone with cancer, and site of data collection. RESULTS Of 5,254 participants approached, 4,877 agreed to participate (response rate, 92.3%). A total of 4,623 questionnaires were included in the final analysis: 2,700 from the West Bank and Jerusalem (WBJ) and 1,923 from the Gaza Strip. Only 219 participants (4.7%) demonstrated good awareness of myths around CRC causation. WBJ participants were twice more likely than those from the Gaza Strip to display good recognition (5.9% v 3.1%). Male sex, living in the WBJ, and visiting hospitals were all associated with an increase in the likelihood of displaying good awareness. Conversely, knowing someone with cancer was associated with a decrease in the likelihood of displaying good awareness. Having a physical trauma was the most recognized CRC causation myth (n = 2,752, 59.5%), whereas eating food containing additives was the least (n = 456, 9.8%). CONCLUSION Only 4.7% displayed good ability to recognize myths around CRC causation. Future educational interventions are needed to help the public distinguish the evidence-based versus mythical causes of CRC.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH
- Ministry of Health, Gaza, Palestine
| | | | | | | | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza, Palestine
| | - Mohammed Ayyad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | - Bashar Yaghi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | - Khayria Ali Assaf
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | | | | | - Iyas Imad Awwad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | - Rinad AlSharif
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Elshami M, Ismail IO, Alser M, Al-Slaibi I, Ghithan RJ, Usrof FD, Qawasmi MAM, Okshiya HM, Shurrab NRS, Mahfouz II, Fannon AA, Hawa MRM, Giacaman N, Ahmaro M, Zaatreh RK, AbuKhalil WA, Melhim NK, Madbouh RJ, Hziema HJA, Lahlooh RAA, Ubaiat SN, Jaffal NA, Alawna RK, Abed SN, Abuzahra BNA, Kwaik AJA, Dodin MH, Taha RO, Alashqar DM, Mobarak RAAF, Smerat T, Albarqi SI, Abu-El-Noor N, Bottcher B. Common myths and misconceptions about breast cancer causation among Palestinian women: a national cross-sectional study. BMC Public Health 2023; 23:2370. [PMID: 38031084 PMCID: PMC10688078 DOI: 10.1186/s12889-023-17074-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND The discussion about breast cancer (BC) causation continues to be surrounded by a number of myths and misbeliefs. If efforts are misdirected towards reducing risk from false mythical causes, individuals might be less likely to consider and adopt risk-reducing behaviors for evidence-based BC causes. This national study aimed to assess the awareness of BC causation myths and misbeliefs among Palestinian women, and examine the factors associated with having good awareness. METHODS This national cross-sectional study recruited adult women from government hospitals, primary healthcare centers, and public spaces in 11 governorates in Palestine. A modified version of the Cancer Awareness Measure-Mythical Causes Scale was used to collect data. The level of awareness of BC causation myths was determined based on the number of myths recognized to be incorrect: poor (0-5), fair (6-10), or good (11-15). RESULTS A total of 5,257 questionnaires were included. Only 269 participants (5.1%) demonstrated good awareness (i.e., recognizing more than 10 out of 15 BC mythical causes). There were no notable differences in displaying good awareness between the main areas of Palestine, the Gaza Strip and the West Bank and Jerusalem (5.1% vs. 5.1%). Having chronic disease as well as visiting hospitals and primary healthcare centers were associated with a decrease in the likelihood of displaying good awareness. Myths related to food were less frequently recognized as incorrect than food-unrelated myths. 'Eating burnt food' was the most recognized food-related myth (n = 1414, 26.9%), while 'eating food containing additives' was the least recognized (n = 599, 11.4%). 'Having a physical trauma' was the most recognized food-unrelated myth (n = 2795, 53.2%), whereas the least recognized was 'wearing tight bra' (n = 1018, 19.4%). CONCLUSIONS A very small proportion of Palestinian women could recognize 10 or more myths around BC causation. There is a substantial need to include clear information about BC causation in future educational interventions besides focusing on BC screening, signs and symptoms, and risk factors.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
- Ministry of Health, Gaza, Palestine.
| | | | - Mohammed Alser
- United Nations Relief and Works Agency for Palestine Refugees (UNRWA), Gaza, Palestine
| | | | | | - Faten Darwish Usrof
- Department of a Medical Laboratory Sciences, Faculty of Health Sciences, Islamic University of Gaza, Gaza City, Palestine
| | | | | | | | | | | | | | | | - Manar Ahmaro
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | | | | | - Nour Ali Jaffal
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | | | | | | | - Tasneem Smerat
- Faculty of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Elshami M, Al-Madhoun S, Alser M, Al-Slaibi I, Yaseen A, Tuffaha A, Jabr H, Ubaiat S, Khader S, Khraishi R, Jaber I, Arafeh ZA, Alqattaa A, Hadi AAE, Barhoush O, Hijazy M, Eleyan T, Alser A, Hziema AA, Shatat A, Almakhtoob F, Mohamad B, Farhat W, Abuamra Y, Mousa H, Adawi R, Musallam A, Albarqi SI, Abu-El-Noor N, Bottcher B. Anticipated time to seek medical advice for possible ovarian cancer symptoms and perceived barriers to early presentation among Palestinian women: a national cross-sectional study. BMC Cancer 2023; 23:975. [PMID: 37833659 PMCID: PMC10571332 DOI: 10.1186/s12885-023-11484-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Several factors contribute to delayed presentation with ovarian cancer (OC) symptoms including poor symptom awareness and barriers to seeking help. This study explored the anticipated time to seek medical advice for possible OC symptoms and its association with OC symptom awareness. In addition, it examined perceived barriers that may delay help-seeking among Palestinian women. METHODS A cross-sectional study was conducted among adult women (≥ 18 years) recruited from hospitals, primary healthcare centers, and public spaces in 11 Palestinian governorates. A modified version of the OC awareness measure was used to collect data in face-to-face interviews. The questionnaire comprised three sections: sociodemographic details, awareness of 11 OC symptoms and time to seek medical advice, and barriers to early presentation. RESULTS Of 6095 participants approached, 5618 completed the OCAM (response rate = 92.1%). The proportion of participants who would immediately seek medical advice for a possible OC symptom varied based on the symptom's nature. For OC symptoms with pain, the proportion that reported immediate seeking of medical advice ranged from 7.9% for 'persistent low back pain' to 13.6% for 'persistent pain in the pelvis'. For non-specific potential OC symptoms, the proportion that reported immediate seeking of medical advice ranged from 2.3% for 'feeling full persistently' to 15.8% for 'increased abdominal size on most days'. Good OC symptom awareness was associated with higher likelihood of seeking medical advice within a week from recognizing 10 out of 11 OC symptoms. Emotional barriers were the most common barriers with 'feeling scared' as the most reported barrier (n = 1512, 52.4%). Displaying good OC symptom awareness was associated with a lower likelihood of reporting ≥ 4 emotional barriers (OR = 0.61, 95% CI: 0.38-0.98). CONCLUSION Participants with good OC symptom awareness were more likely to seek medical advice earlier and to display fewer emotional barriers. Establishing educational interventions to raise OC awareness may help in promoting earlier help-seeking and, thus, facilitate earlier diagnosis and improved prognosis.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7100, Cleveland, OH, 44106, USA.
- Ministry of Health, Gaza, Palestine.
| | | | - Mohammed Alser
- United Nations Relief and Works Agency for Palestine Refugees (UNRWA), Gaza, Palestine
| | | | - Areej Yaseen
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | - Sara Ubaiat
- Faculty of Medicine, Al-Quds University, Bethlehem, Palestine
| | - Salma Khader
- United Nations Relief and Works Agency for Palestine Refugees (UNRWA), Gaza, Palestine
| | - Reem Khraishi
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Inas Jaber
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Aya Alqattaa
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Ola Barhoush
- United Nations Relief and Works Agency for Palestine Refugees (UNRWA), Gaza, Palestine
| | - Maysun Hijazy
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Tamara Eleyan
- United Nations Relief and Works Agency for Palestine Refugees (UNRWA), Gaza, Palestine
| | - Amany Alser
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Amal Abu Hziema
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Amany Shatat
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Balqees Mohamad
- Doctors Without Borders (Medecins Sans Frontieres), Hebron, Palestine
| | - Walaa Farhat
- Faculty of Medicine, Al-Quds University, Jenin, Palestine
| | - Yasmeen Abuamra
- Faculty of Medicine, Al-Azhar University of Gaza, Gaza, Palestine
| | - Hanaa Mousa
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Reem Adawi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Abu-El-Noor N, Aljeesh Y, Aliwaini S, Alhamss S, Darwish R, Abu-El-Noor M. Identifying Priorities and Needs to Improve Oncology Research in the Gaza Strip, Palestine. J Multidiscip Healthc 2023; 16:2529-2541. [PMID: 37664805 PMCID: PMC10474856 DOI: 10.2147/jmdh.s422167] [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: 05/20/2023] [Accepted: 08/22/2023] [Indexed: 09/05/2023] Open
Abstract
Purpose The purpose of this study was to (1) identify the priorities of oncology research in the Gaza Strip; (2) explore the needs for improving oncology research in the Gaza Strip, Palestine. Participants and Methods A qualitative approach for data collection was used in this study. After obtaining the ethical approvals to conduct this study, a sample of 42 health-care providers who are involved in providing oncology care and research in the Gaza Strip were included in this study. Data were collected by the researchers through seven focus groups. Thematic coding was used for data analysis. Two main themes and several sub-themes were extracted during the data analysis. Results The two main themes extracted from data analysis were research priorities and research needs. Participants identified several priorities in relation to oncology research that are assessing for cancer awareness, cancer prevention, exploring and finding new molecular biomarkers, screening for germ-line mutations related to the most common cancers, determining genetic and environmental risk factors for developing cancer, and exploring and testing new cancer therapies. Concerning research needs, participants identified several needs to enhance oncology research, which are financial needs, need for training, availability of data, creation of interdisciplinary research teams, and transforming in vitro studies to in vivo. Conclusion Well-designed studies will certainly help to identify the priorities and needs to improve oncology research in the Gaza Strip, which is considered one of the most important steps to help push these priorities onto the agenda of health policymakers. Therefore, they will work to set goals and design policies and programs aiming to reduce incidence and prevalence rates of cancer in the Gaza Strip, promote early detection of cancer, improve prognosis, and reduce mortality related to cancer.
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Affiliation(s)
- Nasser Abu-El-Noor
- Faculty of Nursing, Islamic University of Gaza, Gaza, Palestine
- Research and Development Center at Turkish-Palestinian Friendship Hospital, Gaza, Palestine
| | - Yousef Aljeesh
- Faculty of Nursing, Islamic University of Gaza, Gaza, Palestine
- Research and Development Center at Turkish-Palestinian Friendship Hospital, Gaza, Palestine
| | - Saeb Aliwaini
- Research and Development Center at Turkish-Palestinian Friendship Hospital, Gaza, Palestine
- Faculty of Science, Islamic University of Gaza, Gaza, Palestine
| | - Sohaib Alhamss
- Research and Development Center at Turkish-Palestinian Friendship Hospital, Gaza, Palestine
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Reda Darwish
- Research and Development Center at Turkish-Palestinian Friendship Hospital, Gaza, Palestine
| | - Mysoon Abu-El-Noor
- Faculty of Nursing, Islamic University of Gaza, Gaza, Palestine
- Research and Development Center at Turkish-Palestinian Friendship Hospital, Gaza, Palestine
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