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Trujillo Rivera A, Sampieri CL, Trujillo Rivera EA, Gómez Cruz JR. Cancer prevention recommendations: awareness in a Mexican public hospital. PeerJ 2024; 12:e17593. [PMID: 39006033 PMCID: PMC11246616 DOI: 10.7717/peerj.17593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 05/28/2024] [Indexed: 07/16/2024] Open
Abstract
Background The recommendations of both the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) for the prevention of cancer are important public health tools. These recommendations for the prevention of specific cancers are related to body weight maintenance; physical activity; foods and drinks that promote weight gain; plant foods; foods of animal origin; alcoholic beverages; preservation, processing, and preparation of food; food supplements; and breastfeeding. Methods This study was a descriptive, cross-sectional, retrospective study. All patients provided written informed consent prior to enrollment in the study. Stratified random sampling was carried out with a convenience sample size of ≥280 participants. The characteristics of the participants were investigated using validated questions. Knowledge about the WCRF/AICR recommendations for the primary prevention of cancer was determined using 14 multiple choice questions validated in this study. Group A included participants who answered that cancer can be prevented and that lifestyle is the main factor related to the onset of cancer; the remaining participants were assigned to Group B. The χ2 test and Mann‒Whitney U test were used to determine differences in the groups. A p-value of ≤0.05 was considered statistically significant. A multiple linear regression analysis with gamma response was performed to assess the knowledge score. Results A total of 289 participants were included; 168 (58%) participants were in group A, and 121 (42%) participants were in group B. Using a 0 to 14 scale, the median (P25, P75) number of correct answers was 11 (10, 12). There was no evidence of a difference between groups in sex, relationship status, literacy skills, years of education, occupation, monthly income per person, and BMI. Most of the participants reported that they did not consume tobacco (n = 259/289) or alcohol (n = 261/289) in the week prior to completing the survey. Discussion Most of the participants (58%) considered cancer preventable and agreed that lifestyle factors were the most important factors in cancer development. The results also showed a high level of public awareness of some evidence-based associations between cancer and lifestyle factors, such as tobacco use. Some confusion among the public on other risk factors was also identified: waist circumference, a variable related to excess weight, was not identified as a risk factor for cancer by most of the participants, but the consumption of foods and beverages high in calories was identified as a risk factor by the majority of participants. Awareness of cancer protective and risk factors may lead to positive behavioral changes and eventually reduce the burden of cancer.
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Affiliation(s)
| | - Clara Luz Sampieri
- Instituto de Salud Pública, Universidad Veracruzana, Xalapa, Veracruz, Mexico
| | - Eduardo Antonio Trujillo Rivera
- Department of Pediatrics, Division of Critical Care Medicine, Children's National Health System, Washington, District of Columbia, United States
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Akbari P, Nemati S, Nahvijou A, Bolourinejad P, Forbes L, Zendehdel K. Survey of awareness and beliefs about cancer (ABC) in Tehran Province, Iran. BMC Cancer 2024; 24:579. [PMID: 38734656 PMCID: PMC11088007 DOI: 10.1186/s12885-024-12211-y] [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: 09/22/2023] [Accepted: 04/01/2024] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION Knowledge, attitudes, and practices are essential measures for planning and evaluating cancer control programs. Little is known about these in Iran. METHODS We conducted a population-based interview survey of adults aged 30-70 using the Farsi version of the Awareness and Beliefs about Cancer questionnaire in the capital province of Tehran, Iran, 2019. We calculated weighted estimates of levels of cancer knowledge, attitudes, and practices to allow for different selection probabilities and nonresponse. We used multivariate logistic regression to understand demographic factors associated with bowel, cervix, and breast screening practices. RESULTS We interviewed 736 men and 744 women. The mean number of recalled cancer warning signs was less than one; 57.7% could not recall any cancer warning signs. Participants recognized 5.6 out of 11 early cancer warning signs and 8.8 of 13 cancer risk factors. Most (82.7%) did not know that HPV infection was a cancer risk factor. Approximately, half had negative attitudes towards cancer treatment, but over 80% had positive attitudes towards the effectiveness of screening for improving survival. Colorectal, breast, and cervical screening rates were 24%, 42%, and 49%, respectively. Higher socioeconomic status increased the odds of taking up screening for cancer. Women aged 60-70 were less likely to report taking up breast and cervical screening than younger women. DISCUSSION The Iranian population has poor awareness and negative attitudes about cancer, and participation in screening programs is low. Public awareness and early detection of cancer should be promoted in Iran.
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Affiliation(s)
- Paria Akbari
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Nemati
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Nahvijou
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Paria Bolourinejad
- Student Research Committee, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | - Lindsay Forbes
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Gatellier L, Charvat H, Ito Y, Matsuda T. Do the general public get cancer statistics?-a questionnaire survey in Japan. Jpn J Clin Oncol 2024; 54:537-548. [PMID: 38336473 DOI: 10.1093/jjco/hyae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/16/2024] [Indexed: 02/12/2024] Open
Abstract
OBJECTIVES The public does not always understand key information conveyed by epidemiologists and statisticians. The purpose of this study was to understand the level of public access to, trust in, and comprehension of, cancer statistics through a population-based survey in Japan. METHODS We used an online research method, requesting online responses to a 15-question questionnaire. The survey was sent to males and females aged 20 years and older, selected by sex, age and prefecture to match the national population proportions shown in the latest census. The final number of valid responses was 10 477. The statistical analyses mainly used χ2 testing. RESULTS Respondents were not frequently exposed to cancer statistics regardless of sex or age group, nor did they necessarily have confidence in the statistics. The increase of collected information and trust in cancer statistics was aligned with increasing age and cancer exposure. Respondents found Relative Risk and Relative Survival Rate easier to understand and more useful than the Standardized Incidence Ratio. In addition, those with cancer experience, higher income and were elderly gave more accurate responses when asked questions related to cancer incidence and probability of getting cancer. CONCLUSIONS Our respondents showed limited familiarity with cancer statistical indicators. Enhanced awareness of indicators such as infographics and visual tools has the potential to enhance cancer visibility, thereby promoting public prevention and early detection efforts. Educating cancer patients about pertinent indicators can boost their confidence in managing their condition. Conversely, the introduction of indicators unrelated to the public should be discouraged.
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Affiliation(s)
- Laureline Gatellier
- Division of International Health Policy Research, Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuo-Ku, Tokyo 104-0045, Japan
| | - Hadrien Charvat
- Faculty of International Liberal Arts, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Yuri Ito
- Department of Medical Statistics, Research & Development Center Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686 Japan
| | - Tomohiro Matsuda
- Division of International Health Policy Research, Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuo-Ku, Tokyo 104-0045, Japan
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Al Bashir S, AlBarakat MM, Alabedalhalim KK, Al-Khalaileh A, Alassaf A, Saleh O, Ayyad AW, Alzoubi KH. Knowledge of cancer symptoms and risk factors: A cross-sectional study from a developing country. Medicine (Baltimore) 2024; 103:e37823. [PMID: 38608047 PMCID: PMC11018150 DOI: 10.1097/md.0000000000037823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 03/15/2024] [Indexed: 04/14/2024] Open
Abstract
The delayed presentation of cancer patients to healthcare facilities for diagnosis is a pressing issue, as late-stage cancer cases are often more challenging to treat effectively. In low-resource settings, such as those with limited access to healthcare facilities, the impact of inadequate awareness of cancer signs and symptoms can be particularly severe. Therefore, this study aimed to evaluate public knowledge of cancer signs and symptoms and risk factors in the context of Jordan. This cross-sectional study was conducted among participants from all settings. Data was obtained from an Arabic version of the cancer awareness measure (CAM), which was answered online. It described demographic data and knowledge of cancer prevalence, age-related risk, signs, symptoms, and risk factors in recall and recognition-type questions. Participants (n = 1998) completed the questionnaire with a Median age of 35 and an interquartile range of 24. About half (n = 1070) thought that cancer is unrelated to age. Most participants identified breast cancer as the most common cancer among women (81%). Awareness of cancer signs/symptoms significantly differed in the level of knowledge in favor of females. The symptom "unexplained weight loss" was most commonly recognized (66.3%) and "persistent difficulty swallowing" the least (42.6%). As for risk factors, "smoking" was the most identified (76.9%) and "eating less than 5 portions of fruits and vegetables a day" was the least (19%), and "doing <30 minutes of moderate physical activity 5 times a week" as a close second least (19.95%). Females identified "smoking," "passive smoking," "HPV infection," and "having a close relative with cancer" as risk factors significantly more than males. Those with good economic status were more aware that smoking is a cancer risk factor by 1.51 times compared to those with poor economic status. To enhance early diagnosis and presentation in Jordan, there is a need for increased public awareness of the signs, symptoms, and risk factors of cancer. One effective strategy to achieve this goal is to conduct targeted public campaigns that cater to different population groups, such as the youth, to improve their understanding and ensure that the message resonates.
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Affiliation(s)
- Samir Al Bashir
- Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Majd M. AlBarakat
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Ali Al-Khalaileh
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Amer Alassaf
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Othman Saleh
- Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Asmaa W. Ayyad
- Branch of Otolaryngology - Department of Special Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H. Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, UAE
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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Zhu L, Zhou Q, Huang Z, Yang Y, Yang Y, Du Y, Zhao Y, Yu X, Li T, Chen W. Factors Influencing Breast Cancer Awareness in Rural Southwest China: A Cross-Sectional Study. Int J Womens Health 2024; 16:509-518. [PMID: 38533523 PMCID: PMC10964776 DOI: 10.2147/ijwh.s453857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/25/2024] [Indexed: 03/28/2024] Open
Abstract
Background This study aimed to explore the current knowledge level of breast cancer among rural women in Southwest China and analyze the influencing factors of breast cancer cognition. Methods From May to November 2022, 1468 rural women were invited to participate in this study. Demographic information and the Chinese version of the Breast Cancer Awareness Measure (C-BCAM) were collected through one-on-one investigations. The data were analyzed using descriptive statistics, chi-square tests, and multiple regression analysis in SPSS 26.0. Results The study included a total of 1468 rural women with a median age of 54.0 (IQR, 47.0, 60.0).The average score of breast cancer in the study population was 73.0 (IQR, 66.0, 82.0). Among women in Southwest China, the awareness rates of knowledge on breast cancer symptoms, barriers to seeking medical help, and risk factors were 68.8%, 98.4%, and 62.1%, respectively. The awareness rate was found to increase with higher education levels (P<0.001) and decrease with increasing age (P<0.001). Multivariate logistic regression analysis identified three variables that might influence breast cancer awareness: education level, contraceptive measures, and history of breast disease (all P<0.05). Specifically, history of breast disease (Odds ratio (OR) = 1.907, 95% CI = 1.128 ~ 3.223), middle school education (OR = 2.155, 95% CI = 1.585 ~ 2.928), and junior college education and above (OR = 5.536, 95% CI = 1.898 ~ 16.148) were positive factors for women's breast cancer awareness. Conversely, the use of intrauterine devices (OR = 0.523, 95% CI = 0.384 ~ 0.712) was found to be a negative factor for women's breast cancer awareness. Conclusion This study highlights the insufficient awareness of breast cancer among women in rural area of Southwest China. It emphasizes the necessity of health education to improve female breast cancer awareness.
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Affiliation(s)
- Lingling Zhu
- College of Public Health, Chengdu Medical College, Chengdu, Sichuan, 610500, People’s Republic of China
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Qiang Zhou
- College of Public Health, Chengdu Medical College, Chengdu, Sichuan, 610500, People’s Republic of China
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Ziyue Huang
- Mianyang Maternal and Child Health Care Hospital, Mianyang, Sichuan, 621000, People’s Republic of China
| | - Yuan Yang
- School of Public Health, Xiamen University, Xiamen, Fujian, 361102, People’s Republic of China
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China
| | - Ying Yang
- Yanting County Maternal and Child Health Hospital, Mianyang, Sichuan, 621600, People’s Republic of China
| | - Yao Du
- Yanting County Maternal and Child Health Hospital, Mianyang, Sichuan, 621600, People’s Republic of China
| | - Yuqian Zhao
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Xiaoping Yu
- School of Preclinical Medicine, Chengdu University, Chengdu, Sichuan, 610106, People’s Republic of China
| | - Tingyuan Li
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Wen Chen
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China
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E R, J T, Ek Q, Ss F, E H, G P, Ce P. Canadians' knowledge of cancer risk factors and belief in cancer myths. BMC Public Health 2024; 24:329. [PMID: 38291409 PMCID: PMC10829248 DOI: 10.1186/s12889-024-17832-3] [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: 02/23/2023] [Accepted: 01/20/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Many untrue statements about cancer prevention and risks are circulating. The objective of this study was to assess Canadians' awareness of known cancer risk factors and cancer myths (untruths or statements that are not completely true), and to explore how awareness may vary by sociodemographic and cognitive factors. METHODS Cancer myths were identified by conducting scans of published, grey literature, and social media. Intuitive-analytic thinking disposition scores included were actively open- and close-minded thinking, as well as preference for intuitive and effortful thinking. A survey was administered online to participants aged 18 years and older through Prolific. Results were summarized descriptively and analyzed using chi-square tests, as well as Spearman rank and Pearson correlations. RESULTS Responses from 734 Canadians were received. Participants were better at identifying known cancer risk factors (70% of known risks) compared to cancer myths (49%). Bivariate analyses showed differential awareness of known cancer risk factors (p < 0.05) by population density and income, cancer myths by province, and for both by ethnicity, age, and all thinking disposition scores. Active open-minded thinking and preference for effortful thinking were associated with greater discernment. Tobacco-related risk factors were well-identified (> 90% correctly identified), but recognition of other known risk factors was poor (as low as 23% for low vegetable and fruit intake). Mythical cancer risk factors with high support were consuming additives (61%), feeling stressed (52%), and consuming artificial sweeteners (49%). High uncertainty of causation was observed for glyphosate (66% neither agreed or disagreed). For factors that reduce cancer risk, reasonable awareness was observed for HPV vaccination (60%), but there was a high prevalence in cancer myths, particularly that consuming antioxidants (65%) and organic foods (45%) are protective, and some uncertainty whether drinking red wine (41%), consuming vitamins (32%), and smoking cannabis (30%) reduces cancer risk. CONCLUSIONS While Canadians were able to identify tobacco-related cancer risk factors, many myths were believed and numerous risk factors were not recognized. Cancer myths can be harmful in themselves and can detract the public's attention from and action on established risk factors.
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Affiliation(s)
- Rydz E
- School of Population and Public Health, CAREX Canada, University of British Columbia, Vancouver, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Telfer J
- School of Population and Public Health, CAREX Canada, University of British Columbia, Vancouver, Canada
| | - Quinn Ek
- School of Population and Public Health, CAREX Canada, University of British Columbia, Vancouver, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Fazel Ss
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Holmes E
- Canadian Cancer Society, Toronto, Canada
| | - Pennycook G
- Department of Psychology, Cornell University, New York, USA
| | - Peters Ce
- School of Population and Public Health, CAREX Canada, University of British Columbia, Vancouver, Canada.
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada.
- BC Centre for Disease Control, Vancouver, BC, Canada.
- BC Cancer, Vancouver, BC, Canada.
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Westermann R, Cordtz RL, Duch K, Mellemkjaer L, Hetland ML, Burden AM, Dreyer L. Cancer risk in patients with rheumatoid arthritis treated with janus kinase inhibitors: a nationwide Danish register-based cohort study. Rheumatology (Oxford) 2024; 63:93-102. [PMID: 37052534 DOI: 10.1093/rheumatology/kead163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/01/2023] [Accepted: 03/24/2023] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVES We aimed to investigate the risk of first primary cancer in patients with RA treated with janus kinase inhibitors (JAKi) compared with those who received biologic DMARDs (bDMARDs) in a real-world setting. METHODS We performed an observational cohort study using the nationwide registers in Denmark. Patients with RA aged 18+ years, without a previous cancer diagnosis, and who initiated treatment with JAKi or bDMARDs from 1 January 2017 to 31 December 2020 were followed for any cancer (except non-melanoma skin cancer). We applied inverse probability of treatment weighting (IPTW) to account for covariate differences between treatment groups. IPTW-generated weights were used with cause-specific Cox (CSC) models to calculate hazard ratios (HRs) for cancer incidence in JAKi-treated compared with bDMARD-treated patients with RA. RESULTS We identified 875 and 4247 RA patients treated with JAKi and bDMARDs, respectively. The JAKi group contributed 1315 person years (PYRS) and 19 cancers, the bDMARD group contributed 8597 PYRS and 111 cancers, with corresponding crude incidence rates per 1000 PYRS of 14.4 and 12.9. Comparing the two groups using weighted CSC models, a HR of 1.41 (95% CI 0.76, 2.37, 95% CIs) was seen for JAKi- vs bDMARD-treated patients with RA. CONCLUSION JAKi treatment in real-world patients with RA was not associated with a statistically significant increased risk of first primary cancer compared with those who received bDMARDs. However, several numerically increased risk estimates were detected, and a clinically important excess risk of cancer among JAKi recipients cannot be dismissed.
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Affiliation(s)
- Rasmus Westermann
- Center of Rheumatic Research Aalborg (CERRA), Department of Rheumatology, Aalborg University Hospital, Aalborg University, Denmark
- Clinical Cancer Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - René Lindholm Cordtz
- Center of Rheumatic Research Aalborg (CERRA), Department of Rheumatology, Aalborg University Hospital, Aalborg University, Denmark
| | - Kirsten Duch
- Center of Rheumatic Research Aalborg (CERRA), Department of Rheumatology, Aalborg University Hospital, Aalborg University, Denmark
- Unit of Clinical Biostatistics, Aalborg University Hospital, Denmark
| | - Lene Mellemkjaer
- Danish Cancer Society Research Center (DCRC), Copenhagen, Denmark
| | - Merete Lund Hetland
- The DANBIO Registry, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Glostrup, Denmark
| | - Andrea Michelle Burden
- Pharmacoepidemiology Group, Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
| | - Lene Dreyer
- Center of Rheumatic Research Aalborg (CERRA), Department of Rheumatology, Aalborg University Hospital, Aalborg University, Denmark
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AlRajhi B, Aljadani FF, Almarwan SR, Alzahrani AA, Sindi MHM, Kano A, Alzahrani RS, Baaqeel R. Breast Cancer Awareness Among Women in Saudi Arabia: A Systematic Review. BREAST CANCER (DOVE MEDICAL PRESS) 2023; 15:913-924. [PMID: 38111500 PMCID: PMC10726713 DOI: 10.2147/bctt.s426079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 11/03/2023] [Indexed: 12/20/2023]
Abstract
Purpose Breast cancer (BC) is the most prevalent cancer worldwide, and second most common cause of cancer-related deaths among women worldwide. Early detection of BC significantly improves prognosis; thus, awareness is an important aspect of BC morbidity and survival as well as the economic burden. This systematic review aimed to explore awareness of BC among women in Saudi Arabia. Patients and Methods A systematic search was performed using Medline, Scopus, the Directory of Open Access Journals (DOAJ), and Google Scholar for all cross-sectional studies conducted in Saudi Arabia, published after the year 2000 and in English. The quality assessment of the included studies was performed using the AXIS tool. Results The total number of included articles after full-text assessment was 13 articles that were conducted between 2005 and 2022. The sample size of all the articles was 7,562 women. All the studies categorized BC awareness into low, moderate, and high groups. The level of low awareness among women reached 66.3% (n=2808), 13.5% (n=570) had moderate awareness levels, and 20.2% (n=858) had high awareness levels. Furthermore, 59.4% (n=1446) of the participants did not perform breast self-examination (BSE) regularly. Conclusion The level of awareness and knowledge regarding BC and BSE was significantly low among women in Saudi Arabia, as all included studies except one have indicated. We highly recommend and urge the implementation of effective special programs and campaigns to raise awareness regarding BC and integrating BSE into school health programs dedicated to women living in Saudi Arabia.
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Affiliation(s)
- Bassam AlRajhi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Faisal F Aljadani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Shahad Rafed Almarwan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Atheer Abdullah Alzahrani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Mostafa Hatim M Sindi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Abdulaziz Kano
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Raghad Saleh Alzahrani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Rasha Baaqeel
- Section of Plastic Surgery, Department of Surgery, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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Dunlop HM, Williams LJ, Hall PS, Barber M, Dodds C, Figueroa JD. Evaluation of the association of area-level socioeconomic deprivation and breast cancer recurrence by oestrogen receptor subtypes in Scotland. Breast Cancer Res 2023; 25:106. [PMID: 37784154 PMCID: PMC10546786 DOI: 10.1186/s13058-023-01704-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 08/30/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Women from socioeconomically deprived areas have lower breast cancer (BC) incidence rates for screen-detected oestrogen receptor (ER) + tumours and higher mortality for select tumour subtypes. We aimed to determine if ipsilateral breast cancer recurrence (IBR) differs by Scottish Index of Multiple Deprivation (SIMD) quintile and tumour subtype in Scotland. METHODS Patient data for primary invasive BC diagnosed in 2007-2008 in Scotland was analysed. Manual case-note review for 3495 patients from 10 years post-diagnosis was used. To determine the probability of IBR while accounting for the competing risk of death from any cause, cumulative incidence functions stratified by ER subtype and surgery were plotted. Multivariable Cox Proportional Hazards models were used to estimate the association of SIMD accounting for other predictors of IBR. RESULTS Among 2819 ER + tumours, 423 patients had a recurrence and 438 died. SIMD was related to death (p = 0.018) with the most deprived more likely to have died in the 10-year period (17.7% vs. 12.9%). We found no significant differences by SIMD in prognostic tumour characteristics (grade, TNM stage, treatment, screen-detection) or risk of IBR. Among 676 patients diagnosed with ER- tumours, 105 died and 185 had a recurrence. We found no significant differences in prognostic tumour characteristics by SIMD except screen detection with the most deprived more likely than the least to have their tumours detected from screening (46.9% vs. 28%, p = 0.03). Among patients with ER- tumours, 50% had mastectomy and the most deprived had increased 5-year IBR risk compared to the least deprived (HR 3.03 [1.41-6.53]). CONCLUSIONS IBR is not a major contributor to mortality differences by SIMD for the majority of BC patients in our study. The lack of inequities in IBR are likely due to standardised treatment protocols and access to healthcare. The association with socioeconomic deprivation and recurrence for ER- tumours requires further study.
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Affiliation(s)
- Hayley M Dunlop
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Linda J Williams
- Edinburgh Clinical Trials Unit, The Usher Institute, The University of Edinburgh, Edinburgh, EH16 4UX, UK
| | - Peter S Hall
- Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Matthew Barber
- Edinburgh Breast Unit, NHS Lothian, Western General Hospital, Edinburgh, UK
| | | | - Jonine D Figueroa
- Centre for Global Health, The Usher Institute, The University of Edinburgh, Edinburgh, EH8 9AG, UK.
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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Gebru T, Mekonnen H, Getahun N, Meseret F, Masrie A, Mandefro M, Shawel S, Tamire A, Berhanu A, Birhanu A. Awareness of prostate cancer and its associated factors among male patients attending care in the urology unit at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. BMJ Open 2023; 13:e073602. [PMID: 37553199 PMCID: PMC10414060 DOI: 10.1136/bmjopen-2023-073602] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/12/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Globally, prostate cancer is the most common cancer among men. It is the second most common cause of cancer-related deaths in men. Symptoms may be non-specific and may not present until the cancer has progressed. Raising awareness, knowing risk factors and symptoms and seeking early medical attention is critical for prevention and detection. The objective of this study is to assess the level of awareness of prostate cancer among male patients attending care in a urology unit in Ethiopia. METHODS We conducted a cross-sectional study among 241 male patients at Tikur Anbessa Specialized Hospital from February to April 2021. Data were collected using an interviewer-administered questionnaire adapted from published studies and cancer awareness measurement tools. We used EpiData V.4.6.0 and SPSS V.26 for data entry and analysis. Descriptive statistics and linear regressions were used for analyses. Bivariate and multivariate linear regression analysis identified factors associated with prostate cancer awareness. Adjusted odd ratio (AOR) at 95% CI and p value<0.05 were considered statistically significant. RESULTS A total of 250 patients were approached, and 241 (96.4%) responded. The mean scores for awareness of prostate cancer risk factors, symptoms, screening and prevention were 41.2%, 43.8%, 44.7% and 49.5%, respectively. Families with an average monthly income of more than 8900 ETB (Ethiopian birr), having heard about prostate cancer, having a regular source of care every six months or more, having a history of hospitalisation and having healthcare providers as the main source of information were all significantly associated with awareness of prostate cancer. CONCLUSION The findings of this study indicate that male patients have a relatively low level of awareness of prostate cancer risk factors, symptoms, screening and prevention. There should be more public awareness initiatives to educate men in Ethiopia on the risk factors, symptoms, screening and prevention of prostate cancer.
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Affiliation(s)
- Tilaye Gebru
- School of Nursing and Midwifery, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Hussien Mekonnen
- School of Nursing and Midwifery, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Negalign Getahun
- School of Nursing and Midwifery, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Fentahun Meseret
- School of Nursing and Midwifery, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Awoke Masrie
- School of Public Health, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Mihiret Mandefro
- School of Public Health, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Samrawit Shawel
- School of Public Health, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Aklilu Tamire
- School of Public Health, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Addisu Berhanu
- School of Public Health, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Abdi Birhanu
- School of Medicine, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
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Tekeste Z, Berhe N, Arage M, Degarege A, Melaku YA. Cancer signs and risk factors awareness in Addis Ababa, Ethiopia: a population-based survey. Infect Agent Cancer 2023; 18:1. [PMID: 36600261 PMCID: PMC9811709 DOI: 10.1186/s13027-022-00477-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/22/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND There is a paucity of data on public awareness of cancer in Ethiopia. This study assessed cancer signs, symptoms, and risk factors awareness among individuals aged 18 and older in Addis Ababa, Ethiopia. METHOD A population-based face-to-face interview was conducted applying a validated cancer awareness measure (CAM) tool. A total of 600 adults (315 males and 285 females) were recruited using a multistage sampling technique. One open-ended and ten closed-ended questions were used to assess awareness of cancer signs and symptoms. To assess awareness of cancer risk factors, one open-ended and twelve closed-ended questions were used. Logistic regression analysis was used to test the association between sociodemographic status and awareness of cancer signs, symptoms, and risk factors. RESULTS Based on the responses for the open-ended questions, unexplained bleeding (23.16%) and smoking (24.17%) were the most frequently recalled cancer sign and risk factor, respectively. Based on the responses for the closed questions, the majority of respondents identified tiredness all the time (80.7%) as a cancer symptom and alcohol use (82.5%) as a cancer risk factor. The odds of cancer signs and symptoms awareness was higher in those with primary (AOR = 4.50, 95% CI, 1.72-11.79, p = 0.02), secondary (AOR = 4.62; 95% CI 1.86-11.43; p = 0.001), and tertiary (AOR = 7.51; 95% CI 3.04-18.56; p < 0.001) education than those who were illiterate. The odds of awareness about cancer signs and risk factors was 0.28 (95% CI 0.12-0.65; p = 0.003) and 0.22 (95% CI 0.83-0.58; p = 0.002) times lower, respectively, among individuals aged 60 and older than those aged 18 to 29. CONCLUSIONS Young adults who attended formal education of primary or higher level may have a better cancer signs and symptoms awareness. Future education interventions to increase awareness of the society in Addis Ababa may target illiterate and the elderly.
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Affiliation(s)
- Zinaye Tekeste
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
| | - Nega Berhe
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Mahlet Arage
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Abraham Degarege
- Department of Epidemiology, College of Public Health, 984395 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Yohannes Adama Melaku
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
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Paytubi S, Benavente Y, Montoliu A, Binefa G, Brotons M, Ibáñez R, Ochoa C, Peremiquel-Trillas P, Serrano B, Travier N, Alemany L, Costas L. Everything causes cancer? Beliefs and attitudes towards cancer prevention among anti-vaxxers, flat earthers, and reptilian conspiracists: online cross sectional survey. BMJ 2022; 379:e072561. [PMID: 36543351 PMCID: PMC9768817 DOI: 10.1136/bmj-2022-072561] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate, using an online non-probability sample, the beliefs about and attitudes towards cancer prevention of people professing vaccination scepticism or conspiracy theories. DESIGN Cross sectional survey. SETTING Data collected mainly from ForoCoches (a well known Spanish forum) and other platforms, including Reddit (English), 4Chan (English), HispaChan (Spanish), and a Spanish language website for cancer prevention (mejorsincancer.org) from January to March 2022. PARTICIPANTS Among 1494 responders, 209 were unvaccinated against covid-19, 112 preferred alternative rather than conventional medicine, and 62 reported flat earth or reptilian beliefs. MAIN OUTCOME MEASURES Cancer beliefs assessed using the Cancer Awareness Measure (CAM) and Cancer Awareness Measure Mythical Causes Scale (CAM-MYCS) (both validated tools). RESULTS Awareness of the actual causes of cancer was greater (median CAM score 63.6%) than that of mythical causes (41.7%). The most endorsed mythical causes of cancer were eating food containing additives or sweeteners, feeling stressed, and eating genetically modified food. Awareness of the actual and mythical causes of cancer among the unvaccinated, alternative medicine, and conspiracy groups was lower than among their counterparts. A median of 54.5% of the actual causes was accurately identified among each of the unvaccinated, alternative medicine, and conspiracy groups, and a median of 63.6% was identified in each of the three corresponding counterparts (P=0.13, 0.04, and 0.003, respectively). For mythical causes, medians of 25.0%, 16.7%, and 16.7% were accurately identified in the unvaccinated, alternative medicine, and conspiracy groups, respectively; a median of 41.7% was identified in each of the three corresponding counterparts (P<0.001 in adjusted models for all comparisons). In total, 673 (45.0%) participants agreed with the statement "It seems like everything causes cancer." No significant differences were observed among the unvaccinated (44.0%), conspiracist (41.9%), or alternative medicine groups (35.7%), compared with their counterparts (45.2%, 45.7%, and 45.8%, respectively). CONCLUSIONS Almost half of the participants agreed that "It seems like everything causes cancer," which highlights the difficulty that society encounters in differentiating actual and mythical causes owing to mass information. People who believed in conspiracies, rejected the covid-19 vaccine, or preferred alternative medicine were more likely to endorse the mythical causes of cancer than their counterparts but were less likely to endorse the actual causes of cancer. These results suggest a direct connection between digital misinformation and consequent erroneous health decisions, which may represent a further preventable fraction of cancer.
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Affiliation(s)
- Sonia Paytubi
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
| | - Yolanda Benavente
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Alexandra Montoliu
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
| | - Gemma Binefa
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Cancer Prevention and Control Program, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
| | - Maria Brotons
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Raquel Ibáñez
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Cristian Ochoa
- eHealth ICOnnecta't and Psycho-oncology Services, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - Paula Peremiquel-Trillas
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Beatriz Serrano
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Noémie Travier
- Cancer Prevention and Control Program, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
| | - Laia Alemany
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Laura Costas
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Ip A, Black G, Vindrola-Padros C, Taylor C, Otter S, Hewish M, Bhuiya A, Callin J, Wong A, Machesney M, Fulop NJ, Taylor C, Whitaker KL. Socioeconomic differences in help seeking for colorectal cancer symptoms during COVID-19: a UK-wide qualitative interview study. Br J Gen Pract 2022; 72:e472-e482. [PMID: 35636968 PMCID: PMC9256043 DOI: 10.3399/bjgp.2021.0644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/24/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND COVID-19 has led to rapid changes in healthcare delivery, raising concern that these changes may exacerbate existing inequalities in patient outcomes. AIM To understand how patients' help-seeking experiences in primary care for colorectal cancer symptoms during COVID-19 were affected by their socioeconomic status (SES). DESIGN AND SETTING Qualitative semi-structured interviews with males and females across the UK, recruited using purposive sampling by SES. METHOD Interviews were carried out with 39 participants (20 higher SES; 19 lower SES) who contacted primary care about possible symptoms of colorectal cancer during COVID-19. Data were analysed using framework analysis followed by comparative thematic analysis to explore differences between groups. RESULTS Three themes were identified with differences between SES groups: 1) how people decided to seek medical help through appraisal of symptoms; 2) how people navigated services; and 3) impact of COVID-19 on how patients interacted with healthcare professionals. The lower SES group expressed uncertainty appraising symptoms and navigating services (in terms of new processes resulting from COVID-19 and worries about infection). There was also potential for increased disparity in diagnosis and management, with other methods of getting in touch (for example, email or 111) taken up more readily by higher SES patients. CONCLUSION The findings suggest that COVID-19 exacerbated disparities between higher and lower SES participants. This study raises awareness around challenges in help seeking in the context of the pandemic, which are likely to persist (post-COVID-19) as healthcare systems settle on new models of care (for example, digital). Recommendations are provided to reduce inequalities of care.
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Affiliation(s)
- Athena Ip
- School of Health Sciences, University of Surrey, Guildford
| | - Georgia Black
- Department of Applied Health Research, University College London, London
| | | | - Claire Taylor
- London North West University Healthcare NHS Trust, London
| | - Sophie Otter
- Royal Surrey County Hospital NHS Foundation Trust, Guildford
| | | | - Afsana Bhuiya
- University College London Hospitals NHS Foundation Trust, London
| | - Julie Callin
- Bart's Health NHS Trust, The Royal Hospital, London
| | - Angela Wong
- Bart's Health NHS Trust, The Royal Hospital, London
| | | | - Naomi J Fulop
- Department of Applied Health Research, University College London, London
| | - Cath Taylor
- School of Health Sciences, University of Surrey, Guildford
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Neglected malignant neoplasms with cutaneous involvement. Postepy Dermatol Alergol 2021; 38:916-920. [PMID: 34849146 PMCID: PMC8610055 DOI: 10.5114/ada.2021.108457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 06/25/2021] [Indexed: 11/17/2022] Open
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Petrova D, Borrás JM, Pollán M, Bayo Lozano E, Vicente D, Jiménez Moleón JJ, Sánchez MJ. Public Perceptions of the Role of Lifestyle Factors in Cancer Development: Results from the Spanish Onco-Barometer 2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910472. [PMID: 34639771 PMCID: PMC8507999 DOI: 10.3390/ijerph181910472] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 01/11/2023]
Abstract
The European Code against Cancer recommends not to smoke, to avoid alcohol consumption, to eat a healthy diet, and maintain a healthy weight to prevent cancer. To what extent is the public aware of the influence of these lifestyle factors on cancer development? The goal of the current study was to describe the perceived influence of four lifestyle factors (tobacco, alcohol, diet, and weight) on cancer development in the general population and identify factors related to low perceptions of influence. We analyzed data from the 2020 Onco-barometer (n = 4769), a representative population-based survey conducted in Spain. With the exception of smoking, lifestyle factors were among those with the least perceived influence, more so among the demographic groups at higher risk from cancer including men and older individuals (65+ years). Individuals from lower socio-economic groups were more likely to report not knowing what influence lifestyle factors have on cancer. Lower perceived influence was also consistently related to perceiving very low risk from cancer. Overall, although there is variation in perceptions regarding the different lifestyle factors, low perceived influence clusters among those at higher risk for cancer. These results signal the need for public health campaigns and messages informing the public about the preventive potential of lifestyle factors beyond avoiding tobacco consumption.
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Affiliation(s)
- Dafina Petrova
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (M.P.); (J.J.J.M.); (M.J.S.)
- Escuela Andaluza de Salud Pública (EASP), 18011 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Correspondence:
| | - Josep Maria Borrás
- Department of Clinical Sciences, University of Barcelona, 08908 Barcelona, Spain;
- Bellvitge Biomedical Research Institute, 08908 Hospitalet, Spain
- NHS Cancer Strategy, Ministry of Health, 28046 Madrid, Spain
| | - Marina Pollán
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (M.P.); (J.J.J.M.); (M.J.S.)
- National Center for Epidemiology, Health Institute Carlos III, 28029 Madrid, Spain
| | - Eloísa Bayo Lozano
- University Hospital Virgen Macarena, 41009 Seville, Spain; (E.B.L.); (D.V.)
| | - David Vicente
- University Hospital Virgen Macarena, 41009 Seville, Spain; (E.B.L.); (D.V.)
| | - José Juan Jiménez Moleón
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (M.P.); (J.J.J.M.); (M.J.S.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Department of Preventive Medicine and Public Health, University of Granada, 18010 Granada, Spain
| | - Maria José Sánchez
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (M.P.); (J.J.J.M.); (M.J.S.)
- Escuela Andaluza de Salud Pública (EASP), 18011 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Department of Preventive Medicine and Public Health, University of Granada, 18010 Granada, Spain
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Human papillomavirus vaccination in immigrants and descendants of immigrants in Denmark. Eur J Cancer Prev 2021; 29:149-156. [PMID: 31425314 DOI: 10.1097/cej.0000000000000524] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
OBJECTIVE In Denmark, human papillomavirus (HPV) vaccination has been offered at age of 12 to girls born in 1996 and later. In this cohort study, we examined routine HPV vaccination uptake in immigrants and descendants from different countries and regions compared with native Danes, including the influence of socioeconomic characteristics and potential changes in uptake by birth cohort. METHODS In nationwide registers, we identified all girls born in 1996-2003 (n = 260 251) and obtained information on country of origin, HPV vaccinations and parents' income and employment. Vaccination was defined as receiving ≥1 dose within 2 years after eligibility for routine vaccination. Odds ratios (ORs) were estimated by logistic regression separately for birth cohorts 1996-2000 and 2001-2003. RESULTS Uptake in immigrants and descendants varied by country and region of origin. Overall, immigrants had lower uptake than native Danes, in birth cohorts 1996-2000 [79% vs. 93%, OR = 0.31; 95% confidence interval (CI), 0.29-0.34] and 2001-2003 (63% vs. 73%, OR = 0.60; 95% CI, 0.54-0.66). Descendants had lower uptake than native Danes in cohorts 1996-2000 (89% vs. 93%, OR = 0.65; 95% CI, 0.60-0.68), but higher uptake in cohorts 2001-2003 (76% vs. 73%, OR = 1.15; 95% CI, 1.08-1.21). Most associations were attenuated, but not entirely explained, when adjusting for socioeconomic characteristics. CONCLUSION HPV vaccination uptake varied by country and region. Most immigrants had lower uptake than native Danes, and in most groups, this was not fully explained by socioeconomic differences. Patterns in descendants were mixed. Interventions to increase uptake should be tailored to specific groups of immigrants/descendants.
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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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Gizaw AB, Gutema HT, Germossa GN. Cancer Warning Symptoms Awareness and Associated Factors Among Individuals Living in Assella Town, Ethiopia. SAGE Open Nurs 2021; 7:23779608211053493. [PMID: 35155771 PMCID: PMC8832288 DOI: 10.1177/23779608211053493] [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: 06/11/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction Community awareness about cancer warning symptoms and risk factors in the
general population is essential and can be considered as a basis for cancer
control programs. Since Patients are rarely aware of the early warning
symptoms and cancer risk factors, the burden of disease is increasing
everywhere in the world. Evidences has been shown that cancer is highly
prevalent in Ethiopia in which the diagnosis is made at later stages of the
disease. Objective To assess Cancer Warning Symptoms awareness and associated factors among
individuals living in Assella Town, Ethiopia. Methods A community-based cross-sectional study was employed in Assella town from May
1st to June 1st, 2020 among 410 adult residents 18
years old and above. A systematic random sampling technique was employed to
select the households from which the study subjects randomly identified.
Data were collected through face-to-face interview by using pre-tested
structured questionnaire and entered into Epi data version 3.1 then exported
to SPSS version 25.0 for analysis. Logistic regression analyses were used to
identify factors associated with outcome variables. Odds ratio and 95% CI at
P-values <0.05 was used to determine the presence of association. Results The findings of this study revealed that the overall level of awareness of
cancer warning symptoms is 214 (52.2% (AOR = 95% CI 47.1, 56.8)).
Educational level (AOR = 3.44, 95%CI, 1.50–7.88 (p = 0.003)), awareness of
cancer risk factors (AOR = 2.56, 95% CI, 1.67, 3.93, (p < 0.001)) and
economic status (AOR = 3.13 (95% CI 1.84, 5.33, p < 0.001)) were
identified as factors significantly associated with awareness of cancer
warning symptoms among adult populations. Conclusion Almost one-out-of-two adults residing in Assella town has awareness about
cancer warning symptoms. Educational level, awareness of cancer risk
factors, and economic status among Assella town residents were identified as
factors associated with good level of awareness about cancer warning
symptoms.
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Affiliation(s)
- Admasu Belay Gizaw
- Jimma University Institute of Health School of Nursing, Jimma, South West Ethiopia
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Czaderny K. Gender gap in cancer prevention and mortality. A multidimensional analysis. Aging Male 2020; 23:812-821. [PMID: 30990353 DOI: 10.1080/13685538.2019.1600495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND During 2015 in Poland, male-to-female ratio in age-adjusted cancer mortality rate amounted to 1.83, which is close to that observed in 1990 (1.94) and considerably more than in 1965 (1.38). DATA AND METHODS Nearest-neighbor matching and latent class model were estimated to assess gender gap in cancer prevention in 2006 and 2014. The analysis is based on nationally representative data from a two-wave survey carried out on a stratified random sample of n=7991+8079 adults. RESULTS Even when controlling for socio-demographic characteristics, health status, and basic knowledge of cancer, three behavioral health characteristics are dramatically lower in men: uptake of preventive health care (ATE of -0.106), perceived caring for own health (-0.070), and fruit and vegetable intake (-0.034). Between 2006 and 2014 the gender gap in uptake of preventive health care and perceived caring for own health had increased, particularly in individuals aged over 40. The adjusted difference in leisure-time physical activity between men and women is near the significance threshold in individuals aged over 40. CONCLUSION The gender differences are higher for the behavioral component of cancer prevention than cognitive domains. Without modifying behavioral risk factors, gender gap in cancer mortality is not expected to close.
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Affiliation(s)
- Krzysztof Czaderny
- Epidemiology and Cancer Prevention Division, Maria Skłodowska-Curie Institute - Oncology Center, Warsaw, Poland
- Warsaw School of Economics, Institute of Statistics and Demography, Warsaw, Poland
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Giuseppe GD, Pelullo CP, Mitidieri M, Lioi G, Pavia M. Cancer Prevention: Knowledge, Attitudes and Lifestyle Cancer-Related Behaviors among Adolescents in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228294. [PMID: 33182588 PMCID: PMC7698075 DOI: 10.3390/ijerph17228294] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 12/24/2022]
Abstract
This study explores knowledge, attitudes and lifestyle behaviors related to cancer in a sample of adolescents. Data were collected through a self-administered questionnaire. 871 adolescents agreed to participate, with a response rate of 96.8%. Only 26.1% had a good level of knowledge on most risk factors for cancer. Adolescents with both parents employed, with a personal, familiar or friend history of cancer or having received information about cancer prevention from a physician, were more likely to have good knowledge about the risk factors for cancer. In total, 41% of participants declared that they consumed alcohol and 25.3% declared they were current smokers, 19.2% consumed fruits or vegetables more than once a day and 75.2% reported poor physical activity. Older adolescents, with a personal, familiar or friend history of cancer, not having one parent in the healthcare sector or not physically active were significantly more likely to be current smokers, whereas physical activity was significantly more likely in adolescents who had been informed by physicians on cancer prevention, and had one parent in the healthcare sector. This study highlights a need for improved education of adolescents about cancer prevention and lifestyle cancer-related behaviors.
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Affiliation(s)
| | | | | | | | - Maria Pavia
- Correspondence: ; Tel./Fax: +39-081-566-7716
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Moodley J, Constant D, Mwaka AD, Scott SE, Walter FM. Mapping awareness of breast and cervical cancer risk factors, symptoms and lay beliefs in Uganda and South Africa. PLoS One 2020; 15:e0240788. [PMID: 33091035 PMCID: PMC7580973 DOI: 10.1371/journal.pone.0240788] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 10/03/2020] [Indexed: 12/30/2022] Open
Abstract
Background Breast and cervical cancer are leading causes of cancer burden in Sub-Saharan Africa (SSA). We measured breast and cervical cancer symptom and risk factor awareness and lay beliefs in Uganda and South Africa (SA). Methods Between August and December 2018 we conducted a cross-sectional survey of women ≥18 years in one urban and one rural site per country. Households were selected using systematic random sampling, then one woman per household randomly selected to participate. Data were collected by interviewers using electronic tablets customised with the locally validated African Women Awareness of Cancer (AWACAN) tool. This has unprompted questions (testing recall) followed by prompted questions (testing recognition) on risk factor, symptom awareness and lay beliefs for breast and cervical cancer. Mann Whitney and Kruskal Wallis tests were used to compare the association between socio-demographic variables and outcomes. Poisson regression with robust variance was conducted to identify independent socio-demographic predictors. Results Of the 1758 women interviewed, 90.8% had heard of breast and 89.4% of cervical cancer. 8.7% recalled at least one breast risk factor and 38.1% recalled at least one cervical cancer risk factor. 78.0% and 57.7% recalled at least one breast/cervical cancer symptom respectively. Recognition of risk factors and symptoms was higher than recall. Many women were unaware that HPV, HIV, and not being screened were cervical cancer risk factors (23.7%, 46.8%, 26.5% respectively). In SA, urban compared to rural women had significantly higher symptom and risk factor awareness for both cancers. In Uganda married women/living with a partner had higher awareness of breast cancer risk factors and cervical cancer symptoms compared to women not living with a partner. Women mentioned several lay beliefs (e.g. putting money in their bra as a breast cancer risk factor). Conclusion We identified gaps in breast and cervical cancer symptom and risk factor awareness. Our results provide direction for locally targeted cancer awareness intervention programs and serve as a baseline measure against which to evaluate interventions in SSA.
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Affiliation(s)
- J. Moodley
- Women’s Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, South Africa
- Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, South Africa
- South African Medical Research Council Gynaecology Cancer Research Centre, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, South Africa
- * E-mail:
| | - D. Constant
- Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, South Africa
| | - A. D. Mwaka
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - S. E. Scott
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London, London, United Kingdom
| | - F. M. Walter
- The Primary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, United Kingdom
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Rosskamp M, Verbeeck J, Sass V, Gadeyne S, Verdoodt F, De Schutter H. Social Inequalities in Cancer Survival in Belgium: A Population-Based Cohort Study. Cancer Epidemiol Biomarkers Prev 2020; 30:45-52. [PMID: 33082205 DOI: 10.1158/1055-9965.epi-20-0721] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/28/2020] [Accepted: 10/09/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Socioeconomic status (SES) is an important factor in cancer survival; however, results are heterogeneous and linked to characteristics of the study population and health care system. This population-based cohort study evaluates the association between individual-level socioeconomic and demographic factors and cancer survival for the first time in Belgium. METHODS From the Belgian Cancer Registry, we identified 109,591 patients diagnosed between 2006 and 2013 with one of eight common cancer types. Information on treatment, socioeconomic parameters, and vital status were retrieved from multiple data sources and linked using a unique personal identification number. The outcome was 5-year observed survival. Associations between survival and socioeconomic and demographic factors were assessed using multivariable Cox proportional-hazard regression models. RESULTS Lower income, unemployment, and living alone were all associated with worse cancer survival. These associations were most pronounced for certain lifestyle-related cancer types (e.g., head and neck cancers) and those with good to moderate prognosis (e.g., colorectal and female breast cancer). CONCLUSIONS These results indicate that, despite a comprehensive and nationwide health insurance program in which equity in rights and access to health care are pursued, SES is associated with disparities in cancer survival in Belgium. IMPACT This population-based study with individual-level socioeconomic information of more than 100,000 patients with cancer identifies patient groups that may be at highest risk for socioeconomic disparities in cancer survival. Reasons behind the observed disparities are multiple and complex and should be further examined. Health policy interventions should consider the observed deprivation gap to plan targeted actions.
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Affiliation(s)
| | | | - Victoria Sass
- Department of Sociology, Interface Demography, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Sociology, University of Washington, Seattle, Washington
| | - Sylvie Gadeyne
- Department of Sociology, Interface Demography, Vrije Universiteit Brussel, Brussels, Belgium
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Shi F, Shaver LG, Kong Y, Yi Y, Aubrey-Bassler K, Asghari S, Etchegary H, Adefemi K, Wang PP. Sociodemographics and their impacts on risk factor awareness and beliefs about cancer and screening: results from a cross-sectional study in Newfoundland and Labrador. BMC Public Health 2020; 20:1513. [PMID: 33023574 PMCID: PMC7539438 DOI: 10.1186/s12889-020-09616-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 09/27/2020] [Indexed: 12/24/2022] Open
Abstract
Background Our objective was to examine cancer risk factor awareness and beliefs about cancer treatment, outcomes, and screening, and how these are mediated by sociodemographic variables, among Newfoundland and Labrador residents. Methods Participants aged 35 to 74 were recruited through Facebook advertising, and a self-administered online questionnaire was used to collect data. Descriptive statistics, Spearman rank correlations, and multivariate logistic regression analyses were performed. Results Of the 1048 participants who responded and met the inclusion criteria for this study, 1019 were selected for this analysis. Risk factor recognition was generally good, though several risk factors had poor awareness: being over 70 years old (53.4% respondents aware), having a low-fiber diet (65.0%), and drinking more than 1 unit of alcohol per day (62.8%). Our results showed that the participants’ awareness of risk factors was significantly associated with higher income level (rs = 0.237, P < 0.001), higher education (rs = 0.231, P < 0.001), living in rural regions (rs = 0.163, P < 0.001), and having a regular healthcare provider (rs = 0.081, P = 0.010). Logistic regression showed that among NL residents in our sample, those with higher income, post-secondary education, those in very good or excellent health, and those with a history of cancer all had higher odds of having more positive beliefs about cancer treatment and outcomes. Those with a history of cancer, and those with very good or excellent health, also had higher odds of having more positive beliefs about cancer screening. Finally, compared to Caucasian/white participants, those who were non-Caucasian/white had lower odds of having more positive beliefs about cancer screening. Conclusion Among adults in NL, there was poor awareness that low-fiber diets, alcohol, and age are risk factors for cancer. Lower income and education, rural residence, and not having a health care provider were associated with lower risk factor awareness. We also found a few associations between sociodemographic factors and beliefs about cancer treatment and outcomes or screening. We stress that while addressing awareness is necessary, so too is improving social circumstances of disadvantaged groups who lack the resources necessary to adopt healthy behaviours.
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Affiliation(s)
- Fuyan Shi
- School of Public Health & Management, Weifang Medical University, Weifang, Shandong, China.,Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, A1B 3V6, Canada
| | | | - Yujia Kong
- School of Public Health & Management, Weifang Medical University, Weifang, Shandong, China.,Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, A1B 3V6, Canada
| | - Yanqing Yi
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, A1B 3V6, Canada
| | | | - Shabnam Asghari
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Holly Etchegary
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, A1B 3V6, Canada
| | - Kazeem Adefemi
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, A1B 3V6, Canada
| | - Peizhong Peter Wang
- School of Public Health & Management, Weifang Medical University, Weifang, Shandong, China. .,Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, A1B 3V6, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
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Khoo SP, Lim WT, Rajasuriar R, Nasir NH, Gravitt P, Woo YL. The Acceptability and Preference of Vaginal Self-sampling for Human Papillomavirus (HPV) Testing among a Multi-ethnic Asian Female Population. Cancer Prev Res (Phila) 2020; 14:105-112. [PMID: 32917643 DOI: 10.1158/1940-6207.capr-20-0280] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/24/2020] [Accepted: 09/02/2020] [Indexed: 11/16/2022]
Abstract
Vaginal self-sampling for human papillomavirus (HPV) testing can potentially increase cervical screening coverage. This study aimed to investigate the acceptability of vaginal self-sampling for HPV testing and factors that might influence a woman's preference for this as a cervical screening method. This was a cross-sectional study that recruited 725 women from the urban and suburban areas of Selangor, Malaysia. All study participants were instructed to self-collect vaginal sample using a dry flocked swab before responding to a detailed questionnaire documenting their experience and preference for self-sampling. Most of the study participants (>80%) perceived vaginal self-sampling as easy, convenient, not embarrassing, comfortable, and were confident in performing the test. This suggests high acceptability toward vaginal self-sampling for HPV testing. Of the 725 women, 83% preferred self-sampling HPV testing over healthcare personnel sampling HPV testing and Pap test. Women with higher household income and full-time employment status were more likely to prefer self-sampling. Those who had not undergone Pap test also expressed preference for self-sampling HPV testing. Convenience and women's confidence in performing a vaginal self-sampling for HPV testing were the independent key factors that influenced the preference for self-sampling method. Vaginal self-sampling for HPV testing is highly acceptable among Malaysian women. It is the preferred choice as a primary cervical screening method and serves as an alternative to healthcare-acquired sample for Pap test. PREVENTION RELEVANCE: Organized cervical cancer screening remains unachievable in many countries. Self-sampling HPV testing is an evidence-based method that can remove barriers to cervical screening. This is particularly important for developing countries in order to achieve the WHO global strategy to accelerate cervical cancer elimination.
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Affiliation(s)
- Su Pei Khoo
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Malaya, Kuala Lumpur Malaysia
| | - Wen Tzien Lim
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Malaya, Kuala Lumpur Malaysia
| | - Reena Rajasuriar
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Patti Gravitt
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Yin Ling Woo
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Malaya, Kuala Lumpur Malaysia.
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Patterns in detection of recurrence among patients treated for breast cancer. Breast Cancer Res Treat 2020; 184:365-373. [DOI: 10.1007/s10549-020-05847-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 07/30/2020] [Indexed: 12/17/2022]
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Thomsen KL, Christensen ASP, Meyer MKH. Awareness of alcohol as a risk factor for cancer: A population-based cross-sectional study among 3000 Danish men and women. Prev Med Rep 2020; 19:101156. [PMID: 32685363 PMCID: PMC7356255 DOI: 10.1016/j.pmedr.2020.101156] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 06/02/2020] [Accepted: 06/28/2020] [Indexed: 01/31/2023] Open
Abstract
Alcohol increases the risk of several cancer types. However, awareness of the link between alcohol and cancer is estimated to be low in Denmark. The objective of this study was to examine awareness of alcohol as a risk factor for cancer in the Danish population. 3000 Danish men and women aged 18–74 years, who are nationally representative participated in a cross-sectional study. Open and closed-ended questions were used to assess unprompted and prompted cancer awareness in relation to the respondents’ demographic profile, alcohol consumption and use of tobacco. Unprompted, 22.2% of respondents were aware of the link between alcohol and cancer, whereas prompted 44.8% were aware of this. When prompted about specific cancer types, 39.5% were aware of the fact that alcohol increases the risk of liver cancer and only 9.6% were aware of the link between alcohol and breast cancer. Being aware of the link between alcohol and cancer was associated with being female, having a higher level of education, living in the Capital Region of Denmark, as well as being a non-smoker. There were no statistical significant associations between awareness of alcohol as a risk factor for cancer and the respondents’ age, marital status and alcohol consumption. Conclusively, the study confirms a rather low public awareness of the link between alcohol and cancer in the Danish population, especially regarding certain cancer types such as breast cancer. There is a continued need to inform the public about the relationship between alcohol and cancer.
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Affiliation(s)
- Karen Linding Thomsen
- Department of Prevention and Information, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Anne Sofie Plum Christensen
- Department of Prevention and Information, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark
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Sarma EA, Rendle KA, Kobrin SC. Cancer symptom awareness in the US: Sociodemographic differences in a population-based survey of adults. Prev Med 2020; 132:106005. [PMID: 32004595 DOI: 10.1016/j.ypmed.2020.106005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 11/27/2019] [Accepted: 01/25/2020] [Indexed: 12/12/2022]
Abstract
Symptom awareness may improve cancer outcomes by prompting timely help-seeking and diagnosis. Research in the UK has shown lower symptom awareness among sociodemographic groups at higher risk of poor cancer outcomes; however, no population-based surveys in the US have assessed whether cancer symptom awareness varies across sociodemographic groups. We therefore examined associations between sociodemographic factors and recognition of 11 cancer symptoms using a novel population-based survey of US adults. We conducted telephone interviews in 2014 with a population-representative sample of English-speaking adults (aged 50 and older) in the US (N = 1425) using an adapted Awareness and Beliefs about Cancer (ABC) survey. Socioeconomic status (SES) was indexed by education. Additional sociodemographic factors included gender, age, marital status, and race. We used multivariable logistic regression models to examine the association between sociodemographic factors and recognition of each symptom, adjusting for cancer experience. Participants recognized an average of 8.43 symptoms as potential signs of cancer. In multivariable analyses, less education consistently predicted lower recognition across the symptoms. As socioeconomic inequalities in cancer mortality widen, it is increasingly important to understand factors that may contribute to these disparities. Our results suggest that US adults of lower SES have lower cancer symptom awareness across symptoms, findings that echo results from other developed countries. With low rates of cancer screening, another approach to reducing cancer burden and disparities may be through greater symptom awareness for symptoms with lower awareness, though additional work is needed to identify mechanisms through which awareness may have its effects on cancer outcomes.
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Affiliation(s)
- Elizabeth A Sarma
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda 20892, MD, USA; Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda 20892, MD, USA.
| | - Katharine A Rendle
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, 19104, PA, USA
| | - Sarah C Kobrin
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda 20892, MD, USA
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Barros ÂF, Murta-Nascimento C, Abdon CHD, Nogueira DN, Lopes ELC, Dias A. Factors associated with time interval between the onset of symptoms and first medical visit in women with breast cancer. CAD SAUDE PUBLICA 2020; 36:e00011919. [PMID: 32022172 DOI: 10.1590/0102-311x00011919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 07/25/2019] [Indexed: 01/07/2023] Open
Abstract
Women presenting with advanced breast cancer tumors are common in Brazil. Little is known about factors contributing to the delay in seeking care. The aim of this study was to identify factors associated with longer time intervals between the onset of breast cancer symptoms and the first medical visit in the Federal District, Brazil. The analysis included 444 symptomatic women with incident breast cancer, interviewed between September, 2012 and September, 2014, during their admission for breast cancer treatment in nine public hospitals in the Federal District. Patients with metastatic disease at diagnosis were not included in this study. The outcome was time interval between symptom onset and the first medical visit, whether > 90 (34% of patients) or ≤ 90 days. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI). In the multivariate analysis, the > 90 day interval was significantly associated with patients not performing mammography and/or breast ultrasound in the two years prior to breast cancer diagnosis (OR = 1.97; 95%CI: 1.26-3.08), and with more advanced stages (OR = 1.72; 95%CI: 1.10-2.72). Furthermore, there was a lower chance of delay in patients with higher levels of education (OR = 0.95; 95%CI: 0.91-0.99). A relatively high proportion of breast cancer patients in the Brazilian Federal District experienced delay to attend the first medical consultation after the symptoms onset. Increasing breast cancer awareness, especially among women with low educational levels and those not participating in mammography screening programs could contribute to reduce this delay.
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Affiliation(s)
- Ângela Ferreira Barros
- Programa de Pós-graduação em Saúde Coletiva, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, Brasil.,Escola Superior de Ciências da Saúde, Brasília, Brasil
| | - Cristiane Murta-Nascimento
- Programa de Pós-graduação em Saúde Coletiva, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, Brasil
| | | | | | | | - Adriano Dias
- Programa de Pós-graduação em Saúde Coletiva, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, Brasil
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Decreasing the Impact of Anxiety on Cancer Prevention through Online Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030985. [PMID: 32033271 PMCID: PMC7038157 DOI: 10.3390/ijerph17030985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/29/2020] [Accepted: 02/03/2020] [Indexed: 12/13/2022]
Abstract
Background: Low levels of public knowledge, incorrect beliefs, and anxiety are the most often mentioned factors that may negatively affect the implementation of preventive campaigns and timely diagnosis of cancer. Cancer is a major unresolved problem for global public health. As a result, many effective preventive measures need to be found and implemented. Methods: For a duration of 18 months, readers of the Polish scientific Internet portal were invited to participate in the Polish On-line Randomized Intervention aimed at Neoplasm Avoidance (PORINA) study. Level of cancer-related anxiety was our main measure (self-declared on a simple five-point Likert scale) in this analysis. Results: A total of 463 participants were qualified for the final analysis. Respondents with a positive family history of cancer (p < 0.001) declared the highest level of cancer-related anxiety, whereas lower levels were declared by those previously treated for cancer (p = 0.006). The conducted educational intervention reduced the declared level of cancer-related anxiety. Conclusions: The results of this study provide evidence that the use of web-based interventions aimed at increasing awareness could reduce cancer-related anxiety and may lead to more frequent consent to undergo some of the medical procedures used to diagnose or treat cancer.
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Hall A, Nguyen SM, Mackenzie L, Sanson-Fisher R, Olver I, Thuan TV, Huong TT. What Caused My Cancer? Cancer Patients' Perceptions on What May Have Contributed to the Development of Their Cancer: A Cross-Sectional, Cross-Country Comparison Study. Cancer Control 2020; 26:1073274819863786. [PMID: 31345063 PMCID: PMC6661799 DOI: 10.1177/1073274819863786] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Accurate public perceptions on the risk factors associated with cancer are important in promoting primary, secondary, and tertiary prevention. Limited studies have explored this topic among patients with cancer in non-western, low-to-middle-income countries. A cross-sectional survey to compare Australian and Vietnamese cancer patients' perceptions of what caused their cancer was undertaken. Adult, patients with cancer from both countries, receiving radiotherapy treatment completed a standardized survey, which included a 25-item module assessing their beliefs on the causes of their cancer. Items ranged from known evidence-based causes (eg, smoking, sun exposure) to non-evidence-based beliefs (eg, stress or anxiety, physical injury, or trauma). Country-specific logistic regression analyses were conducted to identify differences in the determinants of patients' top perceived causes. A total of 585 patient surveys were completed (75% response rate; 285 from Australia, and 300 from Vietnam). Most patients were male (58%) and aged 60 years and older (55%). The most frequently reported risk factor overall and for the Australian sample was "getting older" (overall = 42%, Australia = 49%, and Vietnam = 35%). While the most frequently reported risk factor for the Vietnamese sample was "poor diet" (overall = 39%, Australia = 11%, and Vietnam = 64%). There were differences in the characteristics associated with the top causes of cancer identified by Australian and Vietnamese patients. Patients' beliefs about what may have caused their cancer are complex and likely to be impacted by multiple factors, including the country from which they reside. Developing public awareness campaigns that are accurate and tailored to address the specific beliefs and possible misconceptions held by the target community are needed.
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Affiliation(s)
- Alix Hall
- 1 Priority Research Centre for Health Behaviour, Faculty of Health, The University of Newcastle & Hunter Medical Research Institute, Callaghan, New South Wales, Australia
| | - Sang Minh Nguyen
- 2 Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Lisa Mackenzie
- 1 Priority Research Centre for Health Behaviour, Faculty of Health, The University of Newcastle & Hunter Medical Research Institute, Callaghan, New South Wales, Australia
| | - Rob Sanson-Fisher
- 1 Priority Research Centre for Health Behaviour, Faculty of Health, The University of Newcastle & Hunter Medical Research Institute, Callaghan, New South Wales, Australia
| | - Ian Olver
- 3 University of South Australia Cancer Research Institute, Adelaide, Australia
| | - Tran Van Thuan
- 4 National Cancer Hospital, National Cancer Institute, Hanoi, Vietnam
| | - Tran Thanh Huong
- 5 Vietnam National Cancer Institute, Hanoi Medical University, Hanoi, Vietnam
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Survival Rate of Breast Cancer in Eastern Mediterranean Region Countries: A Systematic Review and Meta-Analysis. Ann Glob Health 2019; 85:138. [PMID: 31857944 PMCID: PMC6896839 DOI: 10.5334/aogh.2521] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background: Breast cancer (BC) is one of the main problems of public health around the world. As a consequence, survival rates are one of the most salient indicators for assessing the quality of cancer control and treatment programs. Objectives: The aim of this study is to evaluate the survival rate of breast cancer in the Eastern Mediterranean region at different periods of time. Methods: Medline/PubMed, ProQuest, Scopus, Embase, Web of Knowledge and Google Scholar databases until February 1, 2018. All observational studies (cross-sectional, case-control, and cohort) referring to the survival of breast cancer were included in the study. The heterogeneity and its value were examined by Cochran test and I2 statistics, respectively. Analysis of subgroups performed was based on geographical area and Human Development Index (HDI), using Stata 12 software. Findings: A total of 58 papers were analyzed. Based on a random effect model, the survival rates of breast cancer in different periods—1, 2, 3, 4, 5 and 10 years—were estimated at 93.9, 85, 79.8, 72.6, 69.2, 62.1 and 55.5 percent, respectively. The highest 10-year survival rate was in Iran (59.2%), and the lowest was observed in Bahrain (45%). Conclusions: Evidence suggests that about half of the patients in this area would die before 10 years survival, which is different from more developed countries. Also, high survival rates are associated with high human development index, which can help health policy-makers to better predict the outcomes of patients.
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Gajda M, Kowalska M. The Web-Based Randomized Controlled Intervention as the Enhancer of Cancer Prevention. ACTA ACUST UNITED AC 2019; 55:medicina55080434. [PMID: 31382569 PMCID: PMC6723358 DOI: 10.3390/medicina55080434] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 12/24/2022]
Abstract
Background and Objectives: Cancer is an unresolved public health issue in society. With the advent of the internet and the development in the technological sector, access to basic health-related information has become more frequent among patients and healthy individuals. The aim of this study is to evaluate the impact of educational intervention on the participant’s willingness to undergo selected medical procedures in case of suspected cancer. Materials and Methods: From 14 May 2015 to 13 November 2016, a total of 1118 who visited the Polish scientific website were enrolled in the ‘Polish Online Randomized Intervention aimed at Neoplasm Avoidance’ (PORINA) and randomized into two groups (educational and control). The original Cancer Knowledge Index (CKI) was used for the evaluation of participants’ cancer-related knowledge. They were asked to declare whether they would consent to undergo selected medical procedures necessary for cancer diagnosis or treatment. Results: Most participants declared their readiness to undergo abdominal ultrasonography, computed tomography, and a nevi excision. The most noticeable changes were found for potential consent to undergo breast fine needle aspiration, mammography and gastroscopy. Conclusions: The level of oncological knowledge has an impact on individual decision to consent to particular medical procedures. Conducted educational intervention has significantly increased the readiness to undergo selected medical procedures.
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Affiliation(s)
- Maksymilian Gajda
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Medyków 18 Str., 40-752 Katowice, Poland.
| | - Małgorzata Kowalska
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Medyków 18 Str., 40-752 Katowice, Poland
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Gutiérrez-González E, López-Abente G, Aragonés N, Pollán M, Pastor-Barriuso R, Sánchez MJ, Pérez-Gómez B. Trends in mortality from cutaneous malignant melanoma in Spain (1982-2016): sex-specific age-cohort-period effects. J Eur Acad Dermatol Venereol 2019; 33:1522-1528. [PMID: 30868690 DOI: 10.1111/jdv.15565] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 02/25/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Mortality from malignant cutaneous melanoma increased alarmingly during the second half of the 20th century in Spain and other European countries. OBJECTIVE The aim was to analyse sex- and age-specific trends in melanoma mortality in Spain in the period 1982-2016. METHODS European age-standardized melanoma mortality rates during the period 1982-2016 were calculated from mortality figures provided by the National Statistics Institute. Joinpoint regressions were used to identify significant points of change in trends and to compute average annual per cent change (AAPC). Age-cohort-period models were fitted to explore the effect of these variables on mortality. RESULTS During the period 1982-2016, age-standardized melanoma mortality rates increased in Spain from 0.90 to 1.80 deaths per 100 000 people in men and from 0.64 to 1.11 per 100 000 in women, rising noticeably from 1982 to 1995 in both sexes and in all age groups. From the mid-90s different trends were observed depending on sex and age: there was a decrease in mortality in the population younger than 45 years (AAPC -2 in both sexes) and aged 45-64 years (AAPC -1 among men and -0.2 among women), but in the group over 64 years rates continued to increase (AAPC 1.7 and 0.2, respectively, for men and women). The mortality sex ratio decreased in the younger population but increased in older individuals. A cohort effect was observed with lower mortality in the cohorts born after 1943 in men and 1956 in women. There was also a period effect with decreased mortality rates at the beginning of the 1990s. CONCLUSIONS Melanoma mortality rates in Spain increased during the last decades of the 20th century; however, later they stabilized in women and began to decrease in younger cohorts and middle-aged men. Promotion of primary and secondary prevention measures should continue, with particular emphasis on males over 65 years.
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Affiliation(s)
- E Gutiérrez-González
- Public Health & Preventive Medicine Teaching Unit, National School of Public Health, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - G López-Abente
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Cancer & Environmental Epidemiology Unit, National analyze Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - N Aragonés
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - M Pollán
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Cancer & Environmental Epidemiology Unit, National analyze Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - R Pastor-Barriuso
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Cancer & Environmental Epidemiology Unit, National analyze Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - M J Sánchez
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria (ibs.GRANADA), University of Granada, Granada, Spain
| | - B Pérez-Gómez
- Public Health & Preventive Medicine Teaching Unit, National School of Public Health, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Cancer & Environmental Epidemiology Unit, National analyze Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cardiovascular & Metabolic Diseases Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
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Hvidberg L, Virgilsen LF, Pedersen AF, Vedsted P. Cancer beliefs and participation in screening for colorectal cancer: A Danish cohort study based on data from the International Cancer Benchmarking Partnership and national registers. Prev Med 2019; 121:11-17. [PMID: 30690041 DOI: 10.1016/j.ypmed.2019.01.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 12/28/2018] [Accepted: 01/24/2019] [Indexed: 12/31/2022]
Affiliation(s)
- Line Hvidberg
- Research Unit for General Practice and Research Centre for Cancer Diagnosis in Primary Care (CaP), Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark.
| | - Line Flytkjær Virgilsen
- Research Unit for General Practice and Research Centre for Cancer Diagnosis in Primary Care (CaP), Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark.
| | - Anette Fischer Pedersen
- Research Unit for General Practice and Research Centre for Cancer Diagnosis in Primary Care (CaP), Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark.
| | - Peter Vedsted
- Research Unit for General Practice and Research Centre for Cancer Diagnosis in Primary Care (CaP), Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark.
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Solikhah S, Promthet S, Hurst C. Awareness Level about Breast Cancer Risk Factors, Barriers, Attitude and Breast Cancer Screening among Indonesian
Women. Asian Pac J Cancer Prev 2019; 20:877-884. [PMID: 30912407 PMCID: PMC6825774 DOI: 10.31557/apjcp.2019.20.3.877] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Globally, breast cancer is the second most common cancer in women and is a leading cause of mortality
in Indonesia. Raising awareness of breast cancer is particularly important to help at risk women seek medical treatment
for this disease. This study aimed to comprehensively investigate the Indonesian women’s level of knowledge about
breast cancer risk factors, barriers, attitude and breast cancer screening. Methods: This population-based cross-sectional
study administered the breast cancer awareness Indonesian scale (BCAS-I) to 856 Indonesian women. Samples were
selected in rural and urban combinations from three provinces by stratified random sampling. The ordinal logistic
model was used to investigate the clustering effect of the participant’s characteristics in this study. Results: Of the
women, 62% lived in rural areas and 38% lived in urban areas. Living in an urban area was significantly associated
with a lower knowledge of the risk factors. However, living in an urban area was significantly associated with better
attitudes and healthier behaviours related to breast cancer awareness. Women with higher education levels had 70%
worse attitudes toward breast cancer awareness. Women living South of Sumatera, women living in Yogyakarta, and
unmarried women were 5.03, 3.84, and 1.56 times as likely to have higher perceived barriers, respectively. Conclusion:
Urban women had a poorer level of knowledge of breast cancer risk factors compared to women living in more rural
areas. The result of this study may reflect inadequate breast cancer awareness campaigns or a lack of breast cancer
awareness campaigns. These findings suggest that additional education programs aiming to increase awareness and
educate the public are needed.
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Affiliation(s)
- Solikhah Solikhah
- Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia.
| | - Supannee Promthet
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.,ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Cameron Hurst
- Biostatistics Center of Excellence, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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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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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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Harder E, Thomsen LT, Hertzum-Larsen R, Albieri V, Hessner MV, Juul KE, Bonde J, Frederiksen K, Kjaer SK. Determinants for Participation in Human Papillomavirus Self-Sampling among Nonattenders to Cervical Cancer Screening in Denmark. Cancer Epidemiol Biomarkers Prev 2018; 27:1342-1351. [DOI: 10.1158/1055-9965.epi-18-0480] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/25/2018] [Accepted: 08/03/2018] [Indexed: 11/16/2022] Open
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Evaluation of the First Polish Web-Based Intervention Aimed at Improving Cancer Prevention (the PORINA Study). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061167. [PMID: 29867044 PMCID: PMC6025227 DOI: 10.3390/ijerph15061167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/13/2018] [Accepted: 05/30/2018] [Indexed: 01/05/2023]
Abstract
The appropriate level of the society’s health-oriented knowledge is essential for improving the effectiveness of actions to reduce the number of new cases and deaths caused by cancer. The aim of this study was to identify the role of web-based educational campaigns in the field of cancer prevention in Poland. From 14.05.2015 to 13.11.2016 readers of Polish scientific websites were invited to participate in the “PORINA” prospective interventional study. A total of 1118 volunteers (unrepresentative sample) were recruited and randomized (interventional and control groups). After applying the inclusion and exclusion criteria, 463 participants (41.4% of the recruited) qualified for the final analysis; 207 were allocated to the interventional and 256 to the control group. A specially designed internet platform, a self-reported questionnaire (validated during the study) and educational materials which were prepared by a physician specialized in clinical oncology were used. Assessments of participants’ knowledge were based on the authors Cancer Knowledge Index (CKI). The number of subjects with an increase in CKI score was significantly higher for the interventional group with minor changes in the control (p < 0.001). The highest increase in CKI scores was obtained in the following demographic groups: females, younger participants, those living in smaller villages and also among the less educated. An overall impact of presented web-based educational intervention was moderate. However, the results obtained confirmed that well-organized intervention supported by oncologists may be useful in cancer prevention.
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Mhaidat NM, Al-Husein BA, Alzoubi KH, Hatamleh DI, Khader Y, Matalqah S, Albsoul A. Knowledge and Awareness of Colorectal Cancer Early Warning Signs and Risk Factors among University Students in Jordan. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:448-456. [PMID: 27943056 DOI: 10.1007/s13187-016-1142-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
In the present study, we aimed to assess the level of awareness regarding CRC warning signs and risk factors among undergraduate students. A cross-sectional survey using standardized questionnaire developed by the Cancer Research Center in the UK was carried out in three different public universities in Jordan including Jordan University of Science and Technology, Yarmouk University, and AL al-Bayt University over a 5-month period. Volunteers were asked about their knowledge regarding CRC symptoms, risk factors, and their behaviors regarding seeking medical advice. Findings revealed that response rate was 80.1%. Vast majority of responders were female (70.9%) and 18.2% of them were studying medical-related specialties. Regarding CRC symptoms, 14.3% of responders experienced poor knowledge, 52.9% have fair knowledge, and 32.8% have good knowledge. Abdominal pain was the most recognized warning signs where 70.8% of responders could recall it. In addition, risk factors awareness was lower than warning signs awareness. About 36.1% of responders have poor knowledge, 47.4% had fair knowledge, and 16.5% had good knowledge. Unhealthy diet was the most recognized risk factor where 32.3% of responders could recall it. Moreover, females were more aware regarding CRC symptoms. Similar findings were obtained for participants who were aged 20 years or more and for those who had previous experience of cancer. Students who were studying medical-related specialties were more aware of both CRC symptoms and risk factors than those who studying other specialties. Furthermore, regarding time to seek medical attention we found that 60.6% of volunteers would seek medical advice within 1 week of noticing CRC symptoms and 12% would seek it within 2 weeks. The mean duration for seeking medical advice was found to be 1.9 weeks. University students' awareness level of CRC is poor, and therefore, extended attention should be attempted to enhance the awareness of CRC via continuous education programs, lectures, or campaigns to encourage the early detection CRC.
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Affiliation(s)
- Nizar M Mhaidat
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan.
| | - Belal A Al-Husein
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Karem H Alzoubi
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Dima I Hatamleh
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Youcef Khader
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Sinaa Matalqah
- Directorate of Health, Ministry of Health, Amman, Jordan
| | - Abla Albsoul
- Faculty of Pharmacy, University of Jordan, Amman, Jordan
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Feller A, Schmidlin K, Bordoni A, Bouchardy C, Bulliard J, Camey B, Konzelmann I, Maspoli M, Wanner M, Zwahlen M, Clough‐Gorr KM. Socioeconomic and demographic inequalities in stage at diagnosis and survival among colorectal cancer patients: evidence from a Swiss population-based study. Cancer Med 2018; 7:1498-1510. [PMID: 29479854 PMCID: PMC5911574 DOI: 10.1002/cam4.1385] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 01/16/2018] [Accepted: 01/16/2018] [Indexed: 12/30/2022] Open
Abstract
Socioeconomic inequalities in cancer stage at diagnosis and survival are important public health issues. This study investigates the association between socioeconomic position (SEP) and colorectal cancer (CRC) stage at diagnosis and survival in Switzerland, a European country with highest level of medical facilities and life expectancy. We used population-based CRC data from seven Swiss cantonal cancer registries 2001-2008 (N = 10,088) linked to the Swiss National Cohort (SNC). Follow-up information was available until the end of 2013. SEP was estimated based on education. The association between cancer stage and SEP was assessed using logistic regression models including cancer localization (colon/rectum), sex, age, civil status, urbanity of residence, language region, and nationality (Swiss/non-Swiss). Survival was analyzed using competing risk regressions reporting subhazard ratios (SHRs) for the risk of dying due to CRC. We observed a social gradient for later stage CRC with adjusted odds ratios (ORs) of 1.11 (95% CI: 0.97-1.19) and 1.28 (95% CI: 1.08-1.50) for middle and low SEP compared to high SEP. Further, single compared to married people had elevated odds of being diagnosed at later stages. Survival was lower in patients with CRC with low SEP in the unadjusted model (SHR: 1.18, 95% CI: 1.07-1.30). After adjustment for stage at diagnosis and further sociodemographic characteristics, significant survival inequalities by SEP disappeared but remained for non-Swiss compared to Swiss citizens and for patients living in nonurban areas compared to their urban counterparts. Swiss public health strategies should facilitate equal access to CRC screening and optimal CRC care for all social groups and in all regions of Switzerland.
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Affiliation(s)
- Anita Feller
- Institute of Social and Preventive Medicine (ISPM)University of BernFinkenhubelweg 11CH‐3012BernSwitzerland
- National Institute for Cancer Epidemiology and Registration (NICER)Hirschengraben 828001ZürichSwitzerland
| | - Kurt Schmidlin
- Institute of Social and Preventive Medicine (ISPM)University of BernFinkenhubelweg 11CH‐3012BernSwitzerland
| | - Andrea Bordoni
- Ticino Cancer RegistryInstituto cantonale di patologiaVia in Selva 246601Locarno 1Switzerland
| | - Christine Bouchardy
- Geneva Cancer RegistryInstitute of Global HealthUniversity of GenevaBd de la Cluse 551205GenevaSwitzerland
| | - Jean‐Luc Bulliard
- Vaud Cancer RegistryUniversity Institute of Social and Preventive Medicine (IUMSP)Route de la Corniche 10, Bâtiment Biopôle 21010LausanneSwitzerland
| | - Bertrand Camey
- Fribourg Cancer RegistrySt. Nicolas de Flüe 21705FribourgSwitzerland
| | - Isabelle Konzelmann
- Health Observatory ValaisValais Cancer RegistryAvenue Grand‐Champsec 641950SionSwitzerland
| | - Manuela Maspoli
- Neuchâtel and Jura Cancer RegistryRue du Plan 302000NeuchâtelSwitzerland
| | - Miriam Wanner
- Cancer Registry Zurich and ZugBiostatistics and Prevention InstituteUniversity ZurichVogelsangstrasse 108091ZurichSwitzerland
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine (ISPM)University of BernFinkenhubelweg 11CH‐3012BernSwitzerland
| | - Kerri M. Clough‐Gorr
- Institute of Social and Preventive Medicine (ISPM)University of BernFinkenhubelweg 11CH‐3012BernSwitzerland
- National Cancer Registry IrelandAirport Business Park6800CorkIreland
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Richards R, McNoe B, Iosua E, Reeder A, Egan R, Marsh L, Robertson L, Maclennan B, Dawson A, Quigg R, Petersen AC. Cancer Awareness in Aotearoa New Zealand (CAANZ), 2001 and 2015: Study Protocols. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:745-748. [PMID: 27216716 DOI: 10.1007/s13187-016-1050-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Population cancer awareness is of interest worldwide, as efforts are made to reduce cancer incidence via changes in risk and protective behaviours. To date, few studies have described changes in awareness over time, despite significant investment in raising awareness about various cancer types and risk behaviours. This paper describes the Cancer Awareness in Aotearoa New Zealand (CAANZ) survey, a cross-sectional telephone survey of adult New Zealanders conducted in 2014/2015 (CAANZ15, n = 1064) and its comparison with a similar 2001 study (CAANZ01, n = 438). Both aimed to describe current cancer awareness among a national sample of New Zealand (NZ) adults, with additional aims for CAANZ15 being to explore emerging issues in information provision and supportive care. Follow-up studies are challenged by changes in communication technologies and, in turn, potential issues in sampling. However, given the value of information about changing awareness, pragmatic steps were taken in CAANZ15 to maximise the response rate and comparability of the surveys. A response rate of 64 % was achieved for both samples. When compared to the adult NZ population, the CAANZ15 sample tended to be older, of higher socioeconomic status and under-representative of people with Pacific, Asian or, to a lesser extent, Māori (the indigenous population of NZ) ethnicity. To compensate for possible disproportionate age-by-ethnicity (Māori/non-Māori) groups in the sample, poststratification weighting was adopted. While caution will need to be exercised in drawing conclusions from comparisons made between these two cohorts, the dearth of such studies means that insights gained should be useful for guiding reflection on future cancer control directions and the generation of new hypotheses.
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Affiliation(s)
- Rosalina Richards
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9016, New Zealand.
| | - Bronwen McNoe
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9016, New Zealand
| | - Ella Iosua
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9016, New Zealand
| | - Anthony Reeder
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9016, New Zealand
| | - Richard Egan
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9016, New Zealand
| | - Louise Marsh
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9016, New Zealand
| | - Lindsay Robertson
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9016, New Zealand
| | - Brett Maclennan
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9016, New Zealand
| | - Anna Dawson
- Kōhatu - Centre for Hauora Māori, Division of Health Sciences, University of Otago, PO Box 56, Dunedin, 9016, New Zealand
| | - Robin Quigg
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9016, New Zealand
| | - Anne-Cathrine Petersen
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9016, New Zealand
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Rat C, Pogu C, Le Donné D, Latour C, Bianco G, Nanin F, Cowppli-Bony A, Gaultier A, Nguyen JM. Effect of Physician Notification Regarding Nonadherence to Colorectal Cancer Screening on Patient Participation in Fecal Immunochemical Test Cancer Screening: A Randomized Clinical Trial. JAMA 2017; 318:816-824. [PMID: 28873160 PMCID: PMC5817465 DOI: 10.1001/jama.2017.11387] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
IMPORTANCE Increasing participation in fecal screening tests is a major challenge in countries that have implemented colorectal cancer (CRC) screening programs. OBJECTIVE To determine whether providing general practitioners (GPs) a list of patients who are nonadherent to CRC screening enhances patient participation in fecal immunochemical testing (FIT). DESIGN, SETTING, AND PARTICIPANTS A 3-group, cluster-randomized study was conducted from July 14, 2015, to July 14, 2016, on the west coast of France, with GPs in 801 practices participating and involving adult patients (50-74 years) who were at average risk of CRC and not up-to-date with CRC screening. The final follow-up date was July 14, 2016. INTERVENTIONS General practitioners were randomly assigned to 1 of 3 groups: 496 received a list of patients who had not undergone CRC screening (patient-specific reminders group, 10 476 patients), 495 received a letter describing region-specific CRC screening adherence rates (generic reminders group, 10 606 patients), and 455 did not receive any reminders (usual care group, 10 147 patients). MAIN OUTCOMES AND MEASURES The primary end point was patient participation in CRC screening 1 year after the intervention. RESULTS Among 1482 randomized GPs (mean age, 53.4 years; 576 women [38.9%]), 1446 participated; of the 33 044 patients of these GPs (mean age, 59.7 years; 17 949 women [54.3%]), follow-up at 1 year was available for 31 229 (94.5%). At 1 year, 24.8% (95% CI, 23.4%-26.2%) of patients in the specific reminders group, 21.7% (95% CI, 20.5%-22.8%) in the generic reminders group, and 20.6% (95% CI, 19.3%-21.8%) in the usual care group participated in the FIT screening. The between-group differences were 3.1% (95% CI, 1.3%-5.0%) for the patient-specific reminders group vs the generic reminders group, 4.2% (95% CI, 2.3%-6.2%) for the patient-specific reminders group vs the usual care group, and 1.1% (95% CI, -0.6% to 2.8%) for generic reminders group vs the usual care group. CONCLUSIONS AND RELEVANCE Providing French GPs caring for adults at average risk of CRC with a list of their patients who were not up-to-date with their CRC screening resulted in a small but significant increase in patient participation in FIT screening at 1 year compared with patients who received usual care. Providing GPs with generic reminders about regional rates of CRC screening did not increase screening rates compared with usual care. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02515344.
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Affiliation(s)
- Cédric Rat
- Department of General Practice, Faculty of Medicine, Nantes, France
- French National Institute of Health and Medical Research, INSERM U1232 - Team 2, Nantes, France
| | - Corinne Pogu
- Association in charge of colorectal cancer screening program, CAPSANTE 44, Nantes, France
| | | | - Chloé Latour
- Department of General Practice, Faculty of Medicine, Nantes, France
| | - Gaelle Bianco
- Association in charge of colorectal cancer screening program, AUDACE, La Roche sur Yon, France
| | - France Nanin
- French Health Insurance System, Division of Nantes, Nantes, France
| | - Anne Cowppli-Bony
- Cancer registry for Loire-Atlantique and Vendée geographic areas, Nantes, France
| | - Aurélie Gaultier
- Department of Epidemiology and Biostatistics, Nantes University Hospital, Nantes, France
| | - Jean-Michel Nguyen
- French National Institute of Health and Medical Research, INSERM U1232 - Team 2, Nantes, France
- Department of Epidemiology and Biostatistics, Nantes University Hospital, Nantes, France
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Feller A, Schmidlin K, Bordoni A, Bouchardy C, Bulliard JL, Camey B, Konzelmann I, Maspoli M, Wanner M, Clough-Gorr KM. Socioeconomic and demographic disparities in breast cancer stage at presentation and survival: A Swiss population-based study. Int J Cancer 2017; 141:1529-1539. [DOI: 10.1002/ijc.30856] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/25/2017] [Accepted: 06/07/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Anita Feller
- Institute of Social and Preventive Medicine (ISPM), University of Bern; Switzerland
- National Institute for Cancer Epidemiology and Registration (NICER); Zürich Switzerland
| | - Kurt Schmidlin
- Institute of Social and Preventive Medicine (ISPM), University of Bern; Switzerland
| | - Andrea Bordoni
- Ticino Cancer Registry, Institute of Pathology; Locarno Switzerland
| | - Christine Bouchardy
- Geneva Cancer Registry, Institute of Global Health, University of Geneva; Switzerland
| | - Jean-Luc Bulliard
- Vaud Cancer Registry, University Institute of Social and Preventive Medicine (IUMSP); Lausanne Switzerland
| | | | | | | | - Miriam Wanner
- Cancer Registry Zurich and Zug; University of Zurich; Switzerland
| | - Kerri M. Clough-Gorr
- Institute of Social and Preventive Medicine (ISPM), University of Bern; Switzerland
- Section of Geriatrics, Boston University Medical Center; Boston MA
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Pedersen AF, Vedsted P. Cancer beliefs in cancer survivors, cancer relatives and persons with no cancer experience. Scand J Public Health 2017; 47:497-503. [PMID: 28673193 DOI: 10.1177/1403494817715380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims: Negative cancer beliefs have been associated with late stage at cancer diagnosis. High levels of negative cancer beliefs have been found among individuals with low socioeconomic position and ethnic minority women, but the impact of cancer experience on cancer beliefs is unexamined. The aim of this study was to examine whether cancer beliefs are associated with cancer experience. Methods: This was a cross-sectional population-based study. Telephone interviews of 2992 Danish residents (30+) were carried out using the Awareness and Beliefs about Cancer Measure (ABC). Respondents reported whether they or someone close had been diagnosed with cancer and whether they agreed/disagreed with three positively and three negatively framed cancer beliefs. Results: Respondents with someone close diagnosed was reference group. Compared with these, respondents with no cancer experience (RRadj=0.91, 95% CI=0.84-0.98) or who had had cancer themselves (RRadj=0.87, 0.77-0.98) were less likely to believe that cancer treatment is worse than the cancer itself, and respondents with no cancer experience were less likely to believe that a diagnosis of cancer is a death sentence (RRadj=0.83, 0.70-0.98), but more likely to report that they did not want to know if they had cancer (RRadj=1.31, 1.01-1.71). Conclusions: The results suggest that cancer beliefs are sensitive to cancer experience. This is an important addition to previous results focusing on the association between cancer beliefs and static factors such as socioeconomic position and ethnicity. Since cancer beliefs may determine health-related behaviour, it is important that negative cancer beliefs are addressed and possibly reframed in population-based interventions.
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Affiliation(s)
- Anette Fischer Pedersen
- Research Centre for Cancer Diagnosis in Primary Care (CaP), Research Unit for General Practice, Aarhus University, Denmark
| | - Peter Vedsted
- Research Centre for Cancer Diagnosis in Primary Care (CaP), Research Unit for General Practice, Aarhus University, Denmark
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46
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Hvidberg L, Pedersen AF, Wulff CN, Carlsen AH, Vedsted P. Measurement properties of the Danish version of the Awareness and Beliefs about Cancer (ABC) measure. BMC Med Res Methodol 2017; 17:74. [PMID: 28446140 PMCID: PMC5405495 DOI: 10.1186/s12874-017-0352-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 04/19/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The International Cancer Benchmarking Partnership aims to study international differences in cancer survival and the possible causes. Participating countries are Australia, Canada, Norway, Sweden, Denmark and the UK and a particular focus area is differences in awareness and beliefs about cancer. In this connection, the Awareness and Beliefs about Cancer (ABC) measure has been translated into multiple languages. The aim of this study is to appraise the translation process and measurement properties of the Danish version of the ABC measure. METHODS The translation process included forward and backward translations and a pilot-test. Data quality was assessed using survey data from 3000 Danish respondents and content validity indexes were calculated based on judgments from ten academic researchers. Construct validity was determined by a confirmative factor analysis (CFA) and exploratory factor analyses (EFA) using survey data and a known group comparison analysis including 56 persons. Test-retest reliability was assessed based on responses from 123 person whom completed the interview twice with an interval of 2-3 weeks. RESULTS The translation process resulted in a Danish ABC measure conceptually equivalent to the English ABC measure. Data quality was acceptable in relation to non-response to individual items which was maximum 0.3%, but the percentage of respondents answering 'don't know' was above 3% for 16 out of 48 items. Content validity indexes showed that items adequately reflected and represented the constructs to be measured (item content validity indexes: 0.9-1.0; construct content validity indexes: 0.8-1.0). The hypothesised factor structure could not be replicated by a CFA, but EFA on each individual subscale showed that six out of seven subscales were unidimensional. The ABC measure discriminated well between non-medical academics and medical academics, but had some difficulties in discriminating between educational groups. Test-retest reliability was moderate to substantial for most items. CONCLUSIONS The Danish ABC measure is a useful measurement that is accepted and understood by the target group and with accepted measurement criteria for content validity and test-retest reliability. Future studies may further explore the factorial structure of the ABC measure and should focus on improving the response categories.
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Affiliation(s)
- Line Hvidberg
- Research Centre for Cancer Diagnosis in Primary Care (CaP), Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark. .,Section for General Medical Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark.
| | - Anette Fischer Pedersen
- Research Centre for Cancer Diagnosis in Primary Care (CaP), Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
| | - Christian Nielsen Wulff
- Department of Oncology, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark
| | - Anders Helles Carlsen
- Research Centre for Cancer Diagnosis in Primary Care (CaP), Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
| | - Peter Vedsted
- Research Centre for Cancer Diagnosis in Primary Care (CaP), Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
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47
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Raine R, Atkin W, von Wagner C, Duffy S, Kralj-Hans I, Hackshaw A, Counsell N, Moss S, McGregor L, Palmer C, Smith SG, Thomas M, Howe R, Vart G, Band R, Halloran SP, Snowball J, Stubbs N, Handley G, Logan R, Rainbow S, Obichere A, Smith S, Morris S, Solmi F, Wardle J. Testing innovative strategies to reduce the social gradient in the uptake of bowel cancer screening: a programme of four qualitatively enhanced randomised controlled trials. PROGRAMME GRANTS FOR APPLIED RESEARCH 2017. [DOI: 10.3310/pgfar05080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BackgroundBowel cancer screening reduces cancer-specific mortality. There is a socioeconomic gradient in the uptake of the English NHS Bowel Cancer Screening Programme (BCSP), which may lead to inequalities in cancer outcomes.ObjectiveTo reduce socioeconomic inequalities in uptake of the NHS BCSP’s guaiac faecal occult blood test (gFOBt) without compromising uptake in any socioeconomic group.DesignWorkstream 1 explored psychosocial determinants of non-uptake of gFOBt in focus groups and interviews. Workstream 2 developed and tested four theoretically based interventions: (1) ‘gist’ information, (2) a ‘narrative’ leaflet, (3) ‘general practice endorsement’ (GPE) and (4) an ‘enhanced reminder’ (ER). Workstream 3 comprised four national cluster randomised controlled trials (RCTs) of the cost-effectiveness of each intervention.MethodsInterventions were co-designed with user panels, user tested using interviews and focus groups, and piloted with postal questionnaires. RCTs compared ‘usual care’ (existing NHS BCSP invitations) with usual care plus each intervention. The four trials tested: (1) ‘gist’ leaflet (n = 163,525), (2) ‘narrative’ leaflet (n = 150,417), (3) GPE on the invitation letter (n = 265,434) and (4) ER (n = 168,480). Randomisation was based on day of mailing of the screening invitation. The Index of Multiple Deprivation (IMD) score associated with each individual’s home address was used as the marker of socioeconomic circumstances (SECs). Change in the socioeconomic gradient in uptake (interaction between treatment group and IMD quintile) was the primary outcome. Screening uptake was defined as the return of a gFOBt kit within 18 weeks of the invitation that led to a ‘definitive’ test result of either ‘normal’ (i.e. no further investigation required) or ‘abnormal’ (i.e. requiring referral for further testing). Difference in overall uptake was the secondary outcome.ResultsThe gist and narrative trials showed no effect on the SECs gradient or overall uptake (57.6% and 56.7%, respectively, compared with 57.3% and 58.5%, respectively, for usual care; allp-values > 0.05). GPE showed no effect on the gradient (p = 0.5) but increased overall uptake [58.2% vs. 57.5% in usual care, odds ratio (OR) = 1.07, 95% confidence interval (CI) 1.04 to 1.10;p < 0.0001]. ER showed a significant interaction with SECs (p = 0.005), with a stronger effect in the most deprived IMD quintile (14.1% vs. 13.3% in usual care, OR = 1.11, 95% CI 1.04 to 1.20;p = 0.003) than the least deprived (34.7% vs. 34.9% in usual care OR = 1.00, 95% CI 0.94 to 1.06;p = 0.98), and higher overall uptake (25.8% vs. 25.1% in usual care, OR = 1.07, 95% CI 1.03 to 1.11;p = 0.001). All interventions were inexpensive to provide.LimitationsIn line with NHS policy, the gist and narrative leaflets supplemented rather than replaced existing NHS BCSP information. This may have undermined their effect.ConclusionsEnhanced reminder reduced the gradient and modestly increased overall uptake, whereas GPE increased overall uptake but did not reduce the gradient. Therefore, given their effectiveness and very low cost, the findings suggest that implementation of both by the NHS BCSP would be beneficial. The gist and narrative results highlight the challenge of achieving equitable delivery of the screening offer when all communication is written; the format is universal and informed decision-making mandates extensive medical information.Future workSocioculturally tailored research to promote communication about screening with family and friends should be developed and evaluated.Trial registrationCurrent Controlled Trials ISRCTN74121020.FundingThis project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full inProgramme Grants for Applied Research; Vol. 5, No. 8. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Rosalind Raine
- Department of Applied Health Research, University College London, London, UK
| | - Wendy Atkin
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Christian von Wagner
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Stephen Duffy
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Ines Kralj-Hans
- Department of Biostatistics, King’s Clinical Trials Unit, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Allan Hackshaw
- University College London Cancer Trials Centre, London, UK
| | | | - Sue Moss
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Lesley McGregor
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Cecily Palmer
- Department of Applied Health Research, University College London, London, UK
| | - Samuel G Smith
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Mary Thomas
- Department of Applied Health Research, University College London, London, UK
| | - Rosemary Howe
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Gemma Vart
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Roger Band
- Patient and Public Involvement Representative, Evesham, UK
| | - Stephen P Halloran
- NHS Bowel Cancer Screening Programme Southern Hub, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Julia Snowball
- NHS Bowel Cancer Screening Programme Southern Hub, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
| | - Neil Stubbs
- NHS Bowel Cancer Screening Programme Southern Hub, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
| | - Graham Handley
- NHS Bowel Cancer Screening Programme North East Hub, Gateshead Health NHS Foundation Trust, Queen Elizabeth Hospital, Gateshead, UK
| | - Richard Logan
- NHS Bowel Cancer Screening Programme Eastern Hub, Nottingham University Hospitals, Nottingham, UK
| | - Sandra Rainbow
- NHS Bowel Cancer Screening Programme London Hub, Northwick Park and St Marks Hospitals NHS Trust, Harrow, UK
| | - Austin Obichere
- North Central London Bowel Cancer Screening Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - Stephen Smith
- NHS Bowel Cancer Screening Programme Midlands and North West Hub, University Hospitals Coventry and Warwickshire NHS Trust, Hospital of St Cross, Rugby, UK
| | - Stephen Morris
- Department of Applied Health Research, University College London, London, UK
| | - Francesca Solmi
- Department of Applied Health Research, University College London, London, UK
| | - Jane Wardle
- Department of Epidemiology and Public Health, University College London, London, UK
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48
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Broom A, Kenny K, Bowden V, Muppavaram N, Chittem M. Cultural ontologies of cancer in India. CRITICAL PUBLIC HEALTH 2017. [DOI: 10.1080/09581596.2017.1288288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Alex Broom
- School of Social Sciences, The University of New South Wales, Sydney, Australia
| | - Katherine Kenny
- School of Social Sciences, The University of New South Wales, Sydney, Australia
| | - Vanessa Bowden
- School of Social Sciences, The University of New South Wales, Sydney, Australia
| | - Nagesh Muppavaram
- Department of Liberal Arts, Indian Institute of Technology, Hyderabad, India
| | - Mahati Chittem
- Department of Liberal Arts, Indian Institute of Technology, Hyderabad, India
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Marcu A, Black G, Vedsted P, Lyratzopoulos G, Whitaker KL. Educational differences in responses to breast cancer symptoms: A qualitative comparative study. Br J Health Psychol 2017; 22:26-41. [PMID: 27680898 DOI: 10.1111/bjhp.12215] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 08/12/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Advanced stage at diagnosis for breast cancer is associated with lower socio-economic status (SES). We explored what factors in the patient interval (time from noticing a bodily change to first consultation with a health care professional) may contribute to this inequality. DESIGN Qualitative comparative study. METHODS Semi-structured interviews with a sample of women (≥47 years) from higher (n = 15) and lower (n = 15) educational backgrounds, who had experienced at least one potential breast cancer symptom. Half the participants (n = 15) had sought medical help, half had not (n = 15). Without making breast cancer explicit, we elicited women's sense-making around their symptoms and help-seeking decisions. RESULTS Containment of symptoms and confidence in acting upon symptoms emerged as two broad themes that differentiated lower and higher educational groups. Women from lower educational backgrounds tended to attribute their breast symptoms to trivial factors and were reticent in using the word 'cancer'. Despite 'knowing' that symptoms could be related to cancer, women with lower education invoked lack of medical knowledge - 'I am not a doctor' - to express uncertainty about interpreting symptoms and accessing help. Women with higher education were confident about interpreting symptoms, seeking information online, and seeking medical help. CONCLUSIONS Our findings suggest that knowledge of breast cancer alone may not explain socio-economic differences in how women respond to breast cancer symptoms as women with lower education had 'reasons' not to react. Research is needed on how to overcome a wider spectrum of psycho-social factors to reduce future inequality. Statement of contribution What is already known on this subject? Seven of ten breast cancers in the UK are diagnosed after people contact their doctor with symptoms. Women from lower socio-economic backgrounds are more likely to be diagnosed with advanced disease. There is little evidence related to potential drivers of this SES inequality. What does this study add? We qualitatively explored socio-economic (SES) differences in help-seeking for breast symptoms. Women with higher education were more confident about interpreting symptoms and navigating health care. Women with lower education were more reluctant to seek help due to fear of cancer.
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Affiliation(s)
- Afrodita Marcu
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Georgia Black
- Department of Applied Health Research, University College London, UK
| | - Peter Vedsted
- Research Unit for General Practice, Research Centre for Cancer Diagnosis in Primary Care (CaP), Faculty of Health, Aarhus University, Denmark
| | - Georgios Lyratzopoulos
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, UK
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Lynes K, Kazmi SA, Robery JD, Wong S, Gilbert D, Thaha MA. Public appreciation of lifestyle risk factors for colorectal cancer and awareness of bowel cancer screening: A cross-sectional study. Int J Surg 2016; 36:312-318. [PMID: 27816703 DOI: 10.1016/j.ijsu.2016.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 10/31/2016] [Accepted: 11/01/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Prevention of colorectal cancer (CRC) via reduction of lifestyle risk factors, and participation in bowel screening are two ways in which public engagement could lower mortality from colorectal cancer. This study examined public awareness of lifestyle risk factors and bowel screening, with determination of the factors affecting this. METHODS A representative population sample (n = 1969) was surveyed using a study specific postal questionnaire to determine demographics, experience of bowel problems, awareness of lifestyle risk factors, knowledge about the incidence of CRC and potential benefits of screening, as well as personal experience of screening. RESULTS The majority of respondents were aged over 50 (74%). 77% had either personal experience or a relative/friend with experience of a bowel problem. Knowledge of dietary advice was better than risks relating to weight and physical activity. Awareness of lifestyle risk factors was significantly worse in those less than 50 years old (p = 0.0004) and with a lower level of education (p = 0.0021). Awareness of bowel cancer diagnosis was significantly lower in those less than 50 years old (p=<0.0001). The most frequent reason for non-completion of a screening kit was that the process was dirty and unpleasant. CONCLUSION Initiatives are required to improve awareness of younger people with regard to lifestyle risk factors for CRC, especially since this group stand to benefit most from risk reduction. Those with a lower educational level also had poor awareness but felt that the NHS should not prescribe exercise and lifestyle change; targeting this group would need to take this into account.
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Affiliation(s)
- Kathryn Lynes
- Blizard Institute, National Centre for Bowel Research & Surgical Innovation, Barts and the London School of Medicine & Dentistry, Queen Mary University London, 2 Newark Street, London, E1 2AT, United Kingdom.
| | - Sahar A Kazmi
- Colorectal Unit, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London, E1 1BB, United Kingdom
| | - Jordan D Robery
- Colorectal Unit, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London, E1 1BB, United Kingdom
| | - Simon Wong
- Colorectal Unit, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London, E1 1BB, United Kingdom
| | - Deborah Gilbert
- Bowel & Cancer Research, 2 Newark Street, London, E1 2AT, United Kingdom
| | - Mohamed A Thaha
- Blizard Institute, National Centre for Bowel Research & Surgical Innovation, Barts and the London School of Medicine & Dentistry, Queen Mary University London, 2 Newark Street, London, E1 2AT, United Kingdom; Colorectal Unit, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London, E1 1BB, United Kingdom
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