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Elshami M, Albandak M, Alser M, Al-Slaibi I, Ayyad M, Dwikat MF, Naji SA, Mohamad BM, Isleem WS, Shurrab A, Yaghi B, Ayyash Qabaja Y, Hamdan FK, Sweity RR, Jneed RT, Assaf KA, Hmaid MM, Awwad II, Alhabil BK, Alarda MN, Alsattari AS, Aboyousef MS, Aljbour OA, AlSharif R, Giacaman CT, Alnaga AY, Abu Nemer RM, Almadhoun NM, Skaik SM, Albarqi SI, Abu-El-Noor N, Bottcher B. Differences in colorectal cancer awareness between screening eligible vs. ineligible Palestinians: a national cross-sectional study. Eur J Public Health 2024; 34:872-878. [PMID: 38745392 PMCID: PMC11430923 DOI: 10.1093/eurpub/ckae083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND This study aimed to compare colorectal cancer (CRC) awareness between screening-eligible and ineligible individuals in Palestine. METHODS Convenience sampling was utilized to recruit Palestinian adults from diverse settings, including hospitals, primary healthcare centers and public spaces across 11 governorates. The evaluation of CRC awareness in terms of signs/symptoms, risk factors and causation myths was conducted using Arabic-translated, modified versions of the validated instruments, the Bowel Cancer Awareness Measure and the Cancer Awareness Measure-Mythical Causes Scale. RESULTS The final analysis included 2698 participants, with 2158 (80.9%) eligible for CRC screening and 540 (19.1%) ineligible for it. The most recognized CRC sign/symptom was 'lump in the abdomen' in both screening-eligible (n = 386, 71.5%) and ineligible (n = 1582, 73.3%) groups. 'Lack of physical activity' was the most recognized risk factor in both groups (eligible: n = 451, 83.5%; ineligible: n = 1766, 81.8%). The most reported causation myth in both groups was 'having a physical trauma' (eligible: n = 340, 63.0%; ineligible: n = 1353, 62.7%). In the screening-eligible group, only 210 participants (38.9%) demonstrated high awareness of CRC signs/symptoms, 213 participants (39.4%) showed high awareness of CRC risk factors and only 46 participants (8.5%) displayed high awareness of CRC causation myths. There were no significant associations between being eligible for screening colonoscopy and the awareness levels of CRC signs/symptoms, risk factors and causation myths. CONCLUSION Overall, awareness levels of CRC signs/symptoms, risk factors and causation myths were notably low among screening-eligible participants. There were no differences in awareness levels between individuals eligible for colonoscopy and those who were not.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- Ministry of Health, Gaza, Palestine
| | - Maram Albandak
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza, Palestine
| | | | - Mohammed Ayyad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Mohammad F Dwikat
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Shoruq A Naji
- Faculty of Pharmacy, Al-Azhar University of Gaza, Gaza, Palestine
| | - Balqees M Mohamad
- Doctors Without Borders (Médecins Sans Frontières), Hebron, Palestine
| | - Wejdan S Isleem
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Bashar Yaghi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Fatma K Hamdan
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Raneen R Sweity
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Remah T Jneed
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Khayria A Assaf
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Mohammed M Hmaid
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Iyas I Awwad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Marah N Alarda
- Faculty of Dentistry, Arab American University, Jenin, Palestine
| | | | | | - Omar A Aljbour
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Rinad AlSharif
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Ali Y Alnaga
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Ranin M Abu Nemer
- Faculty of Allied Medical Sciences, Arab American University, Jenin, Palestine
| | | | - Sondos M Skaik
- Faculty of Medicine, Al-Azhar University, Gaza, Palestine
| | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Elshami M, Dwikat MF, Al-Slaibi I, Alser M, Albandak ME, Ayyad M, Naji SA, Mohamad BM, Isleem WS, Shurrab A, Yaghi B, Qabaja YA, Hamdan FK, Sweity RR, Jneed RT, Assaf KA, Hmaid MM, Awwad II, Alhabil BK, Alarda MN, Alsattari AS, Aboyousef MS, Aljbour OA, AlSharif R, Giacaman CT, Alnaga AY, Nemer RMA, Almadhoun NM, Skaik SM, Albarqi SI, Abu-El-Noor N, Bottcher B. Understanding the interplay of colorectal cancer awareness and attitudes among Palestinians: a national cross-sectional study. BMC Cancer 2024; 24:590. [PMID: 38750448 PMCID: PMC11094844 DOI: 10.1186/s12885-024-12357-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/07/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND In Palestine, colorectal cancer (CRC) is the second most common cause of cancer-related mortality after lung cancer. No studies have examined the relationship between CRC awareness and attitudes. This study aimed to investigate the interplay between CRC awareness and attitudes among the Palestinian population. METHODS A nationwide cross-sectional survey was carried out between July 2019 and March 2020. Convenience sampling was used to collect data from hospitals, primary healthcare facilities, and public areas in 11 governorates. Modified, translated-into-Arabic versions of the validated Bowel Cancer Awareness Measure and Cancer Awareness Measure-Mythical Causes Scale were utilized to assess the awareness of CRC signs/symptoms, risk factors, and causation myths. The cumulative awareness score for each domain was computed and stratified into tertiles. The top tertile denoted 'high' awareness, while the remaining two tertiles denoted 'low' awareness. RESULTS The final analysis included 4,623 participants; of whom, 3115 (67.4%) reported positive attitudes toward CRC. In total, 1,849 participants (40.0%) had high awareness of CRC signs/symptoms. There was no association between displaying a high awareness of CRC signs/symptoms and having positive attitudes toward CRC. A total of 1,840 participants (38.9%) showed high awareness of CRC risk factors. Participants with high CRC risk factor awareness were more likely to display positive attitudes toward CRC (OR = 1.22, 95% CI: 1.07-1.39). Only 219 participants (4.7%) had high awareness of CRC causation myths. Participants with high awareness of CRC causation myths were more likely to exhibit positive attitudes toward CRC (OR = 2.48, 95% CI: 1.71-3.58). CONCLUSION A high awareness level of CRC risk factors and causation myths was associated with a greater likelihood of demonstrating positive attitudes toward CRC in terms of perceived susceptibility, importance of early detection, and consequences of developing the disease. Future educational interventions should focus on raising public awareness about CRC, with a particular emphasis on risk factors and causation myths, to maximize the potential for shaping favorable attitudes toward the disease.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside, Cleveland, OH, 7100, 44106, USA.
- Ministry of Health, Gaza, Palestine.
| | - Mohammad Fuad Dwikat
- Department of Internships, An-Najah National University Hospital, Nablus, Palestine
| | | | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza, Palestine
| | | | - Mohammed Ayyad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | - Bashar Yaghi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | - Khayria Ali Assaf
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | | | - Iyas Imad Awwad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | - Rinad AlSharif
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Elshami M, Abukmail H, Thalji M, Al-Slaibi I, Alser M, Radaydeh A, Alfuqaha A, Khader S, Khatib L, Fannoun N, Ahmad B, Kassab L, Khrishi H, Elhussaini D, Abed N, Nammari A, Abdallah T, Alqudwa Z, Idais S, Tanbouz G, Hajajreh M, Selmiyh HA, Abo-Hajouj Z, Hebi H, Zamel M, Skaik RN, Hammoud L, Rjoub S, Ayesh H, Rjoub T, Zakout R, Alser A, Albarqi SI, Abu-El-Noor N, Bottcher B. Myths and common misbeliefs about cervical cancer causation among Palestinian women: a national cross-sectional study. BMC Public Health 2024; 24:189. [PMID: 38229049 PMCID: PMC10790379 DOI: 10.1186/s12889-024-17733-5] [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: 04/27/2023] [Accepted: 01/10/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Cervical cancer (CC) myths and beliefs can negatively impact women's preventive behaviors, including vaccination against human papillomavirus and having regular screening tests. This study aimed to examine awareness of Palestinian women about myths related to CC causation and investigated factors associated with good awareness. METHODS A national cross-sectional study was conducted to recruit adult Palestinian women from hospitals, primary healthcare facilities, and public areas in 11 Palestinian governorates. A translated-into-Arabic version of the Cancer Awareness Measure-Mythical Causes Scale was used to collect data. Awareness level was determined based on the number of CC myths around CC causation recognized to be incorrect: poor (0-4), fair (5-9), and good (10-13). RESULTS A total of 7058 questionnaires were included. Myths unrelated to food were more commonly recognized as incorrect compared to those related to food. The most recognized food-unrelated myth was 'having a physical trauma' (n = 3714, 52.6%), whereas the least recognized was 'using mobile phones' (n = 2238, 31.7%). The most recognized food-related myth was 'drinking from plastic bottles' (n = 2708, 38.4%), whereas the least recognized was 'eating food containing additives' (n = 1118, 15.8%). Only 575 participants (8.1%) displayed good awareness and promptly recognized at least 10 out of 13 myths around CC causation as incorrect. Factors associated with lower likelihood of displaying good awareness of myths around CC causation included living in the West Bank and Jerusalem, being married, widowed or divorced, knowing someone with cancer, and visiting hospitals or primary healthcare centers. CONCLUSIONS A very small proportion of Palestinian women recognized 10 or more myths around CC causes as incorrect. Initiatives addressing CC myths are needed in the Palestinian community.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7100, Cleveland, OH, USA.
- Ministry of Health, Gaza, Palestine.
| | - Hanan Abukmail
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Harvard Medical School, Boston, MA, USA
- International Medical Corps, Gaza, Palestine
| | - Mariam Thalji
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza, Palestine
| | - Afnan Radaydeh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Alaa Alfuqaha
- Faculty of Graduate Studies, An-Najah National University, Nablus, Palestine
| | - Salma Khader
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Lana Khatib
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Nour Fannoun
- Faculty of Pharmacy, Alazhar University of Gaza, Gaza, Palestine
| | - Bisan Ahmad
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Hiba Khrishi
- Faculty of Dentistry and Dental Surgery, Al-Quds University, Jerusalem, Palestine
| | - Deniz Elhussaini
- Faculty of Medicine, Alazhar University of Gaza, Gaza, Palestine
| | - Nour Abed
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Aya Nammari
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Zaina Alqudwa
- Faculty of Medicine, Alazhar University of Gaza, Gaza, Palestine
| | - Shahd Idais
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
- Hebron Governmental Hospital, Hebron, Palestine
| | - Ghaid Tanbouz
- Faculty of Dentistry and Dental Surgery, Al-Quds University, Jerusalem, Palestine
| | | | | | | | - Haya Hebi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Manar Zamel
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | | | - Lama Hammoud
- Faculty of Dentistry and Dental Surgery, Al-Quds University, Jerusalem, Palestine
| | - Saba Rjoub
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Hadeel Ayesh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Toqa Rjoub
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Rawan Zakout
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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