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Elshami M, Ayyad M, Alser M, Al-Slaibi I, Mohamad BM, Albandak M, Dwikat MF, Naji SA, Isleem WS, Shurrab A, Yaghi B, Qabaja YA, Hamdan FK, Sweity RR, Jneed RT, Assaf KA, Hmaid MM, Awwad II, Alhabil BK, Alarda MN, Alsattari AS, Aboyousef MS, Aljbour OA, AlSharif R, Giacaman CT, Alnaga AY, Abu Nemer RM, Almadhoun NM, Skaik SM, Albarqi SI, Bottcher B, Abu-El-Noor N. Attitudes toward colorectal cancer and colonoscopy in Palestine: a questionnaire-based study. Sci Rep 2024; 14:14563. [PMID: 38914664 PMCID: PMC11196673 DOI: 10.1038/s41598-024-65653-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/21/2024] [Indexed: 06/26/2024] Open
Abstract
Colorectal cancer (CRC) is a frequent cause of cancer-related mortality in the Palestinian population. This cross-sectional study was conducted from July 2019 to March 2020 and examined attitudes toward CRC and colonoscopy, as well as the interplay between both. Participants were recruited using convenience sampling from public spaces, governmental hospitals, and primary healthcare centers across 11 governorates in Palestine. Displaying a positive attitude was defined as agreeing on at least the median number of questions related to CRC (5 of 11 questions) or colonoscopy (6 of 10 questions). A total of 4623 participants were included. Most participants agreed that 'early detection of CRC increases the possibility of more effective treatment' (n = 4161, 89.7%). Similarly, the majority of participants agreed on 'preferring a physician with a gender similar to the participants to perform the colonoscopy' (n = 3738, 80.9%) and 'willingness to have colonoscopy even if the participant had to pay for it' (n = 3727, 80.6%). Furthermore, 3115 participants (67.4%) demonstrated positive attitudes toward CRC, while 2540 participants (55.0%) displayed similar attitudes toward colonoscopy. Participants from the West Bank and Jerusalem were more likely than those from the Gaza Strip to display positive attitudes toward colonoscopy (59.2% vs. 48.9%). Participants with positive attitudes toward CRC were more likely to also display positive attitudes toward colonoscopy and vice versa. About two thirds of study participants exhibited positive attitudes toward CRC, and 55.0% displayed positive attitudes toward colonoscopy. There was a reciprocal relationship between having positive attitudes toward CRC and colonoscopy.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7100, Cleveland, OH, 44106, USA.
- Ministry of Health, Gaza, Palestine.
| | - Mohammed Ayyad
- Department of Internal Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza, Palestine
| | | | - Balqees M Mohamad
- Doctors Without Borders (Médecins Sans Frontières), Hebron, Palestine
| | - Maram Albandak
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Mohammad F Dwikat
- Department of Internships, An-Najah National University Hospital, Nablus, Palestine
| | - Shoruq A Naji
- Faculty of Pharmacy, Al-Azhar University of Gaza, Gaza, Palestine
| | - Wejdan S Isleem
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Adela Shurrab
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Bashar Yaghi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Fatma K Hamdan
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Raneen R Sweity
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Remah T Jneed
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Khayria A Assaf
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Mohammed M Hmaid
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Iyas I Awwad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Marah N Alarda
- Faculty of Dentistry, Arab American University, Jenin, Palestine
| | | | | | - Omar A Aljbour
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Rinad AlSharif
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Ali Y Alnaga
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Ranin M Abu Nemer
- Faculty of Allied Medical Sciences, Arab American University, Jenin, Palestine
| | | | - Sondos M Skaik
- Faculty of Medicine, Al-Azhar University, Gaza, Palestine
| | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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2
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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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3
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Elshami M, Ayyad M, Hamdan FK, Alser M, Al-Slaibi I, Naji SA, Mohamad BM, Isleem WS, Shurrab A, Yaghi B, Qabaja YA, Dwikat MF, Sweity RR, Jneed RT, Assaf KA, Albandak ME, Hmaid MM, Awwad II, Alhabil BK, Alarda MN, Alsattari AS, Aboyousef MS, Aljbour OA, AlSharif R, Giacaman CT, Alnaga AY, Nemer RMA, Almadhoun NM, Skaik SM, Abu-El-Noor N, Bottcher B. Perceived barriers to early presentation and symptom-specific time to seek medical advice for possible colorectal cancer symptoms among Palestinians. Sci Rep 2023; 13:6871. [PMID: 37105988 PMCID: PMC10140026 DOI: 10.1038/s41598-023-34136-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 04/25/2023] [Indexed: 04/29/2023] Open
Abstract
This study explored the anticipated time to seek medical advice for possible colorectal cancer (CRC) signs/symptoms and its association with CRC symptom awareness. In addition, it examined perceived barriers that may delay seeking medical advice. Palestinian adults were recruited from hospitals, primary healthcare centers, and public spaces in 11 governorates. A modified, translated-into-Arabic version of the validated Bowel Cancer Awareness Measure was used. The questionnaire comprised three sections: sociodemographics, assessment of CRC symptom awareness and time to seek medical advice, and barriers to early presentation. A total of 4623 participants were included. The proportion that reported seeking immediate medical advice for possible CRC signs/symptoms with blood or mass ranged from 47.1% for 'blood in stools' to 59.5% for 'bleeding from back passage'. Less than half of the participants reported immediate seeking of medical advice for non-specific symptoms (ranging from 5.4% for 'loss of appetite' to 42.0% for 'anemia') and other gastrointestinal symptoms (ranging from 7.7% for 'feeling persistently full' to 35.7% for 'change in bowel habits'). Good CRC symptom awareness was associated with higher likelihood of seeking medical advice within a week from recognizing a CRC symptom. About 13.0% reported a delay to visit their doctor after recognizing a CRC symptom. The most reported barriers were practical with 'would try some herbs first' (50.9%) as the leading barrier. CRC symptoms with blood or mass prompted earlier help seeking. Participants with good CRC awareness were more likely to seek medical advice within a week.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7100, Cleveland, OH, 44106, USA.
- Ministry of Health, Gaza, Palestine.
| | - Mohammed Ayyad
- 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), Amman, Jordan
| | | | | | | | | | | | - 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
| | | | | | | | | | - Sondos Mahmoud Skaik
- Faculty of Medicine, Al-Quds Abu Dis University Al-Azhar Branch of Gaza, Gaza, Palestine
| | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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4
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Elshami M, Ayyad M, Alser M, Al-Slaibi I, Ahmed Naji S, Mohamad BM, Sudki Isleem W, Shurrab A, Yaghi B, Qabaja YA, Hmdan FK, Fuad Dwikat M, Raed Sweity R, Jneed RT, Assaf KA, Albandak ME, Madhat Hmaid M, Awwad II, Khalil Alhabil B, Alarda MN, Saleh Alsattari A, Aboyousef MS, Aljbour OA, AlSharif R, Teddy Giacaman C, Alnaga AY, Nemer RMA, Almadhoun NM, Mahmoud Skaik S, Abu-El-Noor N, Bottcher B. Awareness of colorectal cancer signs and symptoms: a national cross-sectional study from Palestine. BMC Public Health 2022; 22:866. [PMID: 35501803 PMCID: PMC9063349 DOI: 10.1186/s12889-022-13285-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In low-resource settings, the awareness level of colorectal cancer (CRC) signs and symptoms plays a crucial role in early detection and treatment. This study examined the public awareness level of CRC signs and symptoms in Palestine and investigated the factors associated with good awareness. METHODS This was a national cross-sectional study conducted at hospitals, primary healthcare centers, and public spaces in 11 governorates across Palestine between July 2019 and March 2020. A translated-into-Arabic version of the validated bowel cancer awareness measure (BoCAM) was utilized to assess the awareness level of CRC signs and symptoms. For each correctly identified CRC sign/symptom, one point was given. The total score (ranging from 0 to 12) was calculated and categorized into three categories based on the number of symptoms recognized: poor (0 to 4), fair (5 to 8), and good awareness (9 to 12). RESULTS Of 5254 approached, 4877 participants completed the questionnaire (response rate = 92.3%). A total of 4623 questionnaires were included in the analysis; 1923 were from the Gaza Strip and 2700 from the West Bank and Jerusalem (WBJ). Participants from the Gaza Strip were younger, gained lower monthly income, and had less chronic diseases than participants in the WBJ. The most frequently identified CRC sign/symptom was 'lump in the abdomen' while the least was 'pain in the back passage'. Only 1849 participants (40.0%, 95% CI: 39.0%-41.0%) had a good awareness level of CRC signs/symptoms. Participants living in the WBJ were more likely to have good awareness than participants living in the Gaza Strip (42.2% vs. 37.0%; p = 0.002). Knowing someone with cancer (OR = 1.37, 95% CI: 1.21-1.55; p < 0.001) and visiting hospitals (OR = 1.46, 95% CI: 1.25-1.70; p < 0.001) were both associated with higher likelihood of having good awareness. However, male gender (OR = 0.80, 95% CI: 0.68-0.94; p = 0.006) and following a vegetarian diet (OR = 0.59, 95% CI: 0.48-0.73; p < 0.001) were both associated with lower likelihood of having good awareness. CONCLUSION Less than half of the study participants had a good awareness level of CRC signs and symptoms. Future education interventions are needed to improve public awareness of CRC in Palestine.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7100, Cleveland, OH, USA.
- Ministry of Health, 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
| | | | | | | | | | - Sondos Mahmoud Skaik
- Faculty of Medicine, Al-Quds Abu Dis University Al-Azhar Branch of Gaza, Gaza, Palestine
| | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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5
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Elshami M, Abukmail H, Aqel W, Alser M, Al-Slaibi I, Shurrab H, Qassem S, Usrof FD, Alruzayqat M, Nairoukh R, Mansour A, Kittaneh R, Sawafta N, Habes YMN, Ghanim O, Aabed WA, Omar O, Daraghmeh M, Aljbour J, Elian R, Zuhour A, Habes H, Al-Dadah M, Abu-El-Noor N, Bottcher B. Awareness of Palestinians about lung cancer symptoms: a national cross-sectional study. BMC Pulm Med 2022; 22:135. [PMID: 35395762 PMCID: PMC8991725 DOI: 10.1186/s12890-022-01923-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The majority of lung cancer (LC) cases are diagnosed at an advanced stage. Poor awareness of LC symptoms is a contributor to late diagnosis. This study aimed to assess the awareness of LC symptoms among Palestinians, and to examine the factors associated with displaying good awareness. METHODS Participants were recruited from hospitals, primary healthcare centers and public spaces using convenience sampling. A translated-into-Arabic version of the validated LC awareness measure was used to assess recognition of 14 LC symptoms. One point was given for each recognized symptom. The total score was calculated and categorized based on the number of symptoms recognized: poor (0-4), fair (5-9), and good (10-14). Multivariable logistic regression was used to examine the association between participant characteristics and having good awareness. The multivariable analysis adjusted for age-group, gender, education, monthly income, occupation, residence, marital status, any chronic disease, knowing someone with cancer, smoking history, and site of data collection. RESULTS Of 5174 potential participants approached, 4817 completed the questionnaire (response rate = 93.1%) and 4762 were included in the final analysis. Of these, 2742 (56.9%) were from the West Bank and Jerusalem (WBJ) and 2020 (43.1%) were from the Gaza Strip. Participants from the WBJ were older, had higher monthly income but lower education, and suffered from more chronic diseases. The most recognized respiratory LC symptom was 'worsening in an existing cough'(n = 3884, 81.6%) while the least recognized was 'a cough that does not go away for two or three weeks'(n = 2951, 62.0%). The most recognized non-respiratory LC symptom was 'persistent tiredness or lack of energy'(n = 3205, 67.3%) while the least recognized was 'persistent shoulder pain'(n = 1170, 24.6%). A total of 2466 participants (51.8%) displayed good awareness of LC symptoms. Participants from both the Gaza Strip and the WBJ had similar likelihoods to have good awareness levels. Factors associated with a higher likelihood to display good awareness included female gender, having post-secondary education, being employed, knowing someone with cancer, and visiting hospitals and primary healthcare centers. CONCLUSION About half of the study participants displayed a good level of awareness of LC symptoms. Further improvement in public awareness of LC symptoms by educational interventions might reduce LC mortality by promoting early diagnosis.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7100, Cleveland, OH, 44106, USA. .,Ministry of Health, Gaza, Palestine.
| | - Hanan Abukmail
- Ministry of Health, Gaza, Palestine.,Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Wafa Aqel
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East, Gaza Strip, Palestine
| | | | - Hanan Shurrab
- Faculty of Pharmacy, Al-Azhar University of Gaza, Gaza, Palestine
| | - Shahd Qassem
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Faten Darwish Usrof
- Department of a Medical Laboratory Sciences, Faculty of Health Sciences, Islamic University of Gaza, Gaza City, Palestine
| | | | - Roba Nairoukh
- Faculty of Dentistry, Al-Quds University, Jerusalem, Palestine
| | - Ahmad Mansour
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Rahaf Kittaneh
- Faculty of Nursing, An Najah National University, Nablus, Palestine
| | - Nawras Sawafta
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Obaida Ghanim
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Ola Omar
- Faculty of Medicine, Al Najah National University, Nablus, Palestine
| | - Motaz Daraghmeh
- Faculty of Medicine, Al Najah National University, Nablus, Palestine
| | - Jomana Aljbour
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Razan Elian
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Areen Zuhour
- Faculty of Medicine, Al Najah National University, Nablus, Palestine
| | - Haneen Habes
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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6
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Elshami M, Abukmail H, Aqel W, Alser M, Al-Slaibi I, Shurrab H, Qassem S, Usrof FD, Alruzayqat M, Nairoukh R, Mansour A, Kittaneh R, Sawafta N, Habes YMN, Ghanim O, Aabed WA, Omar O, Daraghmeh M, Aljbour J, Elian R, Zuhour A, Habes H, Al-Dadah M, Abu-El-Noor N, Bottcher B. Awareness of Palestinians about lung cancer symptoms: a national cross-sectional study. BMC Pulm Med 2022; 22:135. [PMID: 35395762 PMCID: PMC8991725 DOI: 10.1186/s12890-022-01923-1 10.1186/s12890-022-01923-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The majority of lung cancer (LC) cases are diagnosed at an advanced stage. Poor awareness of LC symptoms is a contributor to late diagnosis. This study aimed to assess the awareness of LC symptoms among Palestinians, and to examine the factors associated with displaying good awareness. METHODS Participants were recruited from hospitals, primary healthcare centers and public spaces using convenience sampling. A translated-into-Arabic version of the validated LC awareness measure was used to assess recognition of 14 LC symptoms. One point was given for each recognized symptom. The total score was calculated and categorized based on the number of symptoms recognized: poor (0-4), fair (5-9), and good (10-14). Multivariable logistic regression was used to examine the association between participant characteristics and having good awareness. The multivariable analysis adjusted for age-group, gender, education, monthly income, occupation, residence, marital status, any chronic disease, knowing someone with cancer, smoking history, and site of data collection. RESULTS Of 5174 potential participants approached, 4817 completed the questionnaire (response rate = 93.1%) and 4762 were included in the final analysis. Of these, 2742 (56.9%) were from the West Bank and Jerusalem (WBJ) and 2020 (43.1%) were from the Gaza Strip. Participants from the WBJ were older, had higher monthly income but lower education, and suffered from more chronic diseases. The most recognized respiratory LC symptom was 'worsening in an existing cough'(n = 3884, 81.6%) while the least recognized was 'a cough that does not go away for two or three weeks'(n = 2951, 62.0%). The most recognized non-respiratory LC symptom was 'persistent tiredness or lack of energy'(n = 3205, 67.3%) while the least recognized was 'persistent shoulder pain'(n = 1170, 24.6%). A total of 2466 participants (51.8%) displayed good awareness of LC symptoms. Participants from both the Gaza Strip and the WBJ had similar likelihoods to have good awareness levels. Factors associated with a higher likelihood to display good awareness included female gender, having post-secondary education, being employed, knowing someone with cancer, and visiting hospitals and primary healthcare centers. CONCLUSION About half of the study participants displayed a good level of awareness of LC symptoms. Further improvement in public awareness of LC symptoms by educational interventions might reduce LC mortality by promoting early diagnosis.
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Affiliation(s)
- Mohamedraed Elshami
- grid.443867.a0000 0000 9149 4843Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7100, Cleveland, OH 44106 USA ,Ministry of Health, Gaza, Palestine
| | - Hanan Abukmail
- Ministry of Health, Gaza, Palestine ,grid.442890.30000 0000 9417 110XFaculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Wafa Aqel
- grid.16662.350000 0001 2298 706XFaculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East, Gaza Strip, Palestine
| | | | - Hanan Shurrab
- grid.133800.90000 0001 0436 6817Faculty of Pharmacy, Al-Azhar University of Gaza, Gaza, Palestine
| | - Shahd Qassem
- grid.16662.350000 0001 2298 706XFaculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Faten Darwish Usrof
- grid.442890.30000 0000 9417 110XDepartment of a Medical Laboratory Sciences, Faculty of Health Sciences, Islamic University of Gaza, Gaza City, Palestine
| | - Malik Alruzayqat
- grid.16662.350000 0001 2298 706XFaculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Roba Nairoukh
- grid.16662.350000 0001 2298 706XFaculty of Dentistry, Al-Quds University, Jerusalem, Palestine
| | - Ahmad Mansour
- grid.16662.350000 0001 2298 706XFaculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Rahaf Kittaneh
- grid.11942.3f0000 0004 0631 5695Faculty of Nursing, An Najah National University, Nablus, Palestine
| | - Nawras Sawafta
- grid.16662.350000 0001 2298 706XFaculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Yousef M. N. Habes
- grid.16662.350000 0001 2298 706XFaculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Obaida Ghanim
- grid.16662.350000 0001 2298 706XFaculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Wesam Almajd Aabed
- grid.133800.90000 0001 0436 6817Faculty of Dentistry, Al Azhar University of Gaza, Gaza, Palestine
| | - Ola Omar
- grid.11942.3f0000 0004 0631 5695Faculty of Medicine, Al Najah National University, Nablus, Palestine
| | - Motaz Daraghmeh
- grid.11942.3f0000 0004 0631 5695Faculty of Medicine, Al Najah National University, Nablus, Palestine
| | - Jomana Aljbour
- grid.442890.30000 0000 9417 110XFaculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Razan Elian
- grid.442890.30000 0000 9417 110XFaculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Areen Zuhour
- grid.11942.3f0000 0004 0631 5695Faculty of Medicine, Al Najah National University, Nablus, Palestine
| | - Haneen Habes
- grid.16662.350000 0001 2298 706XFaculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Mohammed Al-Dadah
- grid.442890.30000 0000 9417 110XFaculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Nasser Abu-El-Noor
- grid.442890.30000 0000 9417 110XFaculty of Nursing, Islamic University of Gaza, Gaza, Palestine
| | - Bettina Bottcher
- grid.442890.30000 0000 9417 110XFaculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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7
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Elshami M, Tuffaha A, Yaseen A, Alser M, Al-Slaibi I, Jabr H, Ubaiat S, Khader S, Khraishi R, Jaber I, Abu Arafeh Z, Al-Madhoun S, Alqattaa A, Abd El Hadi A, Barhoush O, Hijazy M, Eleyan T, Alser A, Abu Hziema A, Shatat A, Almakhtoob F, Mohamad B, Farhat W, Abuamra Y, Mousa H, Adawi R, Musallam A, Abu-El-Noor N, Bottcher B. Awareness of ovarian cancer risk and protective factors: A national cross-sectional study from Palestine. PLoS One 2022; 17:e0265452. [PMID: 35312720 PMCID: PMC8936444 DOI: 10.1371/journal.pone.0265452] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/01/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Having a good awareness of ovarian cancer (OC) risk and protective factors could facilitate early diagnosis. This study aimed to assess Palestinian women's awareness about OC risk and protective factors and to identify the factors associated with having good awareness. METHODS A cross-sectional study was conducted from July 2019 to March 2020 in the two main areas of Palestine: the West Bank and Jerusalem (WBJ) and the Gaza Strip. A translated-into-Arabic version of the validated OC awareness measure was utilized. Adult women attending hospitals, primary healthcare centers, and public spaces at 11 governorates were invited to participate. The awareness level was categorized based on the number of factors recognized: poor (0 to 5), fair (6 to 10) and good (11 to 15). RESULTS Of the 6095 women approached, 5618 agreed and completed the questionnaire (response rate = 92.1%). The final analysis included 5411 questionnaires. The most identified modifiable OC risk factor was 'being a smoker' (n = 4024, 74.4%), whereas the least identified was 'having in vitro fertilization treatment' (n = 1652, 30.5%). The most identified non-modifiable OC risk factor was 'having ovarian cysts' (n = 3136, 58.0%), whereas the least identified was 'having endometriosis' (n = 1880, 34.7%). The most identified OC protective factor was 'breastfeeding' (n = 4770, 88.2%), whereas the least identified was 'using the pill for a long time' (n = 930, 17.2%). Only 820 women (15.2%) displayed good awareness of OC risk and protective factors. Women from the Gaza Strip were slightly more likely than women from the WBJ to have good awareness (16.4% vs. 14.2%). In contrast, post-secondary education, higher monthly income, being married, and knowing someone with cancer were associated with an increase in the likelihood of displaying good awareness. CONCLUSION The overall awareness of OC risk and protective factors in this study was low. Educational interventions are needed to improve Palestinian women's awareness.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, United States of America
- Ministry of Health, Gaza, Palestine
| | - Aya Tuffaha
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Areej Yaseen
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | - Hadeel Jabr
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Sara Ubaiat
- Faculty of Medicine, Al-Quds University, Bethlehem, Palestine
| | - Salma Khader
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Reem Khraishi
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Inas Jaber
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | - Aya Alqattaa
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Ola Barhoush
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Maysun Hijazy
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Tamara Eleyan
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Amal Abu Hziema
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Amany Shatat
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | | | - Walaa Farhat
- Faculty of Medicine, Al-Quds University, Jenin, Palestine
| | - Yasmeen Abuamra
- Faculty of Medicine, Al-Azhar university-Gaza, Gaza, Palestine
| | - Hanaa Mousa
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Reem Adawi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Elshami M, Yaseen A, Alser M, Al-Slaibi I, Jabr H, Ubaiat S, Tuffaha A, Khader S, Khraishi R, Jaber I, Arafeh ZA, Al-Madhoun S, Alqattaa A, El Hadi AA, Barhoush O, Hijazy M, Eleyan T, Alser A, Hziema AA, Shatat A, Almakhtoob F, Mohamad B, Farhat W, Abuamra Y, Mousa H, Adawi R, Musallam A, Abu-El-Noor N, Bottcher B. Knowledge of ovarian cancer symptoms among women in Palestine: a national cross-sectional study. BMC Public Health 2021; 21:1992. [PMID: 34732142 PMCID: PMC8567700 DOI: 10.1186/s12889-021-12044-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 10/19/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Ovarian cancer (OC) is often diagnosed at advanced stages. This study aimed to assess the Palestinian women's knowledge about OC symptoms and determine the factors associated with having good knowledge. METHODS A cross-sectional study was conducted from July 2019 to March 2020 in the two main areas of Palestine: the West Bank and Jerusalem as well as the Gaza Strip. A translated-into-Arabic version of the validated OC awareness measure (OCAM) was utilized for data collection. Stratified convenience sampling was used to recruit adult women attending hospitals, primary healthcare centers, and public spaces at 11 governorates. The knowledge level was categorized into three categories based on the number of symptoms recognized: poor (0 to 4), fair (5 to 8), and good (9 to 11). RESULTS Of 6095 approached, 5618 participants completed the Arabic OCAM (response rate = 92.1%).A total of 5411 questionnaires were included in the analysis: 2278 from the Gaza Strip and 3133 from the West Bank and Jerusalem. Participants living in the West Bank and Jerusalem were older, of higher monthly income, and with more chronic diseases than those living in the Gaza Strip. The most frequently identified symptoms were 'extreme generalized fatigue' (n = 3821, 70.6%), 'unexplained weight loss' (n = 3607, 66.7%), and 'increased abdominal size on most days' (n = 3252, 60.1%). On the other hand, the least recognized symptoms were 'feeling full persistently' (n = 1553, 28.7%) and 'difficulty eating on most days' (n = 1971, 36.4%). Only 943 participants (17.4%) displayed good knowledge of OC symptoms. Participants from the Gaza Strip had a higher likelihood than participants from the West Bank and Jerusalem to have a good level of knowledge (21.0% vs. 14.8%). Being married, knowing someone with cancer, and visiting hospitals were all associated with a higher likelihood of having good knowledge level. However, living in the West Bank and Jerusalem was associated with a lower likelihood of having good knowledge. CONCLUSION The overall knowledge of OC symptoms in this study was low. Educational interventions are needed to improve Palestinian women's knowledge about OC symptoms.
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Affiliation(s)
- Mohamedraed Elshami
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. .,Ministry of Health, Gaza, Palestine.
| | - Areej Yaseen
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | - Hadeel Jabr
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Sara Ubaiat
- Faculty of Medicine, Al-Quds University, Bethlehem, Palestine
| | - Aya Tuffaha
- Faculty of medicine, An-Najah National University, Nablus, Palestine
| | - Salma Khader
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Reem Khraishi
- Faculty of medicine, An-Najah National University, Nablus, Palestine
| | - Inas Jaber
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | - Aya Alqattaa
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Ola Barhoush
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Maysun Hijazy
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Tamara Eleyan
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Amal Abu Hziema
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Amany Shatat
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | | | - Walaa Farhat
- Faculty of Medicine, Al-Quds University, Jenin, Palestine
| | - Yasmeen Abuamra
- Faculty of Medicine, Al-Azhar University-Gaza, Gaza, Palestine
| | - Hanaa Mousa
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Reem Adawi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Elshami M, Thalji M, Abukmail H, 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, Abu-El-Noor N, Bottcher B. Knowledge of cervical cancer risk factors among Palestinian women: a national cross-sectional study. BMC WOMENS HEALTH 2021; 21:385. [PMID: 34727914 PMCID: PMC8561913 DOI: 10.1186/s12905-021-01510-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 10/12/2021] [Indexed: 12/24/2022]
Abstract
Background High awareness of cervical cancer (CC) risk factors is important to decrease the morbidity and mortality associated with CC. This study aimed to assess the knowledge level of Palestinian women about CC risk factors and to determine the factors associated with good knowledge. Methods This was a national cross-sectional study. Adult women from hospitals, primary healthcare centers, and public spaces of 11 governorates in Palestine were recruited using a stratified convenience sampling. A translated-into-Arabic version of the validated CC awareness measure (CeCAM) was used to assess the knowledge about the 11 CC risk factors. For each correctly identified risk factor, the participant was given one point. The total score was calculated and was categorized into three categories: poor knowledge (0–3), fair knowledge (4–7), and good knowledge (8–11). Results A total of 7223 participants completed the Arabic CeCAM (response rate = 89.3%) and 7058 questionnaires were included in the final analysis: 2655 from the Gaza Strip and 4403 from the West Bank and Jerusalem. Participants recruited from the Gaza Strip were younger, getting lower monthly incomes, and with less chronic diseases than participants recruited from the West Bank and Jerusalem. The most frequently identified risk factor was ‘having a weakened immune system’ (n = 5458, 77.3%) followed by ‘infection with a sexually transmitted infection’ (n = 5388, 76.3%). The least identified risk factor was ‘having many children’ (n = 1597, 22.6%). Only 1670 women (23.7%) had good knowledge of CC risk factors. Women living in the Gaza Strip were more likely than women living in the West Bank and Jerusalem to have good knowledge (25.2% vs 22.7%). Completing a secondary or diploma degree, being employed, and having a monthly income of ≥ 1450 NIS (around $450) were all associated with lower likelihood of having good knowledge of CC risk factors. Conversely, knowing someone with cancer was associated with higher likelihood of having good knowledge. Conclusion The overall awareness of CC risk factors was low. There is a substantial need to establish educational programs to promote Palestinian women’s awareness of CC. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01510-2.
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Affiliation(s)
- Mohamedraed Elshami
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. .,Ministry of Health, Gaza, Palestine.
| | - Mariam Thalji
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Hanan Abukmail
- Ministry of Health, Gaza, Palestine.,Faculty of Medicine, Islamic University of Gaza, 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
| | - Ghaid Tanbouz
- Faculty of Dentistry and Dental Surgery, Al-Quds University, Jerusalem, Palestine
| | | | - Hala Abu Selmiyh
- Faculty of Medicine, Islamic University of Gaza, Gaza, 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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10
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Elshami M, Al-Slaibi I, Abukmail H, Alser M, Radaydeh A, Alfuqaha A, Thalji M, 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 R, Hammoud L, Rjoub S, Ayesh H, Rjoub T, Zakout R, Alser A, Abu-El-Noor N, Bottcher B. Knowledge of Palestinian women about cervical cancer warning signs: a national cross- sectional study. BMC Public Health 2021; 21:1779. [PMID: 34598690 PMCID: PMC8487127 DOI: 10.1186/s12889-021-11792-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 09/15/2021] [Indexed: 11/30/2022] Open
Abstract
Background Timely presentation and diagnosis of cervical cancer (CC) are crucial to decrease its mortality especially in low- and middle-income countries like Palestine. This study aimed to evaluate the knowledge of Palestinian women about CC warning signs and determine the factors associated with good knowledge. Methods This was a national cross-sectional study conducted between July 2019 and March 2020 in Palestine. Stratified convenience sampling was used to recruit adult women from hospitals, primary healthcare centers, and public spaces of 11 governorates. A translated-into-Arabic version of the validated CC awareness measure (CeCAM) was used to assess women’s knowledge of 12 CC warning signs. Results Of 8086 approached, 7223 participants completed the CeCAM (response rate = 89.3%). A total of 7058 questionnaires were included in the analysis: 2655 from the Gaza Strip and 4403 from the West Bank and Jerusalem (WBJ). The median age [interquartile range] for all participants was 34.0 [24.0, 42.0] years. Participants recruited from the WBJ were older, getting higher monthly income, and having more chronic diseases than those recruited from the Gaza Strip. The most frequently identified warning sign was ‘vaginal bleeding after menopause’ (n = 5028, 71.2%) followed by ‘extreme generalized fatigue’ (n = 4601, 65.2%) and ‘unexplained weight loss’ (n = 4578, 64.9%). Only 1934 participants (27.4%) demonstrated good knowledge of CC warning signs. Participants from the Gaza Strip were slightly more likely than participants from the WBJ to have a good level of knowledge. Factors associated with having good knowledge included having a bachelor or postgraduate degree, being married, divorced, or widowed as well as knowing someone with cancer. Conclusion The overall awareness of CC warning signs was low. Educational interventions are needed to increase Palestinian women’s awareness of CC warning signs. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11792-8.
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Affiliation(s)
- Mohamedraed Elshami
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. .,Ministry of Health, Gaza, Palestine.
| | | | - Hanan Abukmail
- Ministry of Health, Gaza, Palestine.,Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Afnan Radaydeh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Alaa Alfuqaha
- Faculty of Graduate Studies, An-Najah National University, Nablus, Palestine
| | - Mariam Thalji
- Faculty of Medicine, Al-Quds University, Jerusalem, 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
| | - Ghaid Tanbouz
- Faculty of Dentistry and Dental Surgery, Al-Quds University, Jerusalem, Palestine
| | | | - Hala Abu Selmiyh
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Haya Hebi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Manar Zamel
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Refqa Skaik
- Faculty of Medicine, Alazhar University of Gaza, Gaza, Palestine
| | - Lama Hammoud
- Faculty of Dentistry and Dental Surgery, Al-Quds University, Jerusalem, Palestine
| | - Siba 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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11
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Hamza A, Argaw Z, Gela D. Awareness of Colorectal Cancer and Associated Factors Among Adult Patients in Jimma, South-West Ethiopia: An Institution-Based Cross-Sectional Study. Cancer Control 2021; 28:10732748211033550. [PMID: 34342519 PMCID: PMC8351030 DOI: 10.1177/10732748211033550] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Colorectal cancer (CRC) is the first commonest diagnosed cancer in men and the fourth commonest in women in Ethiopia. Awareness of CRC and associated factors is crucial in the prevention of CRC. However, there have not been studies about the awareness of CRC and associated factors among adult patients in Ethiopia. Therefore, the study aimed to assess the awareness of CRC and associated factors among adult patients in Jimma, South-West Ethiopia, 2020. Methods This institution-based cross-sectional study design was conducted among 422 adult patients. The study respondents were recruited by a systematic random sampling method. The Cancer Awareness Measure questions were used to measure awareness of CRC of adult patients. Descriptive and logistic regression analyses were conducted. Results More than half (57.6%) of respondents had low-level awareness of CRC. Respondents who were females (adjusted odds ratio [AOR] = 1.86; 95% CI: 1.26, 2.75), who are residing in urban areas (AOR = .45; 95% CI: .30, .67), who had a monthly income of 3000 Ethiopian Birr and above (AOR = 4.72; 95% CI: 3.11, 7.15), who heard about CRC (AOR = 4.48; 95% CI: 2.90, 6.93), who get information through social media about CRC (AOR = 2.51; 95% CI: 1.18, 5.37), and who had a family history of CRC (AOR = 3.27; 95% CI: 1.45, 7.36) had a high level of awareness of CRC, while those who cannot read and write (AOR = 2.83; 95% CI: 1.49, 5.37) and learn elementary school (AOR = 2.12; 95% CI: 1.15, 3.93) had a low level of awareness of CRC. Conclusion This study indicated that awareness of CRC of adult patients was inadequate. Adult patients’ gender, residency, level of education, monthly income, heard about CRC, sources of information about CRC, and a family history of CRC were found to be independent predictors of the awareness of CRC. Therefore, there is a need for health education and awareness campaigns for promoting awareness of CRC of adult patients, and the government should develop policy on CRC prevention and screening program.
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Affiliation(s)
- Abdulmenan Hamza
- School of Nursing and Midwifery, Institute of Health, 107839Jimma University, Jimma, Ethiopia
| | - Zeleke Argaw
- School of Nursing and Midwifery, College of Health Science, 37602Addis Ababa University, Addis Ababa, Ethiopia
| | - Debela Gela
- School of Nursing and Midwifery, College of Health Science, 37602Addis Ababa University, Addis Ababa, Ethiopia
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12
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Elshami M, Bottcher B, Alkhatib M, Ismail I, Abu-Nemer K, Hana M, Qandeel A, Abdelwahed A, Yazji H, Abuamro H, Matar G, Alsahhar A, Abolamzi A, Baraka O, Elblbessy M, Samra T, Alshorbassi N, Elshami A. Perceived barriers to seeking cancer care in the Gaza Strip: a cross-sectional study. BMC Health Serv Res 2021; 21:28. [PMID: 33407426 PMCID: PMC7788935 DOI: 10.1186/s12913-020-06044-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 12/23/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Several factors might contribute to the delay to get cancer care including poor cancer awareness and having barriers to seeking help. This study described these barriers in Gaza and their association with recalling and recognizing cancer symptoms and risk factors. METHODS A cross-sectional study was conducted in Gaza. Adult visitors (≥18 years) to the largest three governmental hospitals and adolescent students (15-17 years) from ten high schools were recruited. A translated-into-Arabic version of the validated Cancer Awareness Measure (CAM) was used to collect data in face-to-face interviews. It described demographic data, barriers to seek cancer care as well as recall and recognition of cancer symptoms and risk factors. Responses were compared between adults and adolescents as well as males and females. RESULTS Of 3033 participants approached, 2886 completed the CAM (response rate= 95.2%). Among them, 1429 (49.5%) were adult (702 females; 49.1%) and 1457 (50.5%) were adolescent (781 females; 53.6%). The mean age± standard deviation (SD) of adult and adolescent participants was 33.7±11.7 years and 16.3±0.8 years, respectively. Emotional barriers were the most common barriers with 'feeling scared' as the most reported barrier (n=1512, 52.4%). Females and adolescents were more likely to report 'feeling scared' as a barrier than males and adults, respectively. Higher recall scores for cancer symptoms were associated with lower likelihood to report 'embarrassment', 'worry about wasting doctor's time' and 'difficulty arranging transport'. This was also seen for recalling risk factors, where 'embarrassment' and all practical barriers showed significant inverse associations with higher scores. In addition, greater recognition scores of cancer risk factors were inversely associated with reporting 'embarrassment' and 'feeling scared'. CONCLUSIONS The most commonly perceived barriers to seeking cancer care were 'feeling scared' and 'feeling worried about what the doctor might find', followed by practical and service barriers. Females and adolescents were more likely to report 'fear' as a barrier to seek medical advice. Having a higher recall of cancer symptoms and risk factors was inversely associated with reporting most barriers. To improve patient outcome, early presentation can be facilitated by targeting barriers specific to population groups.
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Affiliation(s)
- Mohamedraed Elshami
- Harvard Medical School, Boston, MA, USA. .,Ministry of Health, Gaza, Palestine.
| | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Iyad Ismail
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Khitam Abu-Nemer
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Mustafa Hana
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Ahmed Qandeel
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Ahmed Abdelwahed
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Hamza Yazji
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Hisham Abuamro
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Ghadeer Matar
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Ahmed Alsahhar
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Ahmed Abolamzi
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Obay Baraka
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Tahani Samra
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Alaa Elshami
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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13
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Elshami M, Elshami A, Alshorbassi N, Alkhatib M, Ismail I, Abu-Nemer K, Hana M, Qandeel A, Abdelwahed A, Yazji H, Abuamro H, Matar G, Alsahhar A, Abolamzi A, Baraka O, Elblbessy M, Samra T, Bottcher B. Knowledge level of cancer symptoms and risk factors in the Gaza Strip: a cross-sectional study. BMC Public Health 2020; 20:414. [PMID: 32228661 PMCID: PMC7106782 DOI: 10.1186/s12889-020-08553-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/18/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND In low-income settings, cancer is often diagnosed in advanced stages due to late presentation. Good public awareness of cancer signs and symptoms has a positive impact on the time patients take before they present to healthcare professionals. Therefore, this study examined public knowledge of cancer signs and symptoms as well as risk factors in Gaza. METHODS This was a cross-sectional study. Participants were recruited from adult visitors (≥18 years) to governmental hospitals covering all five governorates of Gaza, and adolescent students (15 to 17 years) from 10 high schools in corresponding locations. An Arabic version of the Cancer Awareness Measure (CAM) was completed in a face-to-face interview. It described demographic data and knowledge of: cancer prevalence, age-related risk, signs and symptoms as well as risk factors both in recall and recognition questions. RESULTS Of 3033 participants invited, 2886 completed the CAM (response rate = 95.2%). Adult mean age ± standard deviation was 33.7 ± 11.7 years and that of adolescents was 16.3 ± 0.8 years. Half of the participants (n = 1457, 50.5%) were adolescent (781 females; 53.6%) and 1429 (49.5%) were adult (702 females; 49.1%). About two thirds (n = 1885) thought about cancer as unrelated to age. Only 196 participants (6.8%) identified colorectal cancer as the most common cancer among men. Awareness of cancer signs/symptoms was poor to fair, where 'lump' was most commonly recognized (n = 2227, 77.2%) and 'change of bowel habit' the least (n = 670, 23.2%). Only 217 participants (7.5%) had a good level of recognizing risk factors with 'smoking' being the most identified and 'eating less than five portions of fruits and vegetables a day' the least. There was a higher likelihood for adults to identify most cancer signs/symptoms and risk factors than adolescents, except for recalling 'unexplained pain', 'persistent cough/hoarseness', 'non-healing ulcer', 'smoking', and 'eating less than five portions of fruits and vegetables a day'. CONCLUSION Public awareness of cancer signs/symptoms and risk factors needs to improve to facilitate early presentation and diagnosis in Gaza. Combining the delivery of public campaigns with tailored education to population groups, including the youth, may increase their knowledge and maintain its impact.
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Affiliation(s)
- Mohamedraed Elshami
- Ministry of Health, Gaza, Palestine. .,Harvard Medical School, Boston, MA, USA.
| | - Alaa Elshami
- Faculty of Medicine, Islamic Unviersity of Gaza, Gaza, 108, Palestine
| | | | - Mohammed Alkhatib
- Faculty of Medicine, Islamic Unviersity of Gaza, Gaza, 108, Palestine
| | - Iyad Ismail
- Faculty of Medicine, Islamic Unviersity of Gaza, Gaza, 108, Palestine
| | - Khitam Abu-Nemer
- Faculty of Medicine, Islamic Unviersity of Gaza, Gaza, 108, Palestine
| | - Mustafa Hana
- Faculty of Medicine, Islamic Unviersity of Gaza, Gaza, 108, Palestine
| | - Ahmed Qandeel
- Faculty of Medicine, Islamic Unviersity of Gaza, Gaza, 108, Palestine
| | - Ahmed Abdelwahed
- Faculty of Medicine, Islamic Unviersity of Gaza, Gaza, 108, Palestine
| | - Hamza Yazji
- Faculty of Medicine, Islamic Unviersity of Gaza, Gaza, 108, Palestine
| | - Hisham Abuamro
- Faculty of Medicine, Islamic Unviersity of Gaza, Gaza, 108, Palestine
| | - Ghadeer Matar
- Faculty of Medicine, Islamic Unviersity of Gaza, Gaza, 108, Palestine
| | - Ahmed Alsahhar
- Faculty of Medicine, Islamic Unviersity of Gaza, Gaza, 108, Palestine
| | - Ahmed Abolamzi
- Faculty of Medicine, Islamic Unviersity of Gaza, Gaza, 108, Palestine
| | - Obay Baraka
- Faculty of Medicine, Islamic Unviersity of Gaza, Gaza, 108, Palestine
| | - Mahmood Elblbessy
- Faculty of Medicine, Islamic Unviersity of Gaza, Gaza, 108, Palestine
| | - Tahani Samra
- Faculty of Medicine, Islamic Unviersity of Gaza, Gaza, 108, Palestine
| | - Bettina Bottcher
- Faculty of Medicine, Islamic Unviersity of Gaza, Gaza, 108, Palestine
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