Awareness of risk factors for cancer among Omani adults--a community based study

Development of a cancer risk model and mobile health application to inform the public about cancer risks and risk factors

OBJECTIVE

To develop and evaluate a mobile health application, the Cancer Risk Calculator (CRC), aimed at improving public health literacy by providing personalized information on cancer risks and preventive measures.

MATERIALS AND METHODS

The CRC was developed through a comprehensive process involving the identification of necessary content, integration of average cancer risks using data from reliable sources, creation of a novel risk model emphasizing modifiable factors, and the application's development for easy access. The application covers 38 cancer types, 18 subtypes, and approximately 790 risk factors, utilizing data from the Surveillance, Epidemiology, and End Results Program and scientific literature.

RESULTS

CRC offers users personalized risk assessments across a broad range of cancers, emphasizing modifiable risk factors to encourage preventive behaviors. It distinguishes itself by covering more cancer types and risk factors than existing tools, with preliminary user feedback indicating its utility in promoting health literacy and lifestyle changes.

DISCUSSION

The CRC application stands out as an innovative tool in health informatics, significantly enhancing public understanding of cancer risks. Its development underscores the potential of digital health technologies to bolster preventive healthcare strategies through improved health literacy.

CONCLUSION

The Cancer Risk Calculator is a pivotal development in mobile health technology, offering comprehensive and personalized insights into cancer risks and prevention. It serves as a valuable resource for public health education, facilitating informed decisions and lifestyle modifications for cancer prevention.

Knowledge of cancer symptoms and risk factors: A cross-sectional study from a developing country

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.

Effectiveness of an Educational Program on Awareness of Cancer Risk Factors, Symptoms, and Barriers to Medical Help-Seeking Among Adolescent Omani Students: an Interventional Study

Cancer is the second leading cause of death worldwide, with attributable mortality expected to continue increasing over time. High school students are often targeted to enhance awareness of cancer risk factors and symptoms and promote early medical help-seeking behaviors. This study aimed to evaluate the effectiveness of a cancer education program among Omani adolescents. A total of 12 public schools were randomly selected from three governorates and assigned to either the intervention or control group. Students attending grades 10 and 11 at the selected schools were targeted. The Cancer Awareness Measure tool was used to evaluate knowledge of cancer risk factors and symptoms, perceived barriers to seeking medical help, and anticipated time to consult a doctor for cancer warning symptoms at baseline (T0) and after 4 weeks (T1). After T0, the intervention group participated in a 1-h cancer education program involving a slideshow presentation and group discussion; they also received a leaflet and online access to program materials and videos. A total of 1716 students were enrolled in the study, including 886 (51.6%) assigned to the control group and 830 (48.4%) to the intervention group. Recognition of cancer risk factors (Z = 24.86; p ˂ 0.001) and cancer symptoms (Z = 24.91; p ˂ 0.001) significantly improved in the intervention group between T0 and T1, and compared to the control group at T1 (U = 33.28; p ˂ 0.001, and U = 34.55; p ˂ 0.001, respectively). In addition, anticipated time to help-seeking (Z = 20.15; p ˂ 0.001) and barriers to help-seeking (Z = 10.33; p < 0.001) decreased significantly between T0 and T1, and compared to the control group at T1 (U = 19.00; p ˂ 0.001, and U = 3.58; p < 0.001, respectively). The intervention effectively increased knowledge of cancer risk factors and symptoms and promoted early medical help-seeking behaviors among school-aged Omani adolescents. Integration of cancer education within high school curricula can aid cancer prevention and early intervention efforts. However, additional follow-up is required to confirm the long-term effectiveness of such programs.

Cancers preventive practice and the determinants in Amhara regional state, Northwest Ethiopia

Background

Cancer is the leading cause of morbidity and mortality globally. In Ethiopia, 5.8% of deaths are attributed to cancer. Therefore, this study aimed to examine the cancers preventive practice and associated factors in North West Ethiopia, 2019.

Methods

A community-based cross-sectional study was conducted among Bahir Dar city residents. A multistage sampling technique was used to select 845 study participants. Data were collected through a validated interviewer administered questionnaire. The questionnaire was adapted from the American cancer association cancer prevention toolkit. Descriptive statistics were computed and presented in charts and texts. The model fitness was checked using Hosmer and Lemeshow goodness of fit (P > 0.05). Bivariable and multivariable logistic regressions were used to identify factors associated with cancer preventive practice. A p-value < 0.2 at bivariate analysis was candidate variables for multivariable logistic regression analysis. Finally, p-value of < 0.05 was considered as a statistically significant predictor for cancer preventive practice at the 95% confidence interval.

Result

A total of 845 study participants took part in the study. Nearly 63% of the respondents were females. About 28% (95%CI: 24, 30) of the study participants had good preventive practice. Age ≥ 45 years (AOR = 0.31; 95%CI: 0.15, 0.62), female (AOR = 0.50, 95%CI: 0.35, 0.71) family member with cancer (AOR = 1.68, 95%CI: 1.07, 2.62) and had good knowledge (AOR = 1.66, 95%CI: 1.14, 2.42) were the identified determinants of cancer preventive practices.

Conclusion

This study revealed that the level of cancer preventive practices was low. Family member with cancer, knowledge about cancer, older age, and being female were significantly associated with cancer preventive practices. This finding underscores the importance of interventions to enhance cancer preventive practices.

An Observational Cross-Sectional Study on Cancer Awareness and Beliefs about Carcinogens among Saudi Women

Public knowledge about the risk factors of cancer is essential to ensure an effective prevention program. This study aims to explore the knowledge of the general Saudi population about cancer and carcinogens and to determine the misconceptions about carcinogens to help create appropriate evidence-based prevention awareness programs. A questionnaire of 63 questions related to biographic data, source of knowledge, risk factors, and the burden of cancer was distributed online. The internet was the most sought source for cancer-related information (75.2%). The inclusion of cancer-related subjects in the educational curriculum was believed to be the best way to educate children about cancer (48.4%). Knowledge about cancer risk factors was good overall for 10 out of the 27 risk factors assessed in the study, with cigarette smoking being the most well-known risk factor (91.5%), followed by hookah smoking (85.6%), and nuclear waste exposure (80%). However, only 16.3% of participants were aware of the risk associated with Oral Contraceptive Pills (OCPs), and less than half of the participants knew the risk associated with poor physical activity. About 45% (44.9%) believed that envy and spiritual causes are associated with cancer. Most of the study participants (70%) considered cancer to be a significant health issue in Saudi, mainly due to the increasing incidence rate (44%). Conclusion: This study showed a good level of awareness regarding cancer risk factors and environmental carcinogens, which could serve as a roadmap for future awareness programs and studies targeted at the knowledge of other risk factors for cancer.

Public awareness of environmental risk factors of cancer and attitude towards its prevention among the Lebanese general population

Introduction

Since the majority of cancers occur as a result of modifiable risk factors, cancer is being seen more as a preventable disease. The primary objective of our study was to assess the level of awareness of environmental risk factors of cancer among the Lebanese general population. The secondary objective focused on identifying the predictors of the preventability of the disease.

Methods

We conducted a cross-sectional study between June and July 2020. An online questionnaire was used to collect data pertaining to the knowledge of environmental risk factors of cancer, source of information and personal practice of the participants. Bivariate and multivariate analyzes were performed.

Results

About 387 respondents agreed to participate in the study. The study showed low awareness regarding infectious agents, lifestyle, diet and many work exposures. The predictors of the attitude of respondents regarding the preventability of cancer were: believing that cancer has an environmental cause (p=.014), not having a healthy lifestyle (p = 0.004), not smoking waterpipe (p = 0.023), being single (p = 0.013), and having a university degree (p = 0.049).

Conclusions

Efforts should be made to improve awareness of the cancer risk factors regarding infectious agents, lifestyle, diet and many work exposures. This can also be followed by further studies assessing the impact of these community and governmental cancer prevention initiatives on cancer risk factors level of awareness.

Awareness of Common Cancer Risk Factors and Symptoms in Saudi Arabia: A Community-Based Study

Objective:

To assess the level of cancer awareness and the relationship between the awareness of common cancer symptoms and risk factors and the sample’s sociodemographic profile.

Methods:

A community-based cross-sectional study conducted in Tabuk city, a convenient sample of 675 participants completed a questionnaire about common factors causing cancer and symptoms related to cancer. Descriptive statistics and chi-squared analysis were used to measure sample characteristics and their association with knowledge of cancer risk factors and symptoms.

Results:

Level of education and family history were significantly related to awareness of cancer risk factors (P= 0.017) and (P= 0.048), respectively. Factors were significantly associated with awareness of cancer symptoms include Gender (P=0.000), nationality (P=0.013), and undergoing regular cancer screening tests (0.008). Internet was the primary source of information about cancer and related significantly to knowledge about cancer symptoms(P=0.000) and risk factors(P=0.00). More than half of the sample scored poorly for knowledge of both cancer risk factors (58.7%) and symptoms (66.2%) in terms of the overall level of cancer awareness. Smoking and heredity were the most identifiable cancer risk factors, and unexplained pain and weight loss were identified by the majority of study participants.

Conclusion:

The level of community knowledge requires further investigation, and more cancer awareness programs need to be conducted. People could be encouraged to use reliable sources of information to obtain accurate cancer information.

Knowledge of Risk Factors, Symptoms and Barriers to Seeking Medical Help for Cervical Cancer among Omani Women Attending Sultan Qaboos University Hospital

Objectives

This study aimed to assess knowledge and attitudes among Omani woman regarding cervical cancer risk factors and symptoms as well as barriers to them seeking medical help.

Methods

This cross-sectional study was conducted between December 2017 and March 2018 at the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. A validated Arabic-language version of the Cervical Cancer Awareness Measure questionnaire was used to collect data from 550 Omani women visiting SQUH during the study period.

Results

A total of 490 women participated (response rate: 89.1%) in this study. Overall, the women demonstrated low levels of knowledge of cervical cancer risk factors and symptoms (28.5% and 45.0%, respectively). The most frequently recognised risk factor was having many children (36.1%), while the most recognised symptom was unexplained vaginal bleeding (69.8%). Women reported that being too scared was the greatest barrier to seeking medical help (68.0%). Various factors were significantly associated with greater knowledge of cervical cancer signs and symptoms including education level (odds ratio [OR] = 2.85; 95% confidence interval [CI]: 1.0–8.22; P <0.05), income (OR = 4.34; 95% CI: 1.70–11.12; P <0.05), parity (OR = 3.59; 95% CI: 1.38–9.36; P <0.05) and a family history of cancer (OR = 1.71; CI: 1.0–2.90; P <0.05).

Conclusion

Overall, Omani women demonstrated poor knowledge with regards to cervical cancer; in addition, they identified several emotional barriers to seeking medical help. Healthcare practitioners should reassure female patients to encourage care-seeking behaviour. A national screening programme is also recommended to increase awareness and early diagnosis of cervical cancer in Oman.

Knowledge and Awareness of Prostate Cancer Among Omani Men Attending a Teaching Hospital

Prostate cancer is ranked as the fourth most prevalent cancer in the world and the second most common cancer affecting men. In Oman, prostate cancer is one of the most common cancers among men, with the majority of prostate cancer patients presenting in the more advanced stages of the disease. Public awareness of the risk factors, symptoms and emphasising the importance of seeking early medical attention could help to improve the outcomes and survival rates of prostate cancer patients. The aim of this study is to determine the awareness levels of the risk factors, symptoms and barriers to seeking early medical intervention among adult Omani men. A validated questionnaire measuring the knowledge of risk factors, symptoms and barriers to seeking early medical help was used to collect data from adult Omani men attending a teaching hospital in Muscat, Oman. Out of 720 men who were invited, 600 participated in the study (response rate = 83%). The most recognised risk factor was obesity (366; 61.0%), and the least was sexually transmitted diseases (204; 34.0%); the most recognised symptom was unexplained weight loss (26.5%), the least was changes in seminal fluid (13.3%); the most common barrier to seeking early intervention was "not trusting the medical knowledge of the doctors" (57.5%), the least was "difficulty in arranging transport" (19.5%). Age, education level, marital status and family history of cancer were significantly associated with the participants' knowledge of prostate cancer. Participants received a significant part of their prostate cancer awareness via the social media. National awareness campaigns using social media and information leaflets are needed to educate Omani men on prostate cancer awareness and prevention and to increase trust in the expertise of medical professionals. Further research exploring the barriers to seeking early medical intervention is needed.

Knowledge level of cancer symptoms and risk factors in the Gaza Strip: a cross-sectional study

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.

Knowledge of Cancer Risk Factors, Symptoms, and Barriers to Seeking Medical Help among Omani Adolescents

Objective:

Raising cancer awareness among adolescents should lead to early diagnosis and improve their survival rate into adulthood. This study aims to identify knowledge of cancer risk factors, symptoms and barriers to seek medical help among Omani adolescents.

Methods:

A cross-sectional study with Omani adolescents (aged 15-17 years) has been conducted in six schools in Muscat, the capital of Oman. The general Cancer Awareness Measure questionnaire was used to collect the data.

Results:

A total of 481 adolescents participated. The average recognition of cancer risk factors and symptoms was low (36.8% and 39.6%, respectively). Cancer risk factors and/or symptoms significantly recognised more in girls compared to boys (χ² = 10.136; Odds ratio [OR] = 2.13 ; 95% confidence interval [CI]= 0.33-3.41; P = 0.001); older (age 17 year) versus younger (aged 15 and 16 years) (χ² = 6.075; OR = 11.68; 95% CI: 1.11-2.53; P = 0.014); those with existing co-morbidities compared to those without (χ² = 4.955; OR = 0.41; 95% CI: 0.18-0.92; P = 0.026); and those who knew someone with cancer compared to those who did not (χ² = 15.285; OR 2.70; 95% CI: 1.62-4.49; P <0.001). The majority of adolescents (88.8%) would seek medical help within the first two weeks of noting cancer symptoms. The most notable barriers to seek medical help were “emotional”. Girls were experienced “emotional barriers” significantly more than the boys (χ² = 11.617; OR = 1.89; 95% CI: 1.31-2.72; P = <0.001).

Conclusion:

Adolescents in Oman showed poor cancer awareness with several “emotional” barriers. There is a need to establish and integrate effective cancer educational programs in school curriculums to raise the cancer awareness, address emotional barriers and encourage seeking early medical help. The program could potentially have a life-long impact on encouraging early cancer diagnosis and improving the cancer survival rate.

Self- Reported Personal and Family History of Cancers in Brunei Darussalam: Result of an Integrated Health Survey

Introduction:

Cancers remain an important cause of mortality and morbidity, and overall incidence of cancers continues to increase worldwide with some cancers increasing while others decreasing. Understanding the epidemiology of cancer burden is important for health care planning. Most studies to date have reported incidence based on cancer registry. This aim of this study is to report the incidence of self-reported personal and family history of cancers.

Materials and Methods:

Data on cancers were extracted from an anonymized database of a survey (Integrated Health Screening Survey) for civil servants conducted between 2008 and 2013 (N=21,437, mean age 40.61 ± 9.46 years old, men 45.1%).

Results:

The overall incidence of self-reported cancers was 11.2%; personal and family histories were 0.6% and 9.4% respectively (1.2% did not state if cancers were either personal or family history). Commonly self-reported personal history of cancers were cancer of the breast, cervix and colorectal and for self-reported family history were cancers of the gastrointestinal tract, pulmonary, breast, head/neck and gynecological system. Common associations were with first degree relatives (single parent affected 50.8%, both parents affected 1.8%, siblings affected 21.9% and parents and siblings affected 3.1%). Involvement of grandparents accounted for 13.4%. The numbers affected ranged from one to three family members. For self-reported personal history of cancers, older age and gender were significant on univariate analysis and remained on multivariate analyses (p<0.05). For self–reported family history of cancers, older age, gender, professionals employment and smoking status were significant on univariate analysis but only older age, gender, race and professional employments remained significant factors on multivariate analyses (p<0.05).

Conclusions:

Our study showed that more than one in nine of participants reported personal or family histories of cancers, and certain characteristics were predictive of self-reporting history of cancers. Associations of cancers were mainly with first degree relatives.

Diet, Physical Activity, Obesity, and Breastfeeding: How French People Perceive Factors Associated with Cancer Risk

The French Cancer Barometer, a population-based-survey, is carried out every five years and is, to date, one of the few national studies conducted to investigate individual perception linked to cancer risk factors. The aims of the present study were to describe the perceptions of the French population in 2015 and to assess their evolution over a 5-year period (2010–2015). The French Cancer Barometer surveyed a randomly selected sample of participants aged 15–75 years (n = 3345 in 2010) and 15–85 years (n = 3764 in 2015), representative of the French population. Questions were on perception of diet, physical activity, obesity, and breastfeeding as cancer risk factors. In 2015, nutritional/activity factors were perceived as having an important role in cancer development for the majority of those surveyed (diet (90.8%), obesity (76%), and physical activity (70%)) with the exception being breastfeeding (34%). However, there was a moderate perception of the risks of red meat (43%) and salt or salty food (55%) consumption. Perceptions of nutritional risk factors were mostly associated with age and education level. Interestingly, there was a greater perception of nutritional risk factors in 2015 compared to 2010, and the participants’ opinions were also stronger. Efforts should be made on individuals with lower educational level and to promote the beneficial effects of breastfeeding. However, to impact food behavior, measures are needed at the environmental level and not only at the individual one.

Population insight of the relationship between lifestyle and cancer: A population-based survey

Background

There is a substantial rise in the incidence of cancer in Saudi Arabia. Life style models and lack of awareness are the prime suspect in this substantial increase. Therefore, the objective of the present study was to assess the relationship between lifestyle and cancer in a population-based Survey in Northern Saudi Arabia.

Methodology

This cross-sectional study was conducted in North Saudi Arabia (Hail Region). Data was collected as a part of a community based cancer's awareness movement that covered an area inhibited with approximately 500,000 individuals.

Results

In this study, about 2558/3227 (79.3%) and 641/794 (80.7%) believed that tobacco smoking and smokeless are not a risk of cancer development. In this study large section (87.2%) of the study population believe that exposure to diverse occupational or non-occupational chemicals has no role in cancer development. Furthermore, around 59% of the study subjects in the current study believed that repeated exposure to insecticidal chemicals doesn't influence the risk of cancer.

Conclusion

The present study point to the urgent need for awareness educational programs and preventive measures towards may lifestyle factors that can increase or decrease the overall risk of cancer among Saudi population.

Awareness of Risk Factors, Symptoms and Time to Seek Medical Help of Ovarian Cancer amongst Omani Women Attending Teaching Hospital in Muscat Governorate, Oman

Background

Ovarian cancer has been regarded as most deadly gynaecological cancer in the world. In Oman, ovarian cancer is the third most prevalent gynaecological cancer affecting Omani women. The awareness of risk factors, symptoms and seeking early medical care play a role in the improvement of survival rates. The aim of this study is to explore knowledge, risk factors, symptoms and the time taken to seek early medical help for ovarian cancer among Omani women attended Sultan Qaboos University Hospital.

Methods

The ovarian Cancer Awareness and Measure (CAM) questionnaire (translated into Arabic) was used to collect data.

Results

A total of 499 women participated. The most recognised risk factors were having ovarian cysts (71.3%), smoking (67.5%) and having close relative with ovarian cancer (63.5%); the least recognised were having in vitro fertilization (25.5%), having children (26.3%) and using talcum powder in the genital area (31.5%). The most recognised symptoms were persistent pain in the pelvis (67.7%), persistent pain in the abdomen (60.3%) and extreme fatigue (56.5%); the least recognised were feeling full persistently (22.8%), passing more urine than usual (31.1%) and changes in bowel habits (32.1%). Multinomial logistic regression showed recognition of risk factors and symptoms were associated with a higher level of education, a higher income, increased age, higher number of pregnancies, a longer duration of marriage and having a family history of ovarian cancer. Most of the barriers to seeking medical help were for several emotional, practical and healthcare service reasons.

Conclusion

The overall level of recognition of risk factors and symptoms of ovarian cancer among Omani women were low with several emotional, practical and service barriers preventing them from seeking early medical help. More measures to raise national cancer awareness levels are needed, and support for women to overcome these barriers to minimized delays in the presentation.

Knowledge and Awareness of Colorectal Cancer Early Warning Signs and Risk Factors among University Students in Jordan

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.

Changes in awareness of cancer risk factors among adult New Zealanders (CAANZ): 2001 to 2015

Behaviour change, specifically that which decreases cancer risk, is an essential element of cancer control. Little information is available about how awareness of risk factors may be changing over time. This study describes the awareness of cancer risk behaviours among adult New Zealanders in two cross-sectional studies conducted in 2001 and 2014/5.Telephone interviews were conducted in 2001 (n = 436) and 2014/5 (n = 1064). Participants were asked to recall things they can do to reduce their risk of cancer. They were then presented with a list of potential risk behaviours and asked if these could increase or decrease cancer risk.Most New Zealand adults could identify at least one action they could take to reduce their risk of cancer. However, when asked to provide specific examples, less than a third (in the 2014/5 sample) recalled key cancer risk reduction behaviours such as adequate sun protection, physical activity, healthy weight, limiting alcohol and a diet high in fruit. There had been some promising changes since the 2001 survey, however, with significant increases in awareness that adequate sun protection, avoiding sunbeds/solaria, healthy weight, limiting red meat and alcohol, and diets high in fruit and vegetables decrease the risk of developing cancer.

Determinants of Behavioral Intentions to Screen for Prostate Cancer in Omani Men

Objective:

This study aimed at exploring the perceived barriers and intention to screen for prostate cancer (PCa).

Methods:

A survey questionnaire and a descriptive design were used to collect data from 129 Omani men above the age of 40 years. The questionnaire comprised the International Prostate Symptom Score (IPSS), barriers, and intention to screen scales. The participants were recruited from barbershops located in two cities of Oman.

Results:

The mean IPSS score was 8.31 ± 3.34 and the majority of participants had mild prostate cancer symptoms (60.4%). The others had moderate (28.7%) or severe symptoms (10.9%). Most men had low-to-moderate intention to screen using the method of digital rectal examination (DRE) (76%) and prostate-specific antigen test (PSA) (69.8%). The most common barriers to screening were fear of finding out something wrong (48.1%), not knowing what will be done during screening (54.3%), belief that PCa is not a serious disease (55.8%), and belief that DRE is embarrassing (56.6%). The significant determinants of intention to screen using DRE were perceived threat of the disease (P = 0.006) and past information from doctors that one has any prostate disease (P = 0.017). The determinants of intention to screen using PSA were perceived threat of the disease (P = 0.025), perceived general health (P = 0.047), and past information from doctors that one has any prostate disease (P = 0.017).

Conclusions:

The participants had diminutive intention to undergo PCa screening. Interventions aimed at enhancing PCa disease and risk awareness may help to reduce the barriers and increase PCa screening uptake.

Contrasts in Practices and Perceived Barriers to Colorectal Cancer Screening by Nurses and Physicians Working in Primary Care Settings in Oman

Colorectal cancer (CRC) is the fourth most common type of cancer worldwide and it is responsible for 610,000 deaths annually, despite availability of screening tests that ensure early detection. Predictions specific to the Middle East show that this region will experience a significant increase in cancer mortality over the next 15 years. This study explored the practices and perceived barriers to CRC screening from the perspective of health care providers (HCPs) working in primary care settings in Muscat, Oman. A cross-sectional design and self-administered questionnaires were used to collect data from 142 HCPs. The HCPs were nurses (57.7 %) and physicians (42.3 %) with average age and clinical experience of 32.5 and 9.5 years, respectively. The majority of the HCPs (64.8 %) rarely ordered, referred, health educated, or recommended CRC screening to eligible patients. The only major patient-related barrier to CRC screening reported by HCPs was lack of awareness about CRC tests (63.7 %). There were significant differences between nurses' and physicians' rating of patient-related barriers such as fear of cancer diagnosis (p = 0.037), belief that screening is not effective (p = 0.036), embarrassment or anxiety about screening tests (p = 0.022), and culture (p = 0.001). The major system barriers to CRC screening were lack of hospital policy or protocols, lack of trained HCPs, lack of CRC screening services, and timely appointments to get CRC screening. The findings indicate a need for interventions to enhance patient awareness, HCPs CRC screening practices, and strategies to ameliorate patient and system barriers to CRC screening.

From self-care for healthy people to self-management for cancer patients with cancer portals

Self-care to prevent cancer and self-management to cope with the disease are two discrete effective mechanisms for improving of control and management of neoplasia. Both them have certain strategies and practices. Often the two are used interchangeably despite their different approaches. Strategies of self-care usually refer to prevention at different levels include primary, secondary and tertiary. In contrast, strategies of self-management are related to management and alleviation of unpleasant cancer-related symptoms and treatment-related side effects for improving the quality of life of cancer survivors. Successful promoting of self-care and self-management strategies need people and survivor empowerment. Within this context, innovative approaches open a new window. In this paper after a brief review of related strategies and practices, we provide an explanation of how cancer portals may play an important role in the empowerment process and what are key potentials for implementing of self- care and self-management strategies for cancer.

Risk awareness on uterine cancer among Australian women

Uterine cancer is the most common invasive gynaecological cancer in Australia. Early detection is a key predictive factor achieved by increasing public awareness and participation in screening. This observational study measures awareness of gynaecological malignancies, particularly uterine, among women in two rural areas of New South Wales, Australia. Patients presenting to gynaecology clinics in January to March 2014 were invited to complete a structured questionnaire. Women with a history of cancer and incomplete questionnaires were excluded. Of the 382 patients invited to participate, 329 (86%) responded with complete feedback. Most respondents were younger than than 50 years (66%) and married with at least 2 children (74%). The majority (94%) of participants had no awareness of uterine cancer and many (46%) were unable to identify common risk factors including obesity, diabetes and hypertension. The ability to identify risk factors was correlated to age, marital status and obesity. The study identifies poor awareness on uterine malignancies in two typical areas of rural Australia. Although external validity is limited by sociological factors, poor awareness of uterine cancer among rural patients in this study represents a valid public health concern. It is imperative to improve awareness of uterine cancer and available screening programs to facilitate early detection and cure.

Development of a family nursing model for prevention of cancer and other noncommunicable diseases through an appreciative inquiry

BACKGROUND

Cancer and non-communicable diseases are a major issue not only for the developed but also developing countries. Public health and primary care nursing offer great potential for primary and secondary prevention of these diseases through community and family-based approaches. Within Thailand there are related established educational curricula but less is known about how graduate practitioners enact ideas in practice and how these can influence policy at local levels.

AIM

The aim of this inquiry was to develop family nursing practice in primary care settings in the Isaan region or Northeastern Thailand and to distill what worked well into a nursing model to guide practice.

MATERIALS AND METHODS

An appreciative inquiry approach involving analysis of written reports, focus group discussions and individual interviews was used to synthesize what worked well for fourteen family nurses involved in primary care delivery and to build the related model.

RESULTS

Three main strategies were seen to offer a basis for optimal care delivery, namely: enacting a participatory action approach mobilizing families' social capital; using family nursing process; and implementing action strategies within communities. These were distilled into a new conceptual model.

CONCLUSIONS

The model has some features in common with related community partnership models and the World Health Organization Europe Family Health Nurse model, but highlights practical strategies for family nursing enactment. The model offers a basis not only for planning and implementing family care to help prevent cancer and other diseases but also for education of nurses and health care providers working in communities. This articulation of what works in this culture also offers possible transference to different contexts internationally, with related potential to inform health and social care policies, and international development of care models.

Effects of Nursing Education on Awareness of Risk Factors for Colorectal Cancer

BACKGROUND

The objective of this study is to determine the effect of nursing education on awareness of risk factors for colorectal cancer.

MATERIALS AND METHODS

In this descriptive study, the sample is consisted of 132 volunteer students studying in the 1st and 4th grades of School of Health Nursing Department during the fall semester of 2014-2015. Data were collected via a questionnaire including information on the socio-demographic features of the participants and the correlating risk factors of colorectal cancer, prepared by researchers in view of the literature. The questionnaire was distributed to students and completed during class time. Before presenting the questionnaires to the respondents, informed consent was obtained from each. The data obtained were analyzed with a statistical package (SPSS). At first, a Kolmogorov-Smirnow test was performed on the research data. However, since it was seen that variables did not have a normal distribution, the Wilcoxon Signed Ranks Test was applied. P values of <0.05 were considered statistically significant. Percentages, means and standard deviations were also utilized for evaluation.

RESULTS

Of the total of 132 students participating in this study, 85.6% (n=113) were female, and 14.4% (n=19) were male. The average age was 20.5±2.04. 54.5 % of the students (n=72) were 4th graders and 45.5 % (n=60) were first graders. Total score averages of first graders on risk awareness was X=12 ± 7.24, and fourth graders was X=16.93 ± 7.71. The difference between these two scores were found to be statistically significant (Z= -9,333; p=0.000).

CONCLUSIONS

Nursing education was found out to have a positive influence on the students' awareness of risk factors for colorectal cancer.

Knowledge, attitudes and behaviors of women over 20 years old on cervix cancer in Istanbul, Turkey

PURPOSE

The aim of the study was to evaluate knowledge, attitudes and behaviors of Turkish women over 20 years old on cervix cancer.

MATERIALS AND METHODS

This descriptive study was performed at a primary care center covering 246 women using a questionnaire composed of 3 sections and 38 questions. The data were analyzed using descriptive statistics, chi-square test in univariate analysis and multivariate hierarchical logistic regression analysis.

RESULTS

Of the 93.7% women who knew about cervical cancer, 68.0% of them had heard pap smear test and 46.1% had actually undergone a Pap smear once or more throughout their lives. According to the results of the hierarchical logistic regression analysis about factors affecting the Pap smear test; in Model 1, increase in age and education levels, in Model 2 and Model 3 increase in age and cervical cancer information points were determined. The most important information source for cervical cancer was TV-radio/media (59.9%) and health care workers (62.8%) for pap smear test.

CONCLUSIONS

Although most women have heard of cervical cancer, knowledge about cervical cancer and also Pap smear screening rate are significantly lower. Having Pap smear test for women was affected by age and knowledge level about cervical cancer. Informing women about cervical cancer would be an important intervention.

Molecular Links between Alcohol and Tobacco Induced DNA Damage, Gene Polymorphisms and Patho-physiological Consequences: A Systematic Review of Hepatic Carcinogenesis

Chronic alcohol and tobacco abuse plays a crucial role in the development of different liver associated disorders. Intake promotes the generation of reactive oxygen species within hepatic cells exposing their DNA to continuous oxidative stress which finally leads to DNA damage. However in response to such damage an entangled protective repair machinery comprising different repair proteins like ATM, ATR, H2AX, MRN complex becomes activated. Under abnormal conditions the excessive reactive oxygen species generation results in genetic predisposition of various genes (as ADH, ALDH, CYP2E1, GSTT1, GSTP1 and GSTM1) involved in xenobiotic metabolic pathways, associated with susceptibility to different liver related diseases such as fibrosis, cirrhosis and hepatocellular carcinoma. There is increasing evidence that the inflammatory process is inherently associated with many different cancer types, including hepatocellular carcinomas. The generated reactive oxygen species can also activate or repress epigenetic elements such as chromatin remodeling, non-coding RNAs (micro-RNAs), DNA (de) methylation and histone modification that affect gene expression, hence leading to various disorders. The present review provides comprehensive knowledge of different molecular mechanisms involved in gene polymorphism and their possible association with alcohol and tobacco consumption. The article also showcases the necessity of identifying novel diagnostic biomarkers for early cancer risk assessment among alcohol and tobacco users.