Public awareness of warning signs and symptoms of cancer in oman: a community-based survey of adults

Understanding the interplay of colorectal cancer awareness and attitudes among Palestinians: a national cross-sectional study

BACKGROUND

In Palestine, colorectal cancer (CRC) is the second most common cause of cancer-related mortality after lung cancer. No studies have examined the relationship between CRC awareness and attitudes. This study aimed to investigate the interplay between CRC awareness and attitudes among the Palestinian population.

METHODS

A nationwide cross-sectional survey was carried out between July 2019 and March 2020. Convenience sampling was used to collect data from hospitals, primary healthcare facilities, and public areas in 11 governorates. Modified, translated-into-Arabic versions of the validated Bowel Cancer Awareness Measure and Cancer Awareness Measure-Mythical Causes Scale were utilized to assess the awareness of CRC signs/symptoms, risk factors, and causation myths. The cumulative awareness score for each domain was computed and stratified into tertiles. The top tertile denoted 'high' awareness, while the remaining two tertiles denoted 'low' awareness.

RESULTS

The final analysis included 4,623 participants; of whom, 3115 (67.4%) reported positive attitudes toward CRC. In total, 1,849 participants (40.0%) had high awareness of CRC signs/symptoms. There was no association between displaying a high awareness of CRC signs/symptoms and having positive attitudes toward CRC. A total of 1,840 participants (38.9%) showed high awareness of CRC risk factors. Participants with high CRC risk factor awareness were more likely to display positive attitudes toward CRC (OR = 1.22, 95% CI: 1.07-1.39). Only 219 participants (4.7%) had high awareness of CRC causation myths. Participants with high awareness of CRC causation myths were more likely to exhibit positive attitudes toward CRC (OR = 2.48, 95% CI: 1.71-3.58).

CONCLUSION

A high awareness level of CRC risk factors and causation myths was associated with a greater likelihood of demonstrating positive attitudes toward CRC in terms of perceived susceptibility, importance of early detection, and consequences of developing the disease. Future educational interventions should focus on raising public awareness about CRC, with a particular emphasis on risk factors and causation myths, to maximize the potential for shaping favorable attitudes toward the disease.

"Cancer Education on Wheels," a Novel Cost-Effective Method in Creating Awareness in the Community: a Pilot Study

Cancer education raises disease awareness, the value of early identification and importantly the need for prompt screening and treatment when diagnosed. In this study, an effort was made to understand how well a unique cancer education program, "Cancer Education on Wheels," transfers knowledge in general public in society. The community was shown prerecorded cancer awareness videos using a TV monitor, CD player, and speaker system mounted on an eight-seat Toyota Innova. Before and after seeing the video presentation, consenting volunteers filled out questionnaires asking about demographics and understanding of cancer. Frequency and percentage calculations were done on the demographic information and a Wilcoxon signed-rank test was run on the overall subject score. Data was stratified based on demographic information and compared by applying Kruskal-Wallis test and Mann-Whitney test. p values under 0.05 were regarded as significant. A total of 584 people completed the pre-test and post-test questionnaires. The Wilcoxon signed-rank test revealed a difference between the pre-test and post-test (3.29 ± 2.48 vs. 6.78 ± 3.52; P = 0.0001). The pre-test results showed that volunteers between the ages of 18 and 30; men; students; urban residents; single volunteers; graduates; people who had known a person/or family member with cancer; and people who were aware of the suffering cancer causes had a high baseline knowledge of cancer (p = 0.015 to 0.001). The post-test results show that participants who had less baseline scores like housewives and unemployed people performed better (p = 0.006 to 0.0001). The findings unambiguously demonstrated that "Cancer Education on Wheels" was successful in raising participants' awareness of cancer signs and screening. Additionally, the findings showed that volunteers who were aged, married, housewives, and unemployed had higher scores. Most importantly, this approach to cancer education is simple to organize and carry out in a local setting. It is also affordable and simple to execute using readily available technological equipment and manageable logistics. According to the authors' knowledge, this is the first study to use "Cancer Education on Wheels" to spread awareness of cancer throughout the neighborhood especially in budget constrained areas.

Colorectal Cancer Awareness and Related Factors Among Adults Attending Primary Healthcare in North-Eastern of Iran: A Cross-sectional Study

BACKGROUND

Colorectal cancer (CRC) is the third most prevalent cancer in Iran. This study aimed to assess the level of awareness regarding CRC warning signs, risk factors, screening program, and related factors among adults in North-Eastern Iran. Study Design: A cross-sectional study.

METHODS

The multi-stage sampling method was used to survey 2614 participants attending primary healthcare centers in Mashhad, Iran. The data collection tools were the demographics section and Bowel/ CRC Awareness Measure (Bowel/Colorectal CAM). The data were analyzed by SPSS, version 25. The significance level of the data analysis was less than 0.05.

RESULTS

Mean awareness for CRC warning signs and CRC risk factors were 2.85±2.13 and 3.63±1.85, respectively. Most participants (97.2%) had no awareness of the CRC screening program. There was a significant association between marital status, education, job, income, and family history of CRC with awareness of warning signs (P<0.001); moreover, there was a significant association between age, education, job, income, and family history of CRC with awareness of risk factors (P<0.001). The results of logistic regression indicated that there was a significant association between age (P=0.022, OR=1.794, 95% confidence interval [CI]: 1.087, 2.962), gender (P=0.005, OR=0.488, 95% CI: 0.296, 0.803) and warning sign awareness (P<0.001, OR=1.278, 95% CI: 1.124, 1.454) with awareness of the CRC screening program.

CONCLUSION

In this study, most of the participants had low awareness of CRC. More aimed educational interventions are needed to promote Iranian adults' awareness of CRC.

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

BACKGROUND AND AIM

Women in Oman and low- and middle-income countries (LMICs) are usually diagnosed with BC at a younger age and more advanced stage, with poor five-year survival. This study aims to evaluate the effectiveness of breast cancer (BC) related educational programs among female Omani adolescents.

MATERIALS AND METHODS

Six female-only public schools were randomly selected from three governorates of Oman and assigned to the control or interventional group. An Arabic version of the Breast Cancer Awareness Measure questionnaire was used to evaluate students attending grades 10 and 11 at baseline (T0) and after 4 weeks (T1). After T0, the intervention group participated in a one-hour BC education program involving group discussions, a slideshow presentation, leaflets, and online access to program materials and videos. Non-parametric tests were used to compare scores between intervention and control groups and within each group across time (T0 vs. T1).

RESULTS

A total of 1106 students participated, of which 547 (49.5%) and 559 (50.5%) were allocated to the control and intervention groups, respectively. Recognition of BC risk factors (Z = 18.67; p < 0.001) and symptoms (Z = 20.01; p < 0.001) increased significantly in the intervention group between T0 and T1 and compared to the control group at T1 (U = 27.27; p < 0.001, and U = 25.75; p < 0.001, respectively). Anticipated time to seeking medical help (Z = 18.67; p < 0.001) and barriers to help-seeking (Z = 7.91; p < 0.001) decreased significantly between T0 and T1 in the intervention group and compared to the control group at T1 (U = 15.78; p < 0.001, and U = 3.44; p = 0.001, respectively).

CONCLUSION

The program increased knowledge of BC risk factors and symptoms and promoted early medical help-seeking among Omani female adolescents. Healthcare strategic planners and policy-makers in Oman and low- and middle-income countries should consider incorporating cancer education programs in the national school curriculum to minimize delays in BC diagnosis and improve the survival rate.

Pre- and post-intervention survey on lung cancer awareness among adults in selected communities in KwaZulu-Natal, South Africa: A quasi-experimental study

Background

Lung cancer remains the number one cause of cancer mortality estimated at 1.8 million deaths. There are limited studies in resource poor countries regarding knowledge, attitudes and practices towards lung cancer.

Objective

This study aimed to assess the effects of a lung cancer awareness intervention in selected communities in KwaZulu- Natal, South Africa.

Materials and Methods

A quasi-experimental study design was conducted in the selected communities in KwaZulu-Natal. A community intervention was administered in the communities after a baseline survey. The intervention effects were assessed a month after implementation.

Results

There were statistical differences in the mean age (p<0.001) and proportion of males and females (p<0.001) at baseline and post-intervention. There were no differences in terms of smoking status (p=0.958), however, there was a reduction in the number of cigarettes smoked per day (p<0.001) and the number of packs smoked per week (p=0.026). The mean knowledge score increased from 41.8% (95% CI 35.7 - 47.9) at baseline to 59.9 (95% CI 53.8 - 66.0) post-intervention (p<0.001). The proportion of participants who were aware that lung cancer can be detected early increased from 46.5% (95% CI 39.1 - 53.9) at baseline to 81.1% (95% CI 71.7 - 87.9) post-intervention (p<0.001). The intervention had a statistically significant effect (aOR 4.370, 95% CI 1.477-12.928) on the level of lung cancer knowledge in the selected communities (p<0.001).

Conclusions

Interventions increasing the recognition of signs and symptoms, focusing on the importance of early detection and health seeking behaviour (including screening), smoking cessation, and addressing the perceived health system barriers are required.

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.

Relationship between Health Literacy and Knowledge, Attitude, and Performance Regarding Cancer Warning Signs

BACKGROUND

Health literacy (HL) is considered a cancer-preventive strategy. In addition, success in early diagnosis of cancer largely depends on individuals' knowledge, attitude, and performance regarding cancer warning signs. The aim of the present study was to investigate the potential relationship between HL and Knowledge, Attitude, and Performance (KAP) regarding cancer warning signs.

MATERIALS AND METHODS

This descriptive-correlational study was conducted on 280 adults who were referred to 3 health centers in Tehran, Iran, from January to March 2020. Data were collected using the Health Literacy Instrument for Adults (HELIA) and the researcher-made KAP regarding cancer warning signs questionnaire. Data were analyzed using the Pearson correlation test and linear regression in an adjusted model in the statistical package for social sciences software.

RESULTS

Total HL score was positively and significantly correlated with knowledge (r = 0.35; p < 0.001), attitude (r = 0.17, p = 0.003), and performance (r = 0.46, p < 0.001). Moreover, after controlling for potential confounders, a significant and positive relationship was found between HL and knowledge (β = 0.48; t275= 4.45; p < 0.001), attitude (β =0.17; t265= 4.64; p < 0.001), and performance (β = 0.62; t265= 8.23; p < 0.001).

CONCLUSIONS

It seems that adults' KAP regarding cancer warning signs can be promoted by increasing their HL. Therefore, greater attention should be paid to individuals' HL at community health centers when designing and performing programs to improve their KAP regarding cancer warning signs.

Needs for Cancer Education In Oman Based on the Breast Cancer Screening Program

Most breast cancers in Oman are diagnosed at advanced stages and therefore early detection is important. The Oman Cancer Association (OCA) initiated a mobile mammography program in 2009, but no studies have evaluated its impact. This study aimed at estimating the proportion and predictors of OCA-screened women who had repeated mammography (adherence) and the sensitivity and specificity of the program. Demographic, screening, diagnosis, and treatment data of 13,079 women screened in the OCA mammography clinic from 2009 to 2016, and medical records of all breast cancer patients seen at Royal and Sultan Qaboos University hospitals during the same period were retrieved. Logistic regression analysis was conducted to identify predictors of adherence. A total of 8278 screened women over age 42 years (median age of 50 ± 8 years) were included in the study. Only 18% of initially negative screened women were compliant with recommended subsequent screening. Predictors of adherence included age (50-69 years), family history of cancer, family history of breast cancer, and breast self-examination. The overall cancer detection rate was 4.1/1000 screened women. Positive predictive value of screening was 4.7% with a sensitivity rate of 53% and specificity of 92%. This study showed a low mammography adherence among previously screened women. The study revealed low sensitivity, high specificity, and an acceptable cancer detection rate. Future programs should focus on improving data collection of screened women, maintaining the linkage of databases of screening and treatment clinics, and developing guidelines for breast cancer screening in Oman. The recommendations based on the study results should be incorporated into future professional, patient, and public cancer education programs.

The Effectiveness of Interventional Cancer Education Programs for School Students Aged 8-19 Years: a Systematic Review

The implementation of effective interventional cancer education programs in schools could help to reduce delays in diagnosis and improve cancer survival by increasing awareness of risk factors and symptoms among students. The aim of this review was to determine the effectiveness of interventional cancer education programs delivered to school students aged 8-19 years. Various databases were searched to identify controlled and uncontrolled studies published in English language articles between January 2000 and January 2020. Selected publications were then critically appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews. A total of 12 studies meeting these criteria were identified. Of these, eight were randomized, and five included control groups. All of the studies conducted the intervention over the course of 1, 3, or 4 days, and there was no follow-up phase in seven studies. Various modes and materials were used in the delivery of the interventions, including children's books and booklets, expert talks or presentations, videos, discussions, role-playing exercises, hands-on activities, group work, quizzes, and homework. There was some evidence to indicate that the interventions enhanced short-term knowledge, attitudes, self-efficacy, and behavioral intentions; however, there was less evidence regarding their long-term effectiveness, particularly in terms of help-seeking barriers. Interventional education programs are important to increase knowledge of cancer among school students aged 8-19 years. Decision-makers should consider including relevant topics within the educational curricula. Both healthcare providers and non-educational organizations should work together to support effective cancer interventional education programs for school students as part of their long-term cancer prevention efforts.

Symptom Perceptions and Help-Seeking Behaviours of Omani Patients Diagnosed with Late-Stage Colorectal Cancer: A Qualitative Study

OBJECTIVE

Colorectal cancer (CRC) is the fourth leading cause of mortality in Oman, with most patients diagnosed at advanced stages. Early diagnosis of CRC improves prognosis and survival rate. The aim of this study was to explore the symptom perceptions and help-seeking behaviours (HSBs) of Omani patients diagnosed with late-stage CRC.

METHODS

Semi-structured individual interviews were conducted with 16 patients.

RESULTS

Four main themes emerged, including normalisation and ignorance (patients felt healthy, perceived symptoms as not being serious and related to dietary habits, concealed them or prioritised work and family commitments), self-empowerment and self-management (patients were stubborn, employed 'wait and see' approach, used symptomatic or herbal treatments), disclosure and seeking help (patients disclosed symptoms to family members or friends, sought medical help only when symptoms worsened, visited faith healers or travelled abroad for treatment) and healthcare professionals (patients attributed treatment or diagnosis delays to lack of continuity of care, loss of trust in doctors or delays in referral).

CONCLUSION

Patients attributed delays in CRC diagnosis to several factors based on their perceptions of symptoms. Most HSBs driven by sociocultural and emotional causes. Increased awareness of CRC symptoms and modifying HSBs can encourage early diagnosis. Prompting patients to disclose CRC-related symptoms may aid referral decisions.

Cancer Warning Symptoms Awareness and Associated Factors Among Individuals Living in Assella Town, Ethiopia

Introduction

Community awareness about cancer warning symptoms and risk factors in the general population is essential and can be considered as a basis for cancer control programs. Since Patients are rarely aware of the early warning symptoms and cancer risk factors, the burden of disease is increasing everywhere in the world. Evidences has been shown that cancer is highly prevalent in Ethiopia in which the diagnosis is made at later stages of the disease.

Objective

To assess Cancer Warning Symptoms awareness and associated factors among individuals living in Assella Town, Ethiopia.

Methods

A community-based cross-sectional study was employed in Assella town from May 1^st to June 1^st, 2020 among 410 adult residents 18 years old and above. A systematic random sampling technique was employed to select the households from which the study subjects randomly identified. Data were collected through face-to-face interview by using pre-tested structured questionnaire and entered into Epi data version 3.1 then exported to SPSS version 25.0 for analysis. Logistic regression analyses were used to identify factors associated with outcome variables. Odds ratio and 95% CI at P-values <0.05 was used to determine the presence of association.

Results

The findings of this study revealed that the overall level of awareness of cancer warning symptoms is 214 (52.2% (AOR = 95% CI 47.1, 56.8)). Educational level (AOR = 3.44, 95%CI, 1.50–7.88 (p = 0.003)), awareness of cancer risk factors (AOR = 2.56, 95% CI, 1.67, 3.93, (p < 0.001)) and economic status (AOR = 3.13 (95% CI 1.84, 5.33, p < 0.001)) were identified as factors significantly associated with awareness of cancer warning symptoms among adult populations.

Conclusion

Almost one-out-of-two adults residing in Assella town has awareness about cancer warning symptoms. Educational level, awareness of cancer risk factors, and economic status among Assella town residents were identified as factors associated with good level of awareness about cancer warning symptoms.

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.

Diagnostic delay for head and neck cancer in South India: A Mixed-methods Study

Background:

Early diagnosis is an important aspect of quality of cancer care.Analysis of the diagnostic delays and the reasons for delay helps to plan strategies to improve cancer care.

Objectives:

To determine the primary, secondary, and total diagnostic delay of patients diagnosed with head and neck cancer and to explore the reasons for the delay from the patient perspective.

Methods:

Explanatory mixed method design was used. Two hundred persons with a confirmed diagnosis of head and neck cancer attending the ENT (ear, nose, throat) cancer clinic in a teaching hospital before the initiation of treatment were included in the study. The median delay and the association of the delay with the various factors were analyzed. Sixteen one-to-one interviews of patients were done to identify the reasons for the delays from the patient perspective.

Results:

Median primary, secondary, and total diagnostic delays were 30 days, 30 days, and 73 days, respectively. Statistically, primary delay was found significantly longer among ever users of smokeless tobacco and significantly longer secondary delay was found among those with age less than 60 years. The reasons for the delay were grouped in the categories (i) Symptom appraisal delay due to low perceived seriousness and (ii) health-seeking behavior delay.

Conclusions:

The diagnostic delay was considerable. Measures to enhance symptom appraisal by improving health literacy, opportunistic screening, and strengthening the referral system would decrease diagnostic delay.

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.

The Web-Based Randomized Controlled Intervention as the Enhancer of Cancer Prevention

Background and Objectives: Cancer is an unresolved public health issue in society. With the advent of the internet and the development in the technological sector, access to basic health-related information has become more frequent among patients and healthy individuals. The aim of this study is to evaluate the impact of educational intervention on the participant’s willingness to undergo selected medical procedures in case of suspected cancer. Materials and Methods: From 14 May 2015 to 13 November 2016, a total of 1118 who visited the Polish scientific website were enrolled in the ‘Polish Online Randomized Intervention aimed at Neoplasm Avoidance’ (PORINA) and randomized into two groups (educational and control). The original Cancer Knowledge Index (CKI) was used for the evaluation of participants’ cancer-related knowledge. They were asked to declare whether they would consent to undergo selected medical procedures necessary for cancer diagnosis or treatment. Results: Most participants declared their readiness to undergo abdominal ultrasonography, computed tomography, and a nevi excision. The most noticeable changes were found for potential consent to undergo breast fine needle aspiration, mammography and gastroscopy. Conclusions: The level of oncological knowledge has an impact on individual decision to consent to particular medical procedures. Conducted educational intervention has significantly increased the readiness to undergo selected medical procedures.

Awareness of Stomach and Colorectal Cancer Risk Factors, Symptoms and Time Taken to Seek Medical Help Among Public Attending Primary Care Setting in Muscat Governorate, Oman

Colorectal and stomach cancers are the top ranking cancers in Oman. Most of the patients are diagnosed at advanced disease stages. The aim of this study is to explore the knowledge of risk factors, symptoms and the time needed to seek medical care for stomach cancer and colorectal cancer (CRC) among Omani participants attending 28 local health centres (LHCs) in the governorate of Muscat, the capital city of Oman. The Bowel Cancer/CRC Awareness Measure (CAM) questionnaire (translated into Arabic) was used to collect data from Omani adult participants (aged 18 years and above) who attended the LHCs during the study period. There was a total of 405 participants in the study out of the 500 who were invited (response rate = 81%). The most recognised risk factors were excessive drinking of alcohol (73.1%) and smoking (70.6%); the least recognised were doing less exercise (37.3%), eating food which was high in salt (26.8%) and a diagnosis of diabetes mellitus (24.9%). Multinomial logistic regression showed that young participants recognised more risk factors than older participants; highly educated participants recognised more risk factors than the less-educated and married participants recognised more risk factors than single participants. Participants with a high level of education were more likely to identify signs and symptoms of stomach cancer and CRC than less-educated participants. Multinomial logistic regression showed women were more likely than men to report barriers to seeking medical help (fear, difficulty in arranging transport, worried what the doctor might find). Also, participants with less education were more likely to report barriers than the highly educated (worried about wasting the doctor's time, difficulty in arranging transport, did not feel confident talking about symptoms, embarrassed, scared, worried what doctor might find). The majority of participants (93.6%) were not aware of any CRC screening programme or had undergone any screening (98.3) for CRC. Only 52.6% of participants would have a colonoscopy if the doctors advised; the main reasons for refusal were embarrassment (40.0%), lack of trust in the doctors (33.3%) and religious or culture beliefs (21.3%). Around 39% of participants would prefer to have their colonoscopy examination abroad. There is an urgent need to increase the public's awareness of stomach cancer and CRC in Oman, particularly with evidence emerging of an increase in the incidence. School curriculums could include sessions on cancer education and the information be reiterated to students periodically. A strategy to establish a CRC screening programme in Oman might be paramount as the incidence of CRC increased.

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.