Abstract
BackgroundIn 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.MethodsThis 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.ResultsOf 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’.ConclusionPublic 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.
Highlights
In low-income settings, cancer is often diagnosed in advanced stages due to late presentation
Cancer is responsible for about 9.6 million deaths worldwide in 2018 with 70% of these occurring in low- and middle-income countries [1]
Knowledge of cancer age-related risk and prevalence A total of 1885 participants (65.3%) thought that cancer is unrelated to age and 112 (3.9%) did not know if there was a relation at all (Table 2)
Summary
In low-income settings, cancer is often diagnosed in advanced stages due to late presentation. Cancer is responsible for about 9.6 million deaths worldwide in 2018 with 70% of these occurring in low- and middle-income countries [1]. Cancer is the second leading cause of mortality, after cardiovascular diseases, representing 10.6% of the total reported deaths [3]. In Gaza, breast cancer (BC) is the most common cancer representing 20.5% of all cancer cases and 36.9% of cancers among females with an incidence rate of 18.6 per 100,000 general population per year in 2016 [2]. Colorectal cancer (CRC) is the second most common cancer, responsible for 12.6% of cancers, with an incidence rate of 11.5 per 100,000 male population per year [2]. The most common cause of cancer deaths in 2017 was lung cancer with 19.6% of all cancer-related deaths, followed by CRC with 12.7% and BC by 11.6% [4]
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