Cancer Awareness and Behavioral Determinants Associated with Cancer Prevention-a Quantitative Study Among Young Adults in Rural Settings

The Impact of an Educational Project on Cancer-Related Knowledge and Awareness Among High School Students

Cancer is the second leading cause of death globally, making it a significant global health issue. Approximately half of cancer cases are linked solely to behavioral habits. Lifestyle changes made at a young age are easier to adopt and have lasting effects on future health, making early awareness about cancer essential. The "OncoAcademy: The Key to Health" project, aimed at high school Polish students, has been created to promote a positive health attitude and increase awareness among young people about cancer and methods of its prevention. From September 2023 to November 2024, we conducted educational sessions for 3000 high school students and assessed their cancer prevention knowledge before and after the project. Results revealed that students' level of knowledge before classes was moderate (M = 51.76%; SD = 13.63%). On average, students correctly answered 13 of 26 questions. After classes, the level of knowledge was assessed as moderately good (M = 62.47%; SD = 14.48%). On average, students correctly answered 16 out of 26 questions. The analysis revealed a statistically significant difference between the general level of knowledge-after classes, students achieved significantly better scores. This study highlighted changes in students' awareness and knowledge about cancer brought about by implementing a cancer education project. Generally, high school students in Poland have basic knowledge about cancer and its risk factors. Most adolescents are aware of the significant impact of lifestyle on cancer risk. Early education on cancer prevention, mainly aimed at lifestyle changes, is crucial. Enhancing adolescents' understanding of risk factors can play a significant role in lowering future cancer rates.

Influence of knowledge, attitude and self-efficacy on Opisthorchis viverrini and cholangiocarcinoma prevention: A One Health approach in high-risk areas of Thailand

OBJECTIVE

Opisthorchis viverrini and cholangiocarcinoma have been recognised by the World Health Organisation as critical public health concerns, particularly in northeastern Thailand, where Opisthorchis viverrini is a significant cause of cholangiocarcinoma. This study examines the factors influencing Opisthorchis viverrini and cholangiocarcinoma prevention within the One Health framework in Kanthararom District, Sisaket Province, Thailand.

METHODS

A cross-sectional study was conducted among 327 residents aged 20 and above, utilising a structured questionnaire to assess knowledge, attitudes, perceived self-efficacy and prevention behaviours. Data were analysed using descriptive statistics, Pearson's product-moment correlation coefficient and multiple regression analysis to identify relationships and predictors within the dataset.

RESULTS

The results showed that 53.52% of participants had moderate knowledge and attitudes towards prevention, while perceived self-efficacy was generally high. Positive correlations were found between income, knowledge, attitudes, self-efficacy and prevention behaviours. Key predictors of Opisthorchis viverrini and cholangiocarcinoma prevention behaviours included attitudes towards human health (β = 0.212), perceived self-efficacy in human health (β = 0.211), attitudes towards animal health (β = 0.205) and knowledge about human health (β = 0.138), accounting for 24.40% of the variance in prevention behaviours. These predictors were statistically significant at 0.05 (F = 25.95; p <0.001).

CONCLUSION

The findings suggest that enhancing knowledge, attitudes and self-efficacy is crucial to improving Opisthorchis viverrini and cholangiocarcinoma prevention. This study underscores the need for integrated public health strategies incorporating human, animal and environmental health to reduce the prevalence of Opisthorchis viverrini and cholangiocarcinoma in high-risk regions.

The impact of cancer prevention education on the mental health of college students based on the difference-in-differences method

Background and objective

Cancer, as the second leading cause of death worldwide, poses significant challenges to human health and socio-economic development. In recent years, the incidence of cancer has shown a trend toward younger populations, drawing attention to cancer prevention education among college students. However, research on the specific impact of cancer prevention education on the mental health of college students is limited. This study aims to explore the impact of cancer prevention education on the mental health of college students, revealing the mediating role of disease awareness and the moderating roles of psychological resilience and cultural differences.

Methods

A difference-in-differences (DID) approach was used, involving 1,670 freshmen from a Chinese university, divided into an experimental group (n = 835) and a control group (n = 835). The experimental group received a semester-long cancer prevention education program. Data were collected monthly from November 2022 to June 2023 using the Depression Anxiety Stress Scales (DASS-21) and a custom Disease Awareness Scale.

Results

The study found a significant improvement in mental health scores among the experimental group, with an average increase of 14.738 points on the DASS-21 scale (p < 0.001), representing a 23% reduction in stress, anxiety, and depression levels compared to the control group. Disease awareness in the experimental group improved by 17%, as measured by the Disease Awareness Scale, with a mediation effect of 3.563 points (p < 0.001). Furthermore, psychological resilience and cultural differences moderated the impact of the education program, with those scoring higher in resilience showing an additional 8% improvement in mental health scores (moderation effect = 0.892, p < 0.001), and cultural differences accounting for a 5% variance (moderation effect = 0.756, p < 0.001) in the outcomes.

Conclusion

This study demonstrates that systematic and scientific cancer prevention education has a significant positive impact on the mental health of college students. Universities should promote comprehensive and personalized health education strategies to improve disease awareness, foster psychological resilience, and emphasize cultural differences, thereby enhancing the overall physical and mental health of college students and promoting their holistic development. This finding provides important empirical support and theoretical basis for the design and implementation of health education in universities.

Cancer awareness and its related factors among junior high and high school teachers in Japan: a cross-sectional survey

BACKGROUND

The early detection and prevention of many cancers is possible. Therefore, public awareness about cancer risk factors and warning signs must be increased to ensure early diagnosis. Although Japan has implemented mandatory cancer education in junior high and high schools, few studies have evaluated teachers' cancer awareness. This study aimed to determine Japanese junior high and high school teachers' awareness of cancer and related factors.

METHODS

This cross-sectional study obtained data through an online questionnaire survey using questions from the Cancer Awareness Measure (CAM) developed by Cancer Research UK. Thirty items were selected from three CAM modules: cancer risk factors, cancer warning signs, and barriers to seeking help. Descriptive statistics were used for socio-demografic data and CAM module questions. The χ2 test was performed on the relationship between cancer awareness and socio-demographic data. Multiple logistic regression analysis was used to identify factors influencing cancer awareness.

RESULTS

Respondents included 316 junior high school and 463 high school teachers (541 men; 238 women; average age = 48.2 years; average teaching experience = 23.5 years). An average of 5.41 out of 11 cancer risk factors were recognized. More than 70% of teachers recognized smoking, exposure to another person's cigarette smoke, and having a close relative with cancer as risk factors. On average, 4.52 out of 9 cancer warning signs were recognized. More than 50% of teachers recognized the warning signs of unexplained lump or swelling, unexplained weight loss, and unexplained bleeding. Barriers to seeking help had a low average score of 4.51 out of 20. However, the most commonly recognized "barriers to seeking help" were "too busy to make time," "difficult to make an appointment," "worried about what the doctor might find," and "too scared." Moreover, the common factors that affected awareness of cancer risk factors and cancer warning signs were gender and cancer experience of relatives. Factors that affected awareness of "barriers to seeking help" were "participation in cancer-related workshops," age, gender, and cancer experience of relatives.

CONCLUSIONS

Cancer awareness education should consider interventions that can improve knowledge of the symptoms and signs related to cancer without increasing the awareness of barriers to seeking help.

#4Corners4Health Social Media Cancer Prevention Campaign for Emerging Adults: Protocol for a Randomized Stepped-Wedge Trial

BACKGROUND

Many emerging adults (EAs) are prone to making unhealthy choices, which increase their risk of premature cancer morbidity and mortality. In the era of social media, rigorous research on interventions to promote health behaviors for cancer risk reduction among EAs delivered over social media is limited. Cancer prevention information and recommendations may reach EAs more effectively over social media than in settings such as health care, schools, and workplaces, particularly for EAs residing in rural areas.

OBJECTIVE

This pragmatic randomized trial aims to evaluate a multirisk factor intervention using a social media campaign designed with community advisers aimed at decreasing cancer risk factors among EAs. The trial will target EAs from diverse backgrounds living in rural counties in the Four Corners states of Arizona, Colorado, New Mexico, and Utah.

METHODS

We will recruit a sample of EAs (n=1000) aged 18 to 26 years residing in rural counties (Rural-Urban Continuum Codes 4 to 9) in the Four Corners states from the Qualtrics' research panel and enroll them in a randomized stepped-wedge, quasi-experimental design. The inclusion criteria include English proficiency and regular social media engagement. A social media intervention will promote guideline-related goals for increased physical activity, healthy eating, and human papillomavirus vaccination and reduced nicotine product use, alcohol intake, and solar UV radiation exposure. Campaign posts will cover digital and media literacy skills, responses to misinformation, communication with family and friends, and referral to community resources. The intervention will be delivered over 12 months in Facebook private groups and will be guided by advisory groups of community stakeholders and EAs and focus groups with EAs. The EAs will complete assessments at baseline and at 12, 26, 39, 52, and 104 weeks after randomization. Assessments will measure 6 cancer risk behaviors, theoretical mediators, and participants' engagement with the social media campaign.

RESULTS

The trial is in its start-up phase. It is being led by a steering committee. Team members are working in 3 subcommittees to optimize community engagement, the social media intervention, and the measures to be used. The Stakeholder Organization Advisory Board and Emerging Adult Advisory Board were formed and provided initial input on the priority of cancer risk factors to target, social media use by EAs, and community resources available. A framework for the social media campaign with topics, format, and theoretical mediators has been created, along with protocols for campaign management.

CONCLUSIONS

Social media can be used as a platform to counter misinformation and improve reliable health information to promote health behaviors that reduce cancer risks among EAs. Because of the popularity of web-based information sources among EAs, an innovative, multirisk factor intervention using a social media campaign has the potential to reduce their cancer risk behaviors.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05618158; https://classic.clinicaltrials.gov/ct2/show/NCT05618158.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/50392.

Consumption of Health-Related Videos and Human Papillomavirus Awareness: Cross-Sectional Analyses of a US National Survey and YouTube From the Urban-Rural Context

BACKGROUND

Nearly 70% of Americans use the internet as their first source of information for health-related questions. Contemporary data on the consumption of web-based videos containing health information among American adults by urbanity or rurality is currently unavailable, and its link with health topic awareness, particularly for human papillomavirus (HPV), is not known.

OBJECTIVE

We aim to describe trends and patterns in the consumption of health-related videos on social media from an urban-rural context, examine the association between exposure to health-related videos on social media and awareness of health topics (ie, HPV and HPV vaccine), and understand public interest in HPV-related video content through search terms and engagement analytics.

METHODS

We conducted a cross-sectional analysis of the US Health Information National Trends Survey 6, a nationally representative survey that collects data from civilian, noninstitutionalized adults aged 18 years or older residing in the United States. Bivariable analyses were used to estimate the prevalence of consumption of health-related videos on social media among US adults overall and by urbanity or rurality. Multivariable logistic regression models were used to examine the association between the consumption of health-related videos and HPV awareness among urban and rural adults. To provide additional context on the public's interest in HPV-specific video content, we examined search volumes (quantitative) and related query searches (qualitative) for the terms "HPV" and "HPV vaccine" on YouTube.

RESULTS

In 2022, 59.6% of US adults (152.3 million) consumed health-related videos on social media, an increase of nearly 100% from 2017 to 2022. Prevalence increased among adults living in both urban (from 31.4% in 2017 to 59.8% in 2022; P<.001) and rural (from 22.4% in 2017 to 58% in 2022; P<.001) regions. Within the urban and rural groups, consumption of health-related videos on social media was most prevalent among adults aged between 18 and 40 years and college graduates or higher-educated adults. Among both urban and rural groups, adults who consumed health-related videos had a significantly higher probability of being aware of HPV and the HPV vaccine compared with those who did not watch health videos on the internet. The term "HPV" was more frequently searched on YouTube compared with "HPV vaccine." Individuals were most commonly searching for videos that covered content about the HPV vaccine, HPV in males, and side effects of the HPV vaccine.

CONCLUSIONS

The consumption of health-related videos on social media in the United States increased dramatically between 2017 and 2022. The rise was prominent among both urban and rural adults. Watching a health-related video on social media was associated with a greater probability of being aware of HPV and the HPV vaccine. Additional research on designing and developing social media strategies is needed to increase public awareness of health topics.

Exploring Youth Perceptions About Cancer Prevention and Preferences for Education: a Qualitative Study

This study aimed to characterize adolescents' perspectives on cancer and cancer prevention and to explore their preferences for cancer education. A total of 188 middle and high school students participated in 25 focus groups. Focus groups were led by study team members and included five to ten participants each. Adolescents were asked to discuss their cancer and cancer prevention knowledge, sources of cancer education, and preferences for cancer prevention education. Focus groups were audio-recorded, and professionally transcribed. Transcripts were content and thematically analyzed by two study team members using NVivo qualitative data software. Six themes were identified in focus groups: knowledge about cancer, negative perceptions of cancer, awareness of cancer prevention, engagement in cancer prevention, facilitators and barriers for action, and preferences for cancer education. Adolescents described a wide range of cancer education sources, including friends, family, healthcare professionals, school, technology, and pamphlets. Participants associated cancer with negative emotions, such as sadness and fear. Participants expressed interest in learning about cancer and cancer prevention, but also identified barriers to engaging in preventative behaviors, such as discomfort, lack of knowledge, and lack of personal connection to cancer. Adolescents preferred learning through personal presentations, online videos, school, educational games, and social situations. Adolescence is a critical period for learning and developing healthy behaviors. Awareness of cancer and cancer prevention is crucial to lowering cancer risk in the future. To be effective, cancer education for adolescents should target specific areas of cancer prevention and address barriers to engagement in preventative behaviors.

Awareness of Colorectal Cancer Risk Factors in Palestine: Where Do We Stand?

To assess the public awareness level of colorectal cancer (CRC) risk factors in Palestine and identify factors associated with the good awareness level.

A national study in Palestine finds low awareness of colorectal cancer risk factors.

Public Awareness and Barriers to Seeking Medical Advice for Colorectal Cancer in the Gaza Strip: A Cross-Sectional Study

PURPOSE

Raising awareness of colorectal cancer (CRC) symptoms for early recognition, reduction of modifiable risk factors, and removing barriers to seeking medical help could lower its mortality. This study aimed to assess the level of public awareness of CRC in the Gaza Strip.

MATERIALS AND METHODS

This was a cross-sectional study conducted at three hospitals and 10 high schools between September and October 2017. The Arabic version of the validated Bowel Cancer Awareness Measure (BoCAM) questionnaire was used to evaluate awareness of CRC symptoms and risk factors, and barriers to seeking medical help. Adults (age ≥ 18 years) in three major hospitals and adolescents (ages 15 to 17 years) in 10 schools were recruited for face-to-face interviews to complete the BoCAM.

RESULTS

Of 3,172 potential participants, 3,080 completed the BoCAM (response rate, 97.1%). Among these, 1,578 (51.2%) were adults and 1,614 (52.4%) were females. Persistent abdominal pain was the most commonly recognized CRC symptom (n = 1,899; 61.7%), whereas anorectal pain was the least common (n = 1,056; 34.3%). In total, 2,177 (70.7%) were not confident in recognizing CRC symptoms or signs. Having a bowel disease was the most frequently recognized CRC risk factor (n = 1,456; 47.3%) and diabetes the least recognized (n = 591; 19.2%). The overall mean scores ± standard deviations for recalling and recognizing CRC symptoms were 1.2 ± 1.3 and 4.3 ± 2.3, respectively (out of 9 points). The overall mean scores ± standard deviations for recalling and recognizing CRC risk factors were 0.7 ± 0.8 and 8.0 ± 3.1, respectively (out of 16 points). Emotional barriers were the most commonly reported barriers to seeking medical help, with feeling worried about what a doctor might find as the most common barrier (n = 1,522; 49.4%).

CONCLUSION

Public awareness of CRC is suboptimal in Gaza. Improving CRC awareness with educational interventions is needed, including in local schools.

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.

Personal Narrative: Raising Awareness of Adolescent and Young Adult Cancer Survivors in Similarly Aged University Students

Purpose: As part of a programmatic educational initiative, we developed a personal narrative presentation, embedded with evidence-based data, to raise awareness of adolescents and young adults (AYAs) who have been diagnosed with cancer between the ages of 15 and 39 years among similarly aged university students. The narrative encompassed the cancer care continuum from signs of the disease through survivorship and incorporated psychosocial aspects of the experience. Methods: The presenter, diagnosed with lymphoma at the age of 25 years in 2007, interwove AYA data with her narrative in a series of 26 invited lectures given over 2 academic years, 2016-2017 and 2017-2018. Students were asked to provide anonymous open-ended feedback. Six hundred thirteen forms were collected and retrospectively dually coded and analyzed. Results: The majority of students (97%) referenced at least one of the presentation's three objectives: (1) build awareness of the AYA demographic; (2) encourage a personal health care focus; and (3) expand awareness of the far-reaching impact of cancer (i.e., psychological, social, and medical) both during and beyond the treatment phase. Format- and/or content-related suggestions and potential benefits of hearing the narrative also were reported. Conclusion: The use of personal narrative to raise awareness of the AYA cancer experience in an academic setting is both feasible and effective. Students demonstrated a new or enhanced understanding of AYA cancer and its biopsychosocial implications. We provide evidence to inform the design of awareness interventions directed at similarly aged university students.