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

Elshami, Mohamedraed; Alfaqawi, Maha; Abdalghafoor, Tamer; A.Nemer, Ayoob; Ghuneim, Mohammed; Lubbad, Hussien; Almahallawi, Batool; Samaan, Mosab; Alwali, Abdallah; Alborno, Ahmad; Al-kafarna, Deyaa; Salah, Aseel; Shihada, Karam; Amona, Mohammed Abo; Al-Najjar, Amira; Subha, Rana Abu; Alhelu, Basma; Abujayyab, Israa; Albarqouni, Loai; Böttcher, Bettina

doi:10.2139/ssrn.3289791

Cited by 4 publications

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“…In concordance with other studies, knowledge of cancer risk factors as well as signs and symptoms improved with age [10,11,[22][23][24][25]. This is not surprising as informal learning through experiences in life and exposure to public education programs increases with age.…”

Section: Discussionsupporting

confidence: 90%

“…Therefore, reducing barriers for first presentation is as important as improving knowledge and awareness of cancer symptoms [9,[32][33][34][35]. Barriers can be emotional, like being worried about possible results, embarrassment or fear to see a doctor, service-related such as difficulty getting an appointment with a doctor, or practical like being too busy to see a doctor or difficulty with arranging transport [9][10][11]. However, negative beliefs also have a strong impact, such as the conviction that there is no cure for cancer or the treatment is worse than the actual disease [23,32,33,35].…”

Section: Discussionmentioning

confidence: 99%

“…Governmental hospitals are the main entry point for healthcare services in Gaza [10,11]. Therefore, adults, aged 18 years or over, admitted to or visiting those hospitals, were the target population.…”

Section: Sampling Methodsmentioning

confidence: 99%

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Knowledge Level of Cancer Symptoms and Risk Factors in the Gaza Strip: A Cross-sectional Study

Elshami

Alshorbassi

et al. 2020

Preprint

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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 ten 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 (SD) was 33.7±11.7 years and that of adolescents was 16.3±0.8 years. Half of the participants (n=1457, 50.5%) were adolescent (781 females; 53.6%) and 1429 (49.5%) were adult (702 females; 49.1%). About two thirds (n=1885) thought about cancer as unrelated to age. Only 196 participants (6.8%) identified colorectal cancer as the most common cancer among men. Awareness of cancer signs/symptoms was poor to fair, where ‘lump’ was most commonly recognized (n= 2227, 77.2%) and ‘change of bowel habit’ the least (n=670, 23.2%). Only 217 participants (7.5%) had a good level of recognizing risk factors with ‘smoking’ being the most identified and ‘eating less than five portions of fruits and vegetables a day’ the least. There was a higher likelihood for adults to identify most cancer signs/symptoms and risk factors than adolescents, except for recalling ‘unexplained pain’, ‘persistent cough/hoarseness’, ‘non-healing ulcer’, ‘smoking’, and ‘eating less than five portions of fruits and vegetables a day’. Conclusion Public awareness of cancer signs/symptoms and risk factors needs to improve to facilitate early presentation and diagnosis in Gaza. Combining the delivery of public campaigns with tailored education to population groups, including the youth, may increase their knowledge and maintain its impact.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Knowledge Level of Cancer Symptoms and Risk Factors in the Gaza Strip: A Cross-sectional Study

Elshami

Alshorbassi

et al. 2020

Preprint

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“…The recruitment from different governorates and geographic locations was intended to maximize the representativeness of the study cohort. 5,7,9-18…”

Section: Methodsmentioning

confidence: 99%

Myths and Common Misbeliefs About Colorectal Cancer Causation in Palestine: A National Cross-Sectional Study

Elshami,

Naji,

Dwikat

et al. 2024

JCO Glob Oncol

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PURPOSE To explore public awareness of myths around colorectal cancer (CRC) causation in Palestine and to examine factors associated with good awareness. MATERIALS AND METHODS Convenience sampling was used to recruit adult Palestinians from governmental hospitals, primary health care centers, and public spaces. Recognizing 13 myths around CRC causation was assessed using a translated-into-Arabic version of the Cancer Awareness Measure-Mythical Causes Scale. Awareness level was determined based on the number of CRC mythical causes recognized: poor (0-4), fair (5-9), and good (10-13). Multivariable logistic regression was used to examine the association between sociodemographic characteristics and displaying good awareness. It adjusted for age group, sex, education, occupation, monthly income, residence, marital status, having chronic diseases, being a vegetarian, knowing someone with cancer, and site of data collection. RESULTS Of 5,254 participants approached, 4,877 agreed to participate (response rate, 92.3%). A total of 4,623 questionnaires were included in the final analysis: 2,700 from the West Bank and Jerusalem (WBJ) and 1,923 from the Gaza Strip. Only 219 participants (4.7%) demonstrated good awareness of myths around CRC causation. WBJ participants were twice more likely than those from the Gaza Strip to display good recognition (5.9% v 3.1%). Male sex, living in the WBJ, and visiting hospitals were all associated with an increase in the likelihood of displaying good awareness. Conversely, knowing someone with cancer was associated with a decrease in the likelihood of displaying good awareness. Having a physical trauma was the most recognized CRC causation myth (n = 2,752, 59.5%), whereas eating food containing additives was the least (n = 456, 9.8%). CONCLUSION Only 4.7% displayed good ability to recognize myths around CRC causation. Future educational interventions are needed to help the public distinguish the evidence-based versus mythical causes of CRC.

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“…This model was determined a priori based on previous studies. 15,16,19 Similar analyses were also performed to examine the association between demonstrating high awareness in each domain and showing a positive attitude toward colonoscopy.…”

Section: Methodsmentioning

confidence: 99%

Screening Perspectives: The Role of Colorectal Cancer Awareness in Shaping Attitudes Toward Colonoscopy in Palestine

Elshami,

Albandak,

Alser

et al. 2024

JCO Glob Oncol

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PURPOSE To assess colorectal cancer (CRC) awareness and its influence on attitudes toward colonoscopy in Palestine. MATERIALS AND METHODS Convenience sampling was used to recruit Palestinian adults from hospitals, primary health care centers, and public spaces across 11 governorates. To evaluate the awareness of CRC signs/symptoms, risk factors, and mythical causes, the Bowel Cancer Awareness Measure and Cancer Awareness Measure-Mythical Causes Scale were used after translation into Arabic. For each correctly recognized item, one point was given. The total awareness score of each domain was calculated and categorized into tertiles; the top tertile was considered high awareness, and the other two tertiles were considered low awareness. RESULTS A total of 4,623 questionnaires were included. Only 1,849 participants (40.0%) exhibited high awareness of CRC signs/symptoms. High awareness of CRC symptoms was associated with higher likelihood of showing positive attitudes toward colonoscopy (odds ratio [OR], 1.21 [95% CI, 1.07 to 1.37]). A total of 1,840 participants (38.9%) demonstrated high awareness of CRC risk factors. Participants with high awareness of CRC risk factors were more likely to display positive attitudes toward colonoscopy (OR, 1.20 [95% CI, 1.07 to 1.37]). Only 219 participants (4.7%) demonstrated high awareness of CRC causation myths. There was no association between awareness of CRC causation myths and positive attitudes toward colonoscopy. CONCLUSION Awareness of CRC was poor with less than half of the study participants demonstrating high awareness of CRC signs/symptoms and risk factors, and a minority (<5%) displaying high awareness of CRC causation myths. High awareness of CRC signs/symptoms and risk factors was associated with greater likelihood of demonstrating positive attitudes toward colonoscopy. Educational initiatives are needed to address knowledge gaps and dispel misconceptions surrounding CRC.

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

Cited by 4 publications

References 0 publications

Knowledge Level of Cancer Symptoms and Risk Factors in the Gaza Strip: A Cross-sectional Study

Knowledge Level of Cancer Symptoms and Risk Factors in the Gaza Strip: A Cross-sectional Study

Myths and Common Misbeliefs About Colorectal Cancer Causation in Palestine: A National Cross-Sectional Study

Screening Perspectives: The Role of Colorectal Cancer Awareness in Shaping Attitudes Toward Colonoscopy in Palestine

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