Cancer is one of the leading causes of death worldwide. Most deaths from cancer occurs in low- and middle- income countries, which might be explained by the delayed presentation of the cancer patient. Inadequate public awareness of signs and symptoms of cancer and its risk factors is one of the factors related to this. Our study aimed to assess the level of public awareness of cancer prevalence, symptoms and signs as well as risk factors in Gaza.
This is a cross-sectional study conducted from September to October 2017 in the Gaza-Strip, Palestine. Stratified sampling was used to recruit three major hospitals and ten high schools. A previously pilot-tested, Arabic version of the Cancer Awareness Measure (CAM) questionnaire, which is a validated standardized questionnaire to measure public cancer awareness, was used. It involves four sections: sociodemographics, awareness of cancer prevalence, cancer symptoms and alarming signs, and cancer risk factors. Adults (aged ≥18 years) visiting or admitted to any of the three hospitals, and adolescents (aged 15-17 years) in any of the ten schools were recruited for face-to-face interviews. Patients and visitors to oncology departments were ineligible. Informed consent and ethical approval were obtained. Data were analyzed with SPSS (version 23).
A total of 2886 participants completed the CAM questionnaire (of 3033 approached; response rate was 95.2%). 1483 (51.4%) were women, and 1457 (50.5%) were adolescents. Overall, 2220 (76.9%) identified breast cancer as the most common cancer among women in the Gaza-Strip but only 196 (6.7%) identified colorectal cancer as the most common cancer among males. 1885 (65.2%) thought that the chance of getting cancer is not related to age. A lump was the most commonly recognized cancer symptom (n = 2227, 77.1%) while change of bowel habit was the least (n = 670, 23.2%). Smoking was the most frequently recognized cancer risk factor (n = 2215, 76.7%) and eating less than 5 portions of fruit and vegetables a day was the least (n = 514, 17.8%). The overall mean score for awareness of cancer symptoms is 3.5 ± 1.7 out of 8 and that of risk factors is 7.9 ± 3.1 out of 16.
Level of cancer awareness in Gaza is low. Educational interventions to raise public awareness of cancer are urgently required.
Clinical trial identification
Legal entity responsible for the study
Palestinian Ministry of Health.
Has not received any funding.
All authors have declared no conflicts of interest.