Factors associated with delay in diagnosis of oral cancers.

BACKGROUND: Oral cancer is one of the ten most common malignancies in the world and approximately 90 % of cases are OSCC. Despite the progress in available treatment modalities, the mortality of patients with OSCC has remained steadily high during the last 20 years. Survival data is strongly influenced by the timing of diagnosis: with more than 50 % of patients being diagnosed at an advanced stage, and their 5-year survival rate being less than 50 %. Therefore, early diagnosis plays a crucial role in improving a patient's prognosis, as early stage cancers show a survival rate of over 90 %, whereas it drops to 5-20 % stage III and IV disease. This prospective study has been conducted with an aim of assessing diagnostic delays and looking at the various patient and tumour factors and their association with them. METHODOLOGY: This prospective observational study was conducted from December 2023 to February 2024. The cases for the present study included cases of oral squamous cell carcinoma diagnosed by clinical, radiological and/or histological confirmation. The patient delay was recorded in days as informed by the patients themselves, about the onset of their symptoms to time taken to seek medical attention. This was then associated with various patient and tumour related factors. RESULT: A total of 120 (n) patients were interviewed and these patient's case sheets were recruited for the present study. The median primary delay for the entire population was found to be 90 days while the median secondary delay was 11 days. The median total delay was found to be 106 days. The median total delay was higher among females and younger population though this was not statistically significant. However education showed a significant impact with literate patients presenting much earlier. Smoking and alcohol abuse did not show a significant effect on delay. Various tumour factors also did not show any statistically significant effect on delay although, patients with advanced stage and nodal secondaries presented at a much later time. CONCLUSION: Both patient and tumour related factors as well as the decisions made during the first contact with health care providers influence delay before specialist consultation. Raising awareness of HNC symptoms among the general population and GPs is the way to get patients to curative treatment without long delay.

Psychosocial factors and patient and healthcare delays in large (class T3-T4) oral, oropharyngeal, and laryngeal carcinomas.

BACKGROUND: Psychosocial factors and socioeconomic status have been associated with incidence, survival, and quality of life among patients with head and neck cancer. We investigated the association between different psychosocial factors, socioeconomic status, and patient delays in T3-T4 oral, oropharyngeal, and laryngeal cancer. PATIENTS AND METHODS: We conducted a nationwide prospective questionnaire-based study (n = 203) over a 3-year period. RESULTS: We found no association between psychosocial factors (depression, social isolation, loneliness, and cynical hostility) and patient delay. Depression was three times more common among head and neck cancer patients compared with the general Finnish population. Head and neck cancer patients had lower educational levels and employment status, and were more often current smokers and heavy drinkers. CONCLUSIONS: Although we found no association between patient delay and psychosocial factors, patients diagnosed with a large head and neck cancer appeared to have a lower socioeconomic status and higher risk for developing depression, which should be considered in clinical practice.

Beliefs, screening attitudes and breast cancer awareness of young women with neurofibromatosis type 1: A reflexive thematic analysis.

Neurofibromatosis type 1 (NF1) predisposes individuals to benign and malignant tumours. Young women with NF1 (<50 years) have an up to five-fold increased risk of breast cancer. The UK adopts moderate cancer risk guidelines of NICE, advising women with NF1 to attend breast screening from 40 years. Previous results from a systematic review and meta-analysis found that breast cancer in this cohort predominantly occurs from 34 to 44 years. Without earlier screening, breast awareness is fundamental. Reflexive thematic analysis and semi-structured interview questions based on the health belief model explored whether a tailor-made breast cancer awareness intervention would be beneficial by examining beliefs, screening attitudes and breast cancer awareness of young women with NF1. Findings suggest the establishment of accessible and accurate NF1 and breast awareness information, development and implementation of a breast awareness intervention for young women with NF1, and healthcare professionals.

Evaluation of the Cancer Awareness Measure in Adolescents in Turkiye: A Methodological Study.

Purpose: Cancer awareness can help reduce the associated morbidity and mortality. There is no scale for the assessment of general cancer awareness in Turkiye. This study aimed to evaluate the cultural relevance and psychometric properties of the cancer awareness measure (CAM) for use in adolescents in the Turkish population. Methods: This methodological study included 400 students attending seven high schools in western Turkiye, recruited by convenience sampling. The CAM was translated into Turkish and assessed for content validity by expert panel opinion and content validity index (CVI). The Turkish CAM was administered online, and its reliability was assessed using Cronbach's alpha coefficients, item-total and item-subscale correlation coefficients, and test-retest analysis. Results: The Turkish CAM had excellent content validity (scale CVI = 0.99). Cronbach's alpha for the entire scale was 0.72, and item-subscale correlation coefficients were 0.33-.75 (p < 0.001). Test-retest reliability was good, with an intraclass correlation coefficient of 0.83 for the entire scale (p < 0.001). The students' mean score on the Turkish CAM was 45.60 ± 7.23 (on a scale of 11-77), indicating moderate cancer awareness. Conclusion: The Turkish CAM is a valid and reliable measure that can be used to assess cancer awareness in adolescents in Turkiye. Interventional studies should be performed to measure and increase cancer awareness and promote cancer prevention among young people.

An Introduction to the OutSMART Cancer Serious Game: Current and Future Directions.

Given that cancer is a challenging disease that plagues millions of individuals of all age groups and socioeconomic statuses globally, developmentally appropriate education is often lacking for young people, particularly adolescents. Increasing cancer awareness and prevention education among adolescents using innovative strategies, such as game-based learning, is critical in reducing the burden of this disease. Adolescents are understudied in the field of cancer prevention and control, yet vulnerable as they tackle creating life-long health behavior patterns. Targeting cancer prevention education for adolescents has the potential to support long-term healthy behavior and reduce their risk of cancer. This paper provides an overview of the Collaborative Research on MEdication use and family health (CRoME) Lab's novel game-based cancer prevention education tool. OutSMART Cancer is an innovative, novel educational intervention in the form of a serious game. Serious games are educational tools that seek to impart knowledge and improve behaviors in their players. This game covers information related to breast cancer, colon cancer, and lung cancer. This viewpoint is a summary of the developmental process for the OutSMART Cancer game. We describe in detail the work preceding initial game development, the current version of the game, future directions for the game, and its educational potential. The long-term goal of OutSMART Cancer is to improve cancer awareness and knowledge regarding prevention behaviors in adolescents and support a lifetime of health and wellness.

Cervical cancer prevention in Burkina Faso: a stakeholder's collaboration for the development of awareness messaging.

Background: Cervical Cancer stands as the second leading cause of both incident female cancers and deaths in Burkina Faso. Unfortunately, the prevention, early detection, and care of cervical cancers are suboptimal at individual, institutional, and national levels. In October 2023, we organized a stakeholder's workshop to develop cervical cancer awareness messaging for disease control in the country. Methods: A one-text workshop was organized with stakeholders working toward improving health in general or women's health and well-being. A participatory, learning, and adaptive approach was used to facilitate discussions and activities, ensuring the contribution of all participants. Contextual evidence-based and empirical elements about cervical cancer burden and preventive strategies were presented to the participants by key informants. These served as the foundation for a collaborative formulation of messaging content that aimed at raising awareness about cervical cancer. Results: Sixty-two participants from 28 organizations attended the workshop. They work mainly at local and international non-governmental organizations, civil society organizations, universities, university hospitals, research centers, and the Ministry of Health. During the first and second days of the workshop, the participants explored cervical cancer data, its preventive and treatment options available in Burkina Faso, communication strategies for behavioral change, and determinants of the use of prevention and health promotion services. During the following three days, 3 working groups were formed to define strategies, and key messages adapted to diverse tools and targeted audiences. All information was validated during plenary sessions before the end of the workshop and available to all participants and their organizations for cancer awareness activities. Conclusion: Upon conclusion of the workshop, the participants provided insightful information for the development of cervical awareness messaging in Burkina Faso. They formed the first community of practice to serve as a dynamic platform for implementation, monitoring, evaluation, and continued learning activities.

Systematic Review on the Cost Effectiveness of Prostate Cancer Screening in Europe.

BACKGROUND AND OBJECTIVE: In Europe, prostate cancer (PCa) is the most common cancer in men. Screening may therefore be crucial to lower health care costs, morbidity, and mortality. This systematic review aimed to provide a contemporary overview of the costs and benefits of PCa screening programmes. METHODS: A peer-reviewed literature search was conducted, using the PICO method. A detailed search strategy was developed in four databases based on the following key search terms: "PCa", "screening", and "cost effectiveness". Any type of economic evaluation was included. The search strategy was restricted to European countries, but no restrictions were set on the year of publication. KEY FINDINGS AND LIMITATIONS: A total of 7484 studies were identified initially. Of these, 19 studies described the cost effectiveness of PCa screening in Europe. Among the studies using an initially healthy study population, most focussed on risk- and/or age- and/or magnetic resonance imaging (MRI)-based screening in addition to prostate-specific antigen (PSA) testing and compared this with no screening. Incremental cost ratios (ICERs) varied from €5872 per quality-adjusted life year (QALY) to €372 948/QALY, with a median of €56 487/QALY. Risk-based screening followed by MRI testing seemed to be a more cost-effective strategy than no screening. CONCLUSIONS AND CLINICAL IMPLICATIONS: This systematic review indicates that screening programmes incorporating a risk-based approach and MRI have the potential to be cost effective. PATIENT SUMMARY: In this review, we looked at the cost effectiveness of prostate cancer screening in Europe. We found that a risk-based approach and incorporation of magnetic resonance imaging has the potential to be cost effective. However, there remains a knowledge gap regarding cost effectiveness of prostate cancer screening. Therefore, determinants of cost effectiveness require further investigation.

Enhancing colorectal cancer prevention: a national assessment of public awareness in Egypt.

BACKGROUND: Despite the increasing incidence of colorectal cancer (CRC) in the Egyptian population, it still seems that there is a significant lack of awareness regarding the disease. This study aimed to assess the Egyptian population's awareness of CRC regarding its risk factors, the screening procedures, and the appropriate responses to its diagnosis. METHOD: A cross-sectional study was conducted in Egypt between July 2022 and March 2023 and recruited a convenient sample of adults from seven governorates representing different geographic areas, and socioeconomic and educational backgrounds with the help of the validated Bowel Cancer Awareness Measure (CAM) version 2.1. The modified Arabic questionnaire was validated through a pilot study including 30 patients. Then it was presented through a Google form before being shared via online methods and face-to-face interviews. The questionnaire provided both numerical and categorical data, which were analyzed accordingly. The Chi-square, the Fisher exact, and the Man-Whitney test were used to compare colorectal cancer poor and good knowledge groups. Logistic regression analysis was conducted to predict the factors that affected the awareness level of the study population. RESULTS: Nine hundred forty individuals participated in the survey. Their ages ranged from 18 to 86 years old, with an average of 37.38 ± 12.22 years. The mean Knowledge score was 14.29 ± 7.05 out of 37 with most of our participants (71%) having poor knowledge about CRC. Most of the participants (64.1%) chose colonoscopy as the best screening modality, followed by an abdominal CT (27.8%), and fecal occult blood (15.5%). The study revealed significant differences between participants with good and poor knowledge of colorectal cancer. (78.5%) of participants with good CRC knowledge lived in cities, (85.4%) attained university or higher educational level, and (87.2%) of them were nonsmokers (p < 0.05%). CONCLUSION: In general, there was a lack of awareness about Colorectal cancer among the Egyptian population especially among rural and lower educational levels, and more health education campaigns are required to enhance CRC prevention efforts in Egypt.

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.

Actuarial Analysis of Survival after Breast Cancer Diagnosis among Lithuanian Females.

Breast cancer is the most common cause of mortality due to cancer for women both in Lithuania and worldwide. The chances of survival after diagnosis differ significantly depending on the stage of disease at the time of diagnosis and other factors. One way to estimate survival is to construct a Kaplan-Meier estimate for each factor value separately. However, in cases when it is impossible to observe a large number of patients (for example, in the case of countries with lower numbers of inhabitants), dividing the data into subsets, say, by stage at diagnosis, may lead to results where some subsets contain too few data, thus causing the results of a Kaplan-Meier (or any other) method to become statistically incredible. The problem may become even more acute if researchers want to use more risk factors, such as stage at diagnosis, sex, place of living, treatment method, etc. Alternatively, Cox models can be used to analyse survival data with covariates, and they do not require the data to be divided into subsets according to chosen risks factors (hazards). We estimate the chances of survival for up to 5 years after a breast cancer diagnosis for Lithuanian females during the period of 1995-2016. Firstly, we construct Kaplan-Meier estimates for each stage separately; then, we apply a (stratified) Cox model using stage, circumstance of diagnosis, and year of diagnosis as (potential) hazards. Some directions of further research are provided in the last section of the paper.

Knowledge, attitude, and practices about breast cancer among women in a high-altitude sub-Himalayan region: Are we reaching the unreached?

Background: Breast cancer awareness and early detection are critical for reducing the global burden of the disease. This study assessed breast cancer awareness among women in a high-altitude sub-Himalayan region of North India. Materials and Methods: A cross-sectional survey was conducted among women attending the gynecology outpatient clinic in a district hospital. A structured questionnaire was used to collect data on breast cancer knowledge, attitudes, and practices. Participants received posttest health education and counseling on breast cancer prevention strategies. Result: The study included 188 participants with a mean age of 31.0 ± 8.8 years. The findings revealed inadequate knowledge about breast cancer among a significant portion of the cohort. Misconceptions about risk factors, such as breastfeeding, oral contraceptive use, and past wrongdoings, were observed. Only half of the participants believed early-stage breast cancer could be effectively treated. Limited awareness of screening methods, including self-breast examination and mammography, was noted. Barriers to breast self-examination (BSE) included considering it unnecessary and lacking knowledge about its execution. Conclusion: This study highlights insufficient breast cancer awareness in the high-altitude sub-Himalayan region. Targeted interventions, including health campaigns and electronic media, should be prioritized to improve knowledge and promote early detection practices.

Exploring the Feasibility of a Cancer Awareness Program for High School Students in a Brazilian School: A Pilot Study.

Cancer is a leading cause of mortality globally and is projected to be the primary cause of death in Brazil by 2030. Yet, for high school students, information and understanding about cancer are primarily offered through standard biology lessons. This study aimed to assess the feasibility of a brief educational intervention related to cancer among high school students in a Brazilian private school. Participants attended a 1-h online session regarding different aspects of cancer. A self-reported questionnaire about the main topics addressed in the session was filled out before [pre] and after [post] the educational intervention and the results were compared by McNemar's chi-square test. From 900 parents invited, 44 (4.9%) responded to the invitation and agreed with their children's participation, and 24 students attended the activity. The questionnaire was easy to fill out for the students and allowed us to measure differences after the educational intervention. The high school students considered the most interesting topics cancer myths and protective/risk factors. The project was feasible and showed easy application and better knowledge after the educational intervention. The main challenge is related to the access to parents to authorize their children's participation. Designing interventions that focus on cancer education might be a viable way to increase prevention and early diagnosis with implications for students, their families, and the community.

Need for Culturally Competent and Responsive Cancer Education for African Immigrant Families and Youth Living in the United States.

Cancer prevalence data for Black Americans is monolithic and fails to consider the diverse cultures and backgrounds within that community. For instance, African immigrants constitute a meaningful proportion of the foreign-born Black immigrants in the United States (42%), but the prevalence of cancer in the African immigrant community itself is unknown. Therefore, without accurate cancer prevalence data, it is impossible to identify trends and other key factors that are needed to support the health of African immigrants and their children. Moreover, it is impossible to understand how the culture and language of subgroups influence their cancer-related health behavior. While research in this area is limited, the existing literature articulates the need for culturally responsive and culturally tailored cancer education for African immigrants and their adolescent children, which is what we advocate for in this viewpoint paper. Existing projects demonstrate the feasibility of culturally responsive programming for adults; however, few projects include or focus on adolescents or children born to African immigrants. To best meet the needs of this understudied community, researchers must use culturally competent interventions alongside familiar, usable media. For adolescents, technology is ubiquitous thus, the creation of a culturally tailored digital intervention has immense potential to improve cancer awareness and prevention for youth and their community. More research is needed to address many of the existing research gaps and develop a rich understanding of the unique experience of cancer among African immigrant families that can be used to inform intervention development. Through this viewpoint, we review the current state of cancer-related research among African immigrant families in the United States. In this paper, we acknowledge the current knowledge gaps and issues surrounding measurement and then discuss the factors relevant to designing an educational intervention targeted at African immigrants and the role of African immigrant youth.

A Double-Edged Sword: Quality and Credibility of Colon Cancer Screening Content on YouTube.

Introduction Colorectal cancer (CRC) remains a significant public health challenge globally, with its pathogenesis involving the transformation of benign adenomas into malignant carcinomas. Despite advancements in screening and early detection significantly improving outcomes, the rise of digital platforms like YouTube for disseminating health information presents new challenges. Concerns over the accuracy and reliability of content underline the necessity for rigorous evaluation of these digital health education tools. Methods Our study was conducted at Nassau University Medical Center, East Meadow, New York. We meticulously analyzed YouTube videos on "colon cancer screening awareness," employing strict selection criteria to ensure both relevance and quality, focusing on English-language content with pertinent audio. Videos were evaluated for their quantitative and qualitative attributes-views, subscriber counts, likes/dislikes, comments, and content type, classifying them as scholarly or personal. We assessed video credibility through scientific accuracy using the DISCERN instrument, Global Quality Score (GQS), and Patient Education Materials Assessment Tool (PEMAT), ensuring consistency in quality and reliability evaluation among seven researchers via the intraclass correlation coefficient. These tools - DISCERN for assessing reliability and quality, GQS for evaluating overall quality, and PEMAT for understandability and actionability - facilitated a comprehensive evaluation framework. Our analysis, leveraging descriptive and inferential statistics, scrutinized differences in content quality between academic and private institutions, employing t-tests to identify statistically significant disparities. The study utilized Microsoft Excel (version 16.73, Microsoft Corporation, Redmond, Washington, United States) and IBM SPSS Statistics for Windows, version 29.0 (released 2022; IBM Corp., Armonk, New York, United States). for robust data processing and analysis, confirming the educational value and trustworthiness of the examined YouTube content. Results Our study of 156 YouTube videos on educational content, split between academic (68 videos) and private sources (88 videos), revealed significant quality differences. Using the DISCERN, PEMAT, and GQS metrics, academic videos consistently outperformed private ones, with significant margins: DISCERN (54.61 vs. 34.76), PEMAT (3.02 vs. 2.11), and GQS (3.90 vs. 2.02), supported by low p-values indicating a statistically significant superiority. These findings suggest that the source of content-academic versus private-plays a crucial role in determining the quality and reliability of educational materials on platforms like YouTube, highlighting the academic sector's commitment to higher educational standards. Conclusion The study emphasizes the critical role of credible sources in enhancing the quality of health education content on YouTube, particularly concerning CRC screening. The superiority of academic institutions in providing high-quality content suggests a need for viewers to critically assess the source of information. It also calls for enhanced regulatory oversight and measures to ensure the accuracy and reliability of health information online.

Factors Influencing Prostate Cancer Screening Intentions in Lebanese Men.

OBJECTIVE: The objective of this study is to investigate the perceived obstacles and willingness of Lebanese men aged 40 and above to undergo screening for prostate cancer. MATERIAL AND METHOD: A cross-sectional research design was employed. The study utilized a survey questionnaire to collect data on various factors influencing screening behaviors. The research instrument consisted of a comprehensive survey questionnaire that incorporated validated scales to assess barriers to prostate cancer screening, intention to screen, and the International Prostate Symptom Score (IPSS). RESULTS: The study found that the 120 participants had an average IPSS score of 7.20 ± 2.23, most people (70%) had mild symptoms of prostate cancer, whereas others had moderate (20%) or severe symptoms (10%). The majority of the men indicated a low to moderate inclination to undergo screening through Prostate-specific antigen testing, or digital rectal examination (DRE) (PSA), with 76% considering DRE and 70% considering PSA. The main barriers to screening included the dread of receiving distressing outcomes (48%) and a lack of understanding about the screening procedure (54%). The study identified key factors affecting the intention to undergo a prostate cancer screening. Regarding DREs, these factors included the perceived danger of the illness and prior information from doctors about prostate conditions. When it came to the intention to undergo screening through the prostate-specific antigen test (PSA), determinants included the perceived threat of the disease, one's general health perception, and prior information from doctors about prostate-related issues. Additionally, a significant proportion of participants believed that prostate cancer was not a serious illness (56%) and 57% thought DRE was embarrassing. CONCLUSIONS: The participants displayed a low willingness to get screened for prostate cancer. Implementing interventions that focus on increasing awareness of the disease and its associated risks could potentially reduce the barriers and boost participation in prostate cancer screening.

Cancer risk-factor and symptom awareness among adults with intellectual disabilities, paid and unpaid carers, and healthcare practitioners: a scoping review.

BACKGROUND: The physical health of people with intellectual disabilities (ID) has been identified as an area of ongoing concern and priority. Research has increasingly focused on cancer, with studies indicating that people with ID are at an increased risk of cancer and of mortality, compared with the general population. This review aims to systematically identify and synthesise the published academic literature exploring cancer risk-factor and symptom awareness among people with IDs, carers and healthcare professionals. METHODS: In line with Arksey and O'Malley's (2005) framework for scoping reviews, five incremental stages were followed: (1) identifying research question, (2) identifying relevant studies, (3) study selection, (4) extracting and charting of data, and (5) collating, summarising and reporting results. Findings were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews (PRISMA-Scr). RESULTS: The search strategy identified 352 records, 16 records met all eligibility criteria and were included for review. The studies address a range of areas including knowledge and awareness of cancer risk-factors and symptoms and interventions to promote awareness of cancer. CONCLUSIONS: Cancer risk-factor and symptom awareness is low among adults with ID, paid and unpaid carers and healthcare practitioners (HCPs). Theoretically underpinned, co-designed tools and interventions to improve awareness are lacking. There is uncertainty surrounding how to best support people with ID in raising cancer awareness, even within the professional healthcare environment. There is a predominance of research on breast cancer awareness. Future studies focusing on other cancers are needed to build a complete picture of awareness among adults with IDs, paid and unpaid carers, and HCPs.

Awareness of the causal association between human papillomavirus and anal cancer among US adults.

PURPOSE: The incidence of anal cancer is on the rise in the US, especially among high-risk groups. This study examined the prevalence and determinants of awareness of the causal relationship between HPV and anal cancer among US adults. METHODS: Study data was obtained from the 2017 to 2020 iterations of the Health Information National Trends Survey. The prevalence of awareness that HPV causes anal cancer was estimated among HINTS respondents who were aware of HPV in general. Survey weights were used to provide estimates representative of the adult US population. Multivariable logistic regressions were used to examine the associations between awareness that HPV causes anal cancer and cancer-related behaviors/perceptions and sociodemographic characteristics of respondents. RESULTS: Two thousand six hundred and eighty four (27.2%) of the study population were aware that HPV caused anal cancer. Those of gay sexual orientation were more aware than heterosexuals [OR 2.27; 95% CI (1.24, 4.14)]. Compared to respondents with a high school diploma or less, individuals with some college education [OR 1.38; 95% CI (1.03, 1.85)] and those with at least a college degree [OR 1.52; 95% CI (1.17, 1.98)] were more likely to be aware. Participants who had positive cancer information seeking behavior were more aware of the HPV-anal cancer link compared to those who did not [OR 1.57; 95% CI (1.30, 1.89)]. CONCLUSION: Population-level awareness that HPV causes anal cancer remains critically low in the US. Sexual orientation, level of education and cancer information seeking behavior are associated with increased awareness of the causal relationship between HPV and anal cancer. Efforts should be directed toward addressing the awareness gap among individuals with lower education levels and promoting curiosity-driven information seeking behaviors.

Knowledge and Attitude of Inflammatory Bowel Disease Patients Toward Colorectal Cancer Risk, Its Management, and the Role of Healthcare Providers: A Cross-Sectional Study in the UK.

Background: Inflammatory bowel disease (IBD) increases the risk for colorectal cancer (CRC). Limited literature exists on patients' knowledge of CRC risk and management. Attitude toward doctor-recommended management and the role of healthcare providers (HCPs) in CRC risk awareness remain unexplored. This study aimed to fill the gap in knowledge about CRC risk awareness and management in IBD patients in the UK. Methods: This cross-sectional internet-based study was conducted in April-July 2019. Adult (>18 years) IBD patients with a confirmed diagnosis for 2 years and adequate command of English language were invited from non-Natinal Health Services sources. A self-designed and piloted questionnaire with open- and closed-ended questions was used. Closed-ended data were analyzed using descriptive statistics and open-ended responses were analyzed using content analysis. Results: Ninety-two participants (52.5% Crohn's disease and 67.5% females) responded. Around 88% knew that IBD increased CRC risk. Only 20.7% were aware of colonoscopy as the best screening tool; 88% were unaware of screening initiation time. Almost 90% would agree to a doctor's recommendation of colonoscopy. For dysplasia with 10% risk of CRC, 46.7% would not agree with colectomy. Some 48% reported to have never had a discussion about the risk of CRC in IBD with their HCPs, while 58% were not informed of the role of screening and surveillance in managing CRC risk. Conclusions: IBD patients were poorly aware of CRC risk management and had mixed willingness to comply with a doctor's recommendation. HCP's role in cancer knowledge dissemination was suboptimal and patients desired more information.

The impact of an online educational game on breast cancer awareness among university female students, Malaysia: a pilot study.

BACKGROUND: Breast cancer is one of the world's most prevalent cancer and the most common type of cancer in Malaysia. Interestingly, breast cancer in young women is more aggressive compared to older women and the survival rate among these groups of individuals is poor. Thus, breast cancer awareness is essential among young women as early detection is possible and treatment will be effective during which the disease is curable. Hence, the purpose of this study is to design and evaluate the impact of an educational game on breast cancer awareness among female university students in Malaysia. METHODS: This is a one-group pre-and post-intervention pilot study. It was conducted in Private and public higher education institutions around Malaysia. An online education game was created and used as the intervention. A self-administered questionnaire was administered to the participants during the pre-and post-intervention test to evaluate the online educational game on breast cancer awareness. RESULTS: A total of 52 responses were collected. The mean age of the participants was 21.98 (SD = 1.896) years. The findings showed a statistically significant median increase (p < 0.05) in breast cancer knowledge scores among participants in the post-intervention. A median increase in breast cancer knowledge score of 6 was shown when participants were exposed to the online education game (24.00) compared to before they were exposed to it (17.00). CONCLUSION: Using online educational games effectively raised awareness of breast cancer among university students. Online games can be used as a health educational tool to promote awareness of a topic of interest, as digital games can be accessed easily, game content can be tailored made or updated, and improve participant engagement in learning.

Self-negligence and awareness among oral precancerous and cancer patients - A cross-sectional questionnaire study.

Background: The National Institute of Health and Family Welfare (NIHFW) reports that India has the highest global prevalence of oral cancers. The incidence is significantly more in developing countries when compared to the developed countries. Early detection is key to increasing the survival rate of the patients. Important causes for this late diagnosis could be self-negligence, lack of patient awareness about the causes and asymptomatic and subtle clinical presentation of the lesions. Aim: To assess the causes of self-neglect and awareness levels among oral cancer and pre-cancerous patients. Settings and Design: A cross-sectional questionnaire study was conducted among pre-cancerous and cancerous patients. Methods and Material: A questionnaire with 16 closed-ended questions was framed relating to the causes of self-neglect and awareness of the patients. A total of 45 patients were selected by convenient sampling technique from the Institutional Tumour Board register of which 62 per cent were male patients and 38 per cent were female patients. Statistical Analysis: Data analysis for demographic data, patients' awareness, and causes of self-neglect about precancer and cancer was done using SPSS Version 10. Results and Conclusions: The present study concluded that the patients had adequate awareness that deleterious habits could lead to cancer but had a low level of awareness about the other causes of cancer, symptoms and management options available to treat cancer. The study result emphasizes that the government should plan for more cancer-screening camps in order to prevent the progression of cancer and to increase the awareness. (Reference I.D.: 2015-05006 for funding the project. ICMR).