951Can cancer-related health literacy predict cancer preventive behaviours?

Background Health literacy has direct relevance to outcomes in patients with cancer. An adequate level of health literacy may increase uptake of screening and other supportive cancer prevention programs, which may contribute to improved outcomes. However, existing literature is limited in measuring cancer-specific health literacy and its role in cancer prevention. This study aims to investigate the relationship between cancer-related health literacy and cancer preventive behaviours through a population survey in Beijing, China. Methods A cross-sectional design was utilised to collect survey data such as respondents’ sociodemographic characteristics, cancer-related health literacy, cancer status and cancer prevention behaviours. Logistic regression modelling was applied to identify significant sociodemographic predictors for cancer literacy. Multinomial logistic regression analysis was further performed to determine the association between cancer-related health literacy and cancer preventive behaviours after adjusting for effects from sociodemographic variables. Results The findings confirmed that cancer-related health literacy was significant in predicting participants’ cancer preventive behaviours, including individual’s cancer information seeking behaviour, intention to participate in cancer screenings, early diagnosis and treatments. In addition, the results also showed that respondents’ gender, age, education, household income, residential region and cancer status were significantly associated with their levels of cancer-related health literacy. Conclusions/Key messages The results of this study have provided useful evidence on the importance of applying cancer-related health literacy to predict individual’s cancer preventive behaviours. The study has also identified the variations in cancer literacy between different sub-population groups. Future studies can develop targeted health promotion and education campaigns for more effective cancer prevention.

The Nine Cancer Frames: A Tool to Facilitate Critical Reading of Cancer-Related Information

People’s ability to critically assess cancer-related information is essential from a preventional and therapeutic, as well as a general democratic perspective. Such cancer literacy is not just about acquiring factual knowledge. It also involves the ability to analyze how the information is contextualized—how cancer is framed. Previous research concerning the framing of cancer in public discourse is voluminous and penetrating but also fragmented and inaccessible to non-experts. In this study, we have developed an integrated and applicable tool for analyzing cancer discourse by systematically classifying distinctive ways of framing of the concept of cancer. Building on previous research and an inductive framing analysis of a broad range of public cancer discourse, systematically selected from British and Norwegian newspapers, we have characterized nine cancer frames: the biomedical, the environmental, the epidemiological, the personal, the sociopolitical, the economic, the antagonistic, the alternative, and the symbolic frame. This framing scheme may be applied to analyze cancer-related discourse across a plurality of themes and contexts. We also show how different frames combine to produce more complex messages, thereby revealing underlying patterns, strategies, and conflicts in cancer communication. In conclusion, this analytical tool enables critical reading of cancer-related information and may be especially useful in educational initiatives to advance health communication and public understanding of cancer.

Role of cancer literacy in cancer screening behaviour among adults of Kaski district, Nepal

Cancer Screening is a key approach to detect cancer at an early stage and help reduce cancer mortality globally. Inadequate Cancer Literacy may pose a barrier to patient engagement in getting screened for cancer. This study assessed Cancer Screening behavior and its association with Cancer Literacy and other factors among adults of Kaski district, Nepal. A cross-sectional study was carried out among 180 adults from March to August 2019, selected using a multi-stage random sampling method. Data on demographics, history of cancer, use of naturopathy, fatalism, family support, cancer literacy and cancer screening behaviour were collected using a semi-structured questionnaire, with the aid of face-to-face interviews. Cancer Literacy was measured using a cancer health literacy tool (CHLT-6), and Cancer Screening behaviour was assessed on the basis of the self reported information about having gone through any type of cancer screening in the past. Odds ratio (OR) with 95% Confidence Interval (CI) was calculated to determine the strength of association using Multivariate Logistic Regression analysis. Only 43.4% of the respondents had Cancer Literacy scores more than the median and only 11.7% had ever gone through any Cancer Screening test in the past. In this study, Cancer Screening behaviour was significantly associated with Cancer Literacy [OR = 1.43, 95% CI (1.01–2.02)]. Similarly, significant association was found between Cancer Screening behaviour and other exposure variables such as age [OR = 1.06, 95% CI (1.02–1.11)] and gender [OR = 0.06, 95% CI (0.01–0.35)]. This study showed low cancer screening and cancer literacy scores amongst the respondents. This suggests that to tackle the ever increasing burden of cancer and hence, to increase cancer screening, we need to focus on improving knowledge and awareness about cancer, as well as, on targeting efforts towards people’s understanding of basic health and cancer terminologies.

Head and Neck Cancer Literacy in Nigeria: A systematic Review of the Literature

Introduction: Head and neck cancer (HNC), oral cancer inclusive (OC), is one of the major causes of cancer-related deaths globally, especially in Nigeria – a developing African country. Public literacy about HNC plays a very crucial role in HNC prevention. Aim: This study aimed to systematically review existing literature on literacy of HNC in Nigeria. Methods: We searched the PubMed, Google Scholar and AJOL databases for all relevant English articles published on HNC literacy in Nigeria from January 2000 till October 2020. Only relevant articles were included for the study. Quality assessment of the full text of the included articles was done using the Appraisal Tool for Cross-Sectional Studies (AXIS); also, relevant data were extracted from these articles and analyzed thematically. Results: A total of 21 articles (19 surveys and 2 interventional studies), which studied a total population of 7,883 people, were included in the study. All the included articles were rated “excellent” (70 – 100%), regarding quality. The awareness rates of HNC/OC, as documented in the included studies, ranged from 0% to 100%; however, the rate recorded in the majority of these studies was <50%. In-depth knowledge of HNC/OC was found to be generally poor among the surveyed population groups; however, education intervention was found to improve in-depth knowledge of HNC and attitudes toward peer and nonpeer education about HNC among Nigerians. Conclusion: The level of knowledge regarding HNC, in Nigeria, is low. The use of relevant health education programs to boost knowledge about HNC among the Nigerian public is highly recommended.

Knowledge and Practice of Breast Cancer Screening and Awareness of Its Risk Factors Among Reproductive Women of Jammu and Kashmir

INTRODUCTION: Breast cancer is the most common type of malignancy among women worldwide, therefore, it becomes necessary to understand the breast cancer literacy among women. Breast cancer literacy includes knowledge of breast cancer screening, practice of breast cancer screening and awareness of breast cancer risk factors. OBJECTIVES: To determine level of awareness and practice of breast cancer screening, to assess level of awareness of breast cancer risk factors and to establish role of demographics in uptake and knowledge of breast cancer screening. MATERIALS AND METHOD: In this study, reproductive women were taken and questionnaires given were filled by 381 respondents. Relevant questions were asked keeping in view the objectives. Role of age and maximum education of women was also established. RESULTS: It was found that majority of women who were aware of breast cancer screening belonged to age-group 21-30 having mean of 56.19% and also showed higher practice of the same as compared to others (mean=50.1%) followed by women belonging to age-group 31-40 whose knowledge mean came out to be 25.5% and mean of practice was found to be 35.26%. The other two age groups of 15-20 and 41-45 showed low knowledge and less practice of breast cancer screening. Similar results were found out for other parameter. CONCLUSION: Women whose maximum education was graduate and above showed higher level of awareness of breast cancer screening and risk factors and also higher practice of breast cancer screening as compared to women who had lower educational background.

Enhancing cancer literacy among Appalachian Kentucky middle and high school students.

11008 Background: Kentucky has the highest rates of overall cancer incidence and mortality in the United States and the Appalachian region of the state experiences the highest burden of the disease. Poor health behaviors, poverty, poor health care access, low education levels, and low health literacy drive the cancer disparities in Kentucky. Inadequate health literacy is associated with lower participation in preventive measures, which can increase one’s risk of developing cancer. Increasing cancer literacy among youth represents an opportunity to potentially decrease cancer disparities across Kentucky. In a recent study, we piloted a cancer education intervention in Kentucky middle and high schools to determine if such an intervention could enhance students’ cancer literacy. Through the study, we documented a significant increase in students’ short-term cancer literacy levels (Hudson L. et al. Journal of Cancer Education, in press). Methods: This quantitative survey research study aims to examine the long-term effects of the cancer education intervention on the cancer literacy of Kentucky middle and high school students. An online pretest cancer literacy survey consisting of 10 items was administered to a new set of 164 participants from six new schools, followed by the delivery of a cancer education presentation. Immediately following the presentation, participants took a posttest with identical items to the pretest. A follow-up identical test is being administered 3 months after the initial intervention to determine participants’ longer-term knowledge retention. Results: Replicating our prior work, significant (p < 0.0001) increases in both average and median percent of correctly marked items (average: pretest = 50% versus posttest = 77%; median: pretest = 50% versus posttest = 80%) and scores on each individual question were observed immediately following the intervention. Additionally, the average rating as to how the intervention influenced students considerations toward encouraging a family member or friend to change their habits following the intervention was 8 (1 = extremely unlikely;10 = extremely likely). Conclusions: This work demonstrates an increase in cancer literacy levels after the educational intervention and indicates that the information motivates participants to share cancer prevention information with others. A follow-up survey will measure participants’ longer term knowledge retention levels. These data may suggest that a school-based educational intervention can change behaviors that can lower cancer incidence and mortality rates.

Testing the Preliminary Validity of a Multidimensional Framework for Studying the Effects of Cancer Health Literacy on Cancer Screening Behaviors among Diverse Populations

The objective of this study was to evaluate the applicability of a multidimensional framework to explore factors associated with cancer literacy and its effects on receiving cancer screenings among diverse populations. Based on the conceptual framework, we developed and pilot-tested the Multidimensional Cancer Literacy Questionnaire (MCLQ) among 1500 individuals (African Americans, Latinos and Whites) in Louisiana. Exploratory factor analysis was used to identify the MCLQ underlying structure and predominant factors explaining each of the dimensions in the model. A total of 82 items (explaining 67% of the total variance) in the MCLQ were grouped into 20 factors associated with three key dimensions related to cancer literacy. Preliminary validity of the MCLQ was supported: Cronbach alpha for the scale score was 0.89 and internal consistency reliability coefficients for each factor were all above 0.67. The Facilitators Domain included five factors (28 items) that may positively influence individuals to have early-detection cancer screenings. The Barriers Domain included seven factors (26 items) explaining aspects that may negatively influence individuals to have cancer screenings. The Cultural Domain included eight factors (28 items) related to aspects that influence positively or negatively individuals’ perceptions regarding cancer as a disease, screenings and treatments. A multidimensional framework to study cancer literacy, including cultural attitudes, beliefs and practices, as well as facilitators and barriers, among diverse populations, will increase understanding of factors influencing individuals’ approach to cancer prevention and screening. Results will inform further testing of the multidimensional framework and questionnaire.