Public awareness of cancer risk factors in the Moroccan population: a population-based cross-sectional study

BMC Cancer

Karima El Rhazi¹  Bahia Bennani²  Samira El Fakir¹  Ahmadou Boly¹  Rachid Bekkali³  Ahmed Zidouh³  Chakib Nejjari¹ 

[1] Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdillah University, B.P 1893, Route Sidi Harazem, Km 2.2, Fez, Morocco

[2] Department of Microbiology and Molecular Biology, Team of Microorganisms and Oncogene factors Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdillah University, Fez, Morocco

[3] Lalla Salma Fondation of Prevention and Traitement of Cancers, Rabat, Morocco

关键词: Morocco;    Risk factors;    Cancer;    Determinants;    Awareness;   

Others  :  1121046
DOI  :  10.1186/1471-2407-14-695

 received in 2013-01-30, accepted in 2014-09-20,  发布年份 2014

【 摘 要 】

Background

In Morocco, knowledge of cancer risk factors, a crucial element in the process of behavioral change, has never been evaluated. This study aims to provide information on the level of awareness of cancer risk factors among the Moroccan general population.

Methods

A cross sectional survey was carried out in May 2008, using a stratified sampling method in a representative sample of the Moroccan adult population. The used questionnaire included social and demographic data as well as questions about 14 cancer related factors regarding passive or active smoking, alcoholic beverages, obesity, physical inactivity, food coloring, red meat, fat, salt, fruit, vegetables, olive oil, green tea, coffee, breast-feeding. Subjects had to choose between 3 propositions for each proposed factor (risk factor/Protective factor/Don’t Know). The knowledge score was calculated by summing the correct answer for each proposed factor except coffee and food coloring. The answer was assigned 1 if it’s correct or 0 if it was incorrect or the participant responded ‘don’t know. The maximum knowledge score was 12. Multivariate linear regression model was used to evaluate the determinants of knowledge score.

Results

Among 2891 subjects who participated to the survey, 49.5% were men and 42% were from a rural area. The mean age was 41.6 ± 15.2 years. The mean knowledge score of cancer related factors was 8.45 ± 3.10 points. Knowledge score increased with educational level (β = −0.65 if school year ≤6 versus >6) and housing category (β = 1.80 in high standing housing vs rural housing). It was also higher in urban area, among never smokers and among people never consuming alcohol compared to others groups.

Conclusion

These results provide valuable information necessary to establish relevant cancer prevention strategies in Morocco aiming to enhance and improve people’s knowledge about risk factors especially in some target groups.

【 授权许可】

   
2014 El Rhazi et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Doll R, Peto R: The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. J Natl Cancer Inst 1981, 66(6):1191-1308.
• [2]Wiseman M, The second World Cancer Research Fund/American Institute for Cancer Research expert report: Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Proc Nutr Soc 2008, 67(3):253-256. Epub 2008
• [3]Inoue M, Iwasaki M, Otani T, Sasazuki S, Tsugane S: Public awareness of risk factors for cancer among the Japanese general population: a population-based survey. BMC Public Health 2006, 10(6):2.
• [4]Tachfouti N: The main risk factors of cancer in Morocco. Data available in the literature. Rev Epidemiol Sante Publique 2009, 57(S1):S56.
• [5]Breslow RA, Sorkin JD, Frey CM, Kessler LG: Americans’ knowledge of cancer risk and survival. Prev Med 1997, 26:170-177.
• [6]Pohls UG, Renner SP, Fasching PA, Lux MP, Kreis H, Ackermann S, Bender HG, Beckmann MW: Awareness of breast cancer incidence and risk factors among healthy women. Eur J Cancer Prev 2004, 13:249-256.
• [7]McMenamin M, Barry H, Lennon AM, Purcell H, Baum M, Keegan D, McDermott E, O’Donoghue D, Daly L, Mulcahy H: A survey of breast cancer awareness and knowledge in a Western population: lots of light but little illumination. Eur J Cancer 2005, 41:393-397.
• [8]Sakurai H: Healthy Japan 21. JMAJ 2003, 46(2):47-49.
• [9]Sanderson SC, Waller J, Jarvis MJ, Humphries SE, Wardle J: Awareness of lifestyle risk factors for cancer and heart disease among adults in the UK. Patient Educ Couns 2009, 74(2):221-227. Epub 2008 Dec 6
• [10]Registre des cancers de la région du grand casablanca 2012. http://www.contrelecancer.ma/site_media/uploaded_files/RCRC_-_28_mai_2012.pdf webcite. Accessed October 2013
• [11]Haut Commissariat au Plan: Recensement Général de la Population et de l’Habitat 2004: caractéristiques démographiques et socio- économiques de la population. Rapport national. http://www.hcp.ma/downloads/Demographie-Caracteristiques-demographiques-et-socio-economiques-RGPH-2004_t13063.html webcite. (accessed October 2013)
• [12]do Carmo França-Botelho A, Ferreira MC, França JL, França EL, Honório-França AC: Breastfeeding and its relationship with reduction of breast cancer: a review. Asian Pac J Cancer Prev 2012, 13(11):5327-5332.
• [13]Pelucchi C, Bosetti C, Negri E, Lipworth L, La Vecchia C: Olive oil and cancer risk: an update of epidemiological findings through 2010. Curr Pharm Des 2011, 17:805-812.
• [14]Cuyun Carter GB, Katz ML, Ferketich AK, Clinton SK, Grainger EM, Paskett ED, Bloomfield CD: Dietary intake, food processing, and cooking methods among Amish and non-Amish adults living in Ohio Appalachia: relevance to nutritional risk factors for cancer. Nutr Cancer 2011, 63(8):1208-1217. doi:10.1080/01635581.2011.607547. Epub 2011 Oct 25
• [15]Harold P, Freeman HP: Cancer in the socioeconomically disadvantage3d. CA Cancer J Clin 1989, 39(5):266-288.
• [16]Freeman HP: Cancer in the economically disadvantaged. CA Cancer J Clin 1989, 64(1):324-334.
• [17]Oranratanaphan S, Amatyakul P, Iramaneerat K, Srithipayawan S: Knowledge, Attitudes and Practices about the Pap Smear among Medical Workers in Naresuan University Hospital, Thailand. Asian Pac J Cancer Prev 2010, 11(6):1727-1730.
• [18]Ministry of Health of Morocco http://srvweb.sante.gov.ma/Publications/Etudes_enquete/Documents/effetsglobaux/2InfrastructurePublicPrivve.pdf webcite. (accessed 25 April 2011)
• [19]Anastasiou I, Mygdalis V, Mihalakis A, Adamakis I, Constantinides C, Mitropoulos D: Patient awareness of smoking as a risk factor for bladder cancer. Int Urol Nephrol 2010, 42(2):309-314. Epub 2009 Jul 10
• [20]Akhigbe AO, Omuemu VO: Knowledge, attitudes and practice of breast cancer screening among female health workers in a Nigerian urban city. BMC Cancer 2009, 9:203. BioMed Central Full Text
• [21]Pakfetrat A, Falaki F, Esmaily HO, Shabestari S: Oral cancer knowledge among patients referred to Mashhad Dental School, Iran. Arch Iran Med 2010, 13(6):543-548.
• [22]San Turgay A, Sari D, Türkistanli EC: Knowledge, attitudes, risk factors, and early detection of cancer relevant to the schoolteachers in Izmir, Turkey. Prev Med 2005, 40(6):636-641.
• [23]Walker S, Saltman DL, Colucci R, Martin L: Awareness of risk factors among persons at risk for lung cancer, chronic obstructive pulmonary disease and sleep apnea: a Canadian population-based study. Can Respir J 2010, 17(6):287-294.
• [24]Jimenez EA, Xie Y, Goldsteen K, Chalas E: Promoting knowledge of cancer prevention and screening in an underserved Hispanic women population: a culturally sensitive education program. Health Promot Pract 2010., 18
• [25]Blake KD, Viswanath K, Blendon RJ, Vallone D: The role of tobacco-specific media exposure, knowledge, and smoking status on selected attitudes toward tobacco control. Nicotine Tob Res 2010, 12(2):117-126. Epub 2009
• [26]Nejjari C, Benjelloun MC, Berraho M, El Rhazi K, Tachfouti N, Elfakir S, Serhier Z, Slama K: Prevalence and demographic factors of smoking in Morocco. Int J Public Health 2009, 54:447-451.
• [27]El Rhazi K, Nejjari C, Berraho M, Serhier Z, Tachfouti N, El Fakir S, Benjelloun M, Slama K: Inequalities in smoking profiles in Morocco: the role of educational level. Int J Tuberc Lung Dis 2008, 12(11):1327-1332.
• [28]Bostock Y: International Network of Women Against Tobacco – Europe. In Searching for the Solution: Women, Smoking and Inequalities in Europe. London: Health Development Agency; 2003.
• [29]Martin-Moreno JM, Soerjomataram I, Magnusson G: Cancer causes and prevention: a condensed appraisal in Europe in 2008. Eur J Cancer 2008, 44(10):1390-1403.
• [30]Mukamal KJ, Conigrave KM, Mittleman MA, Camargo CA Jr, Stampfer MJ, Willett WC, Rimm EB: Roles of drinking pattern and type of alcohol consumed in coronary heart disease in men. N Engl J Med 2003, 348(2):109-118.
• [31]Redeker C, Wardle J, Wilder D, Hiom S, Miles A: The launch of Cancer Research UK’s ‘Reduce the Risk’ campaign: baseline measurements of public awareness of cancer risk factors in 2004. Eur J Cancer 2009, 45(5):827-836. Epub 2008 Dec 4