Awareness of Cancer Symptoms and Barriers to Seeking Medical Help Among Adult People Attending Primary Care Settings in Oman

Abstract

Objectives:To explore the public’s awareness of cancer symptoms and the barriers to seeking medical help among Omani adults attending primary care settings in Muscat governorate, the capital city of Oman.Methods:The Cancer Awareness Measure (CAM) questionnaire (translated into Arabic) was used to collect data from a total of 12 randomly selected local health centers (LHCs) in Muscat governorate, the capital city of Oman. Omani adults aged 18 years and above attending LHCs during the study period were invited to participate in the study. Statistical Package for the Social Sciences (SPSS version 22) was used to analyze the data.Results:A total of 999 participants completed the CAM questionnaire from 1200 invitations (response rate = 83%). The overall recognition of common cancer symptoms was less than 50% except for an unexplained lump/swelling, which was 71%. Multinomial logistic regression showed that women recognized more cancer symptoms than men (odds ratio [OR] = 1.79; 95% confidence interval [CI]: 1.27-2.51), that more highly educated participations recognized more cancer symptoms than less educated participants (OR = 39; 95% CI: 0.23-0.69). The majority of participants (91.2%) agreed that the right time to seek medical help for possible cancer symptom was within 2 weeks. Multinomial logistic regression showed that women rather than men were more likely to perceive barriers to seeking medical help (OR = 2.10; 95% CI: 1.60-2.76). Also the less educated participants, rather than more educated, were more likely to perceive barriers to seeking medical help (OR = 2.17; 95% CI: 1.16-4.05).Conclusion:Levels of awareness of cancer symptoms are low in Oman. More national CAMs are needed in Oman to increase public knowledge of cancer symptoms. Also, more public awareness is needed to overcome the barriers to seeking timely medical help particularly among groups of women and the unmarried, widowed, divorced, or separated if delays in presentation are to be minimized.

Knowledge of Cancer Risk Factors, Symptoms, and Barriers to Seeking Medical Help among Omani Adolescents

“…A similar study from the UK which used the CAM questionnaire showed that awareness levels among adolescents of cancer symptoms was also low, a similar finding to the current study (Kyle et al, 2013). Previous studies conducted in Oman among adults indicated low awareness levels in identifying risk factors and symptoms for the most common cancers, and the levels were also low for specific types of cancer, such as colorectal and ovarian (Al-Azri et al, 2015;Al-Azri et al, 2016;Al-Azri et al, 2014).…”

“…Female adolescents in this study were more likely than the males to identify several emotional barriers from seeking medical help, such as "embarrassment", "being scared" and "worried about what the doctor might find". There is a paucity in the literature regarding teenage cancer diagnosis delay; one study from the UK found that the reasons for delay were mainly attributable to the actions of healthcare professionals (Fern et al, 2011) Previous studies conducted in Oman and in the UK showed that women were more likely than men to perceive similar emotional barriers to the ones listed above which would prevent them from seeking early medical help (Al-Azri et al, 2016;Robb et al, 2009). Women have been noted to worry about cancer symptoms, due to being worried about side effects of treatments or because they believed that there was no cure for cancer, which could lead to a delay in their diagnosis (Murphy et al, 2018).…”

“…The CAM questionnaire was translated from English to Arabic and back-translated into English again by several people proficient in both languages, and the Arabic version of the CAM questionnaire has been used in previous studies conducted among adults in Oman (Al-Azri et al, 2014;Al-Azri et al. 2015;Al-Azri et al, 2016).…”

“…Furthermore, there are currently no screening programs available for cancer, except for breast cancer, as a program was introduced in 2010 (Ministry of Health, 2010). Previous studies among the adult Omani population have shown that the majority of the public were not aware of the risk factors and symptoms for most types of cancer (Al-Azri et al, 2017;Al-Azri et al, 2016;Al-Azri et al, 2014). There are also several notable social and cultural barriers contributing to the delays in cancer diagnosis, particularly among vulnerable groups (Al-Azri et al, 2016).…”

“…Previous studies among the adult Omani population have shown that the majority of the public were not aware of the risk factors and symptoms for most types of cancer (Al-Azri et al, 2017;Al-Azri et al, 2016;Al-Azri et al, 2014). There are also several notable social and cultural barriers contributing to the delays in cancer diagnosis, particularly among vulnerable groups (Al-Azri et al, 2016). To the best of our knowledge, there have been no previous studies conducted among the adolescents in Oman to identify their awareness levels of cancer risk factors, the warning symptoms, anticipated delay time and perceived barriers to seeking medical help.…”