Awareness of Ovarian Cancer Risk and Protective Factors: A National Cross-sectional Study from Palestine

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2022 Mar 21

PMID 35312720

Authors

Mohamedraed Elshami

Aya Tuffaha

Areej Yaseen

Mohammed Alser

Ibrahim Al-Slaibi

Hadeel Jabr

Sara Ubaiat

Salma Khader

Reem Khraishi

Inas Jaber

Zeina Abu Arafeh

Sondos Al-Madhoun

Aya Alqattaa

Asmaa Abd El Hadi

Ola Barhoush

Maysun Hijazy

Tamara Eleyan

Amany Alser

Amal Abu Hziema

Amany Shatat

Falasteen Almakhtoob

Balqees Mohamad

Walaa Farhat

Yasmeen Abuamra

Hanaa Mousa

Reem Adawi

Alaa Musallam

Nasser Abu-El-Noor

Bettina Bottcher

Affiliations

Soon will be listed here.

Abstract

Introduction: Having a good awareness of ovarian cancer (OC) risk and protective factors could facilitate early diagnosis. This study aimed to assess Palestinian women's awareness about OC risk and protective factors and to identify the factors associated with having good awareness.

Methods: A cross-sectional study was conducted from July 2019 to March 2020 in the two main areas of Palestine: the West Bank and Jerusalem (WBJ) and the Gaza Strip. A translated-into-Arabic version of the validated OC awareness measure was utilized. Adult women attending hospitals, primary healthcare centers, and public spaces at 11 governorates were invited to participate. The awareness level was categorized based on the number of factors recognized: poor (0 to 5), fair (6 to 10) and good (11 to 15).

Results: Of the 6095 women approached, 5618 agreed and completed the questionnaire (response rate = 92.1%). The final analysis included 5411 questionnaires. The most identified modifiable OC risk factor was 'being a smoker' (n = 4024, 74.4%), whereas the least identified was 'having in vitro fertilization treatment' (n = 1652, 30.5%). The most identified non-modifiable OC risk factor was 'having ovarian cysts' (n = 3136, 58.0%), whereas the least identified was 'having endometriosis' (n = 1880, 34.7%). The most identified OC protective factor was 'breastfeeding' (n = 4770, 88.2%), whereas the least identified was 'using the pill for a long time' (n = 930, 17.2%). Only 820 women (15.2%) displayed good awareness of OC risk and protective factors. Women from the Gaza Strip were slightly more likely than women from the WBJ to have good awareness (16.4% vs. 14.2%). In contrast, post-secondary education, higher monthly income, being married, and knowing someone with cancer were associated with an increase in the likelihood of displaying good awareness.

Conclusion: The overall awareness of OC risk and protective factors in this study was low. Educational interventions are needed to improve Palestinian women's awareness.

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References

Elshami M, Bottcher B, Alkhatib M, Ismail I, Abu-Nemer K, Hana M . Perceived barriers to seeking cancer care in the Gaza Strip: a cross-sectional study. BMC Health Serv Res. 2021; 21(1):28. PMC: 7788935. DOI: 10.1186/s12913-020-06044-1. View

Saki S, Ali N, Saki S, AlRabeea Z, AlRemeithi F, Carrick F . Barriers to healthcare seeking, beliefs about ovarian cancer and the role of socio-economic position. A cross-sectional multilevel study in Dubai, a multicultural society. J Public Health Res. 2021; 10(3). PMC: 8419630. DOI: 10.4081/jphr.2021.2073. View

Reid F, Bhatla N, Oza A, Blank S, Cohen R, Adams T . The World Ovarian Cancer Coalition Every Woman Study: identifying challenges and opportunities to improve survival and quality of life. Int J Gynecol Cancer. 2020; 31(2):238-244. DOI: 10.1136/ijgc-2019-000983. View

Brain K, Smits S, Simon A, Forbes L, Roberts C, Robbe I . Ovarian cancer symptom awareness and anticipated delayed presentation in a population sample. BMC Cancer. 2014; 14:171. PMC: 3975332. DOI: 10.1186/1471-2407-14-171. View

Elshami M, Thalji M, Abukmail H, Al-Slaibi I, Alser M, Radaydeh A . Knowledge of cervical cancer risk factors among Palestinian women: a national cross-sectional study. BMC Womens Health. 2021; 21(1):385. PMC: 8561913. DOI: 10.1186/s12905-021-01510-2. View

Brand N, Qu L, Chao A, Ilbawi A . Delays and Barriers to Cancer Care in Low- and Middle-Income Countries: A Systematic Review. Oncologist. 2019; 24(12):e1371-e1380. PMC: 6975966. DOI: 10.1634/theoncologist.2019-0057. View

Lockwood-Rayermann S, Donovan H, Rambo D, Kuo C . Women's awareness of ovarian cancer risks and symptoms. Am J Nurs. 2009; 109(9):36-45. DOI: 10.1097/01.NAJ.0000360309.08701.73. View

Pedersen A, Forbes L, Brain K, Hvidberg L, Wulff C, Lagerlund M . Negative cancer beliefs, recognition of cancer symptoms and anticipated time to help-seeking: an international cancer benchmarking partnership (ICBP) study. BMC Cancer. 2018; 18(1):363. PMC: 5879768. DOI: 10.1186/s12885-018-4287-8. View

Viswanath K, Breen N, Meissner H, Moser R, Hesse B, Steele W . Cancer knowledge and disparities in the information age. J Health Commun. 2006; 11 Suppl 1:1-17. DOI: 10.1080/10810730600637426. View

10.

Okunowo A, Adaramoye V . Women's Knowledge on Ovarian Cancer Symptoms and Risk Factors in Nigeria: An Institutional-based Study. J Epidemiol Glob Health. 2019; 8(1-2):34-41. PMC: 7325817. DOI: 10.2991/j.jegh.2018.07.002. View

11.

ElMokhallalati Y, Alaloul E, Shatat M, Shneewra T, El Massri S, Shaer O . The Symptom Burden and Quality of Life in Cancer Patients in the Gaza Strip, Palestine: A Cross-Sectional Study. PLoS One. 2022; 17(1):e0262512. PMC: 8758072. DOI: 10.1371/journal.pone.0262512. View

12.

Bray F, Ferlay J, Soerjomataram I, Siegel R, Torre L, Jemal A . Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68(6):394-424. DOI: 10.3322/caac.21492. View

13.

Fallowfield L, Fleissig A, Barrett J, Menon U, Jacobs I, Kilkerr J . Awareness of ovarian cancer risk factors, beliefs and attitudes towards screening: baseline survey of 21,715 women participating in the UK Collaborative Trial of Ovarian Cancer Screening. Br J Cancer. 2010; 103(4):454-61. PMC: 2939792. DOI: 10.1038/sj.bjc.6605809. View

14.

Hvidberg L, Wulff C, Pedersen A, Vedsted P . Barriers to healthcare seeking, beliefs about cancer and the role of socio-economic position. A Danish population-based study. Prev Med. 2014; 71:107-13. DOI: 10.1016/j.ypmed.2014.12.007. View

15.

Elshami M, Alfaqawi M, Abdalghafoor T, Nemer A, Ghuneim M, Lubbad H . Public Awareness and Barriers to Seeking Medical Advice for Colorectal Cancer in the Gaza Strip: A Cross-Sectional Study. J Glob Oncol. 2019; 5:JGO1800252. PMC: 6550031. DOI: 10.1200/JGO.18.00252. View

16.

Keng S, Abdul Wahab S, Chiu L, Yusuf A . Awareness of ovarian cancer risk factors among women in Malaysia: a preliminary study. Asian Pac J Cancer Prev. 2015; 16(2):537-40. DOI: 10.7314/apjcp.2015.16.2.537. View

17.

Elshami M, Al-Slaibi I, Abukmail H, Alser M, Radaydeh A, Alfuqaha A . Knowledge of Palestinian women about cervical cancer warning signs: a national cross- sectional study. BMC Public Health. 2021; 21(1):1779. PMC: 8487127. DOI: 10.1186/s12889-021-11792-8. View

18.

Fujita M, Tase T, Kakugawa Y, Hoshi S, Nishino Y, Nagase S . Smoking, earlier menarche and low parity as independent risk factors for gynecologic cancers in Japanese: a case-control study. Tohoku J Exp Med. 2008; 216(4):297-307. DOI: 10.1620/tjem.216.297. View

19.

Rebbeck T, Kauff N, Domchek S . Meta-analysis of risk reduction estimates associated with risk-reducing salpingo-oophorectomy in BRCA1 or BRCA2 mutation carriers. J Natl Cancer Inst. 2009; 101(2):80-7. PMC: 2639318. DOI: 10.1093/jnci/djn442. View

20.

Elshami M, Elshami A, Alshorbassi N, Alkhatib M, Ismail I, Abu-Nemer K . Knowledge level of cancer symptoms and risk factors in the Gaza Strip: a cross-sectional study. BMC Public Health. 2020; 20(1):414. PMC: 7106782. DOI: 10.1186/s12889-020-08553-4. View