Iseme-Ondiek Rosebella, Abuodha Joseph, Ngugi Anthony, Abayo Innocent, Saleh Mansoor
Department of Population, Medical College, Aga Khan University, University Centre, Nairobi, Kenya.
Department of Haematology-Oncology, Medical College, Aga Khan University Cancer Centre, Nairobi, Kenya.
JCO Glob Oncol. 2025 May;11:e2400421. doi: 10.1200/GO-24-00421. Epub 2025 May 9.
In sub-Saharan Africa (SSA), there has been an epidemiologic transition from infectious diseases to noncommunicable diseases, including a projected doubling in incidence of cancer. Understanding the underlying factors driving this surge is crucial for designing effective strategies to mitigate the cancer burden. This study focuses on assessing knowledge, attitudes, screening practices, and health behaviors related to five most prevalent cancers in SSA: prostate, breast, cervical, esophageal, and colorectal-among a predominantly rural coastal population in Kenya.
We used a cross-sectional study design targeting 1,500 adult respondents randomly selected from an existing community health and demographic surveillance system. Face-to-face interviewer-administered questionnaires were used to collect data.
One thousand four hundred fifty-two adults participated in the final survey. Breast cancer awareness was highest (69.1%), while awareness of colorectal cancer was lowest (34.6%). Given a list of possible risk factors and symptoms, most respondents (>50%) could only recognize one to two per cancer type. Perceptions of survival from colorectal cancer were particularly pessimistic, with <70% recognizing early detection as a means to improve survival outcomes. In terms of cancer-associated risk factors, more men engaged in tobacco and alcohol use (20.5% and 22.4%, respectively). Additionally, fewer than 10% of eligible participants had ever undergone cancer screening.
This study addresses a gap in population-level Knowledge, Attitudes, and Practices studies in rural SSA, offering insights crucial for cancer prevention, early detection, and treatment. The low awareness and knowledge levels and unhealthy behaviors emphasize a need for targeted educational campaigns at community level and enhanced understanding of barriers to uptake of screening if we are to effectively combat the growing cancer burden in this region.
在撒哈拉以南非洲（SSA），已经出现了从传染病向非传染性疾病的流行病学转变，包括癌症发病率预计将翻倍。了解推动这一激增的潜在因素对于设计减轻癌症负担的有效策略至关重要。本研究重点评估肯尼亚一个主要为农村沿海人口中与SSA最常见的五种癌症（前列腺癌、乳腺癌、宫颈癌、食管癌和结直肠癌）相关的知识、态度、筛查实践和健康行为。
我们采用横断面研究设计，目标是从现有的社区卫生和人口监测系统中随机选择1500名成年受访者。通过面对面访谈由访员管理问卷来收集数据。
1452名成年人参与了最终调查。乳腺癌知晓率最高（69.1%），而结直肠癌知晓率最低（34.6%）。给出一系列可能的风险因素和症状后，大多数受访者（>50%）每种癌症类型只能识别一到两个。对结直肠癌生存的认知尤其悲观，不到70%的人认识到早期检测是改善生存结果的一种手段。在癌症相关风险因素方面，更多男性有吸烟和饮酒行为（分别为20.5%和22.4%）。此外，不到10%的符合条件的参与者曾接受过癌症筛查。
本研究填补了SSA农村地区人群层面知识、态度和实践研究的空白，为癌症预防、早期检测和治疗提供了至关重要的见解。低知晓率、低知识水平和不健康行为强调了在社区层面开展有针对性的教育活动的必要性，以及如果我们要有效应对该地区日益增长的癌症负担，就需要增强对筛查障碍的理解。
