Recognition of cancer warning signs and symptoms.

PurposeThe aim of this study was to assess adolescents’ awareness of cancer signs and symptoms, cancer risk factors, cancer screening programmes, and perceived barriers to seeking medical advice.MethodsA cross-sectional survey was conducted using an adapted version of the adolescent cancer awareness tool which was originally modified from the Cancer Awareness Measure (CAM) (Version 2.1). The sample included 474 adolescents aged 15 to 18 years recruited from nine Irish schools between November 2021 and May 2022.ResultsAwareness of cancer warning signs and symptoms was low when open-ended (recall) questions were used and relatively high for closed (recognition) questions. Unexplained lump or swelling was the most frequently identified cancer symptom. The least reported were difficulty swallowing and a sore that does not heal. Smoking was the most reported cancer risk factor. The least reported were not eating enough fruit and vegetables, a diet high in fat, and infection with viruses. Generally, females had greater awareness than males. The greatest barrier to seeking help was “worry about what the doctor might find” and the least reported barrier was “I don’t feel respected by the doctor.”ConclusionsOverall recognition of symptoms or risk factors of cancer was higher than recall. Several modifiable barriers to medical help-seeking were identified. Findings from this study suggest further exploration using a qualitative approach to investigate the factors influencing adolescents’ cancer awareness and barriers to help-seeking.

研究目的：本研究旨在评估青少年对癌症体征与症状、癌症危险因素、癌症筛查项目的认知水平，以及其就医咨询时感知到的阻碍因素。
研究方法：本研究采用横断面调查设计，使用经改编的青少年癌症认知评估工具——该工具最初由《癌症认知量表（Cancer Awareness Measure，CAM）2.1版》修订而来。研究样本于2021年11月至2022年5月间，从爱尔兰9所学校招募，共纳入474名15至18岁青少年。
研究结果：当采用开放式（回忆型）提问时，受试者对癌症警示体征与症状的认知水平较低；而采用封闭式（识别型）提问时，认知水平相对更高。不明原因的肿块或肿胀是最常被识别的癌症症状，吞咽困难与长期不愈的溃疡则是报告率最低的症状。吸烟是被提及最多的癌症危险因素，蔬果摄入不足、高脂饮食及病毒感染则是报告率最低的危险因素。总体而言，女性的癌症认知水平高于男性。就医求助的最大阻碍为“担忧医生可能查出的问题”，报告率最低的阻碍为“我未感受到医生的尊重”。
研究结论：总体而言，对癌症症状或危险因素的识别型认知高于回忆型认知。本研究明确了若干可干预的就医求助阻碍因素。本研究结果提示，未来可采用质性研究方法进一步探索影响青少年癌症认知水平及就医求助障碍的相关因素。