Awareness of head and neck cancers in Saudi Arabia

Discussion

Most cases of HNC are detected at later stages owing to various factors. A common reason is that patients cannot identify the early signs of HNCs.10 Therefore, improving the knowledge, awareness, and attitude of the general population towards HNCs will ameliorate cancer prognosis and allow for earlier diagnosis. Studies investigating awareness and knowledge of this topic among the general Saudi population are scarce. Herein, we shed light on this public health concern through a population-based analysis. The analysis revealed that most of the study respondents were not knowledgeable on HNCs. Most participants incorrectly believed that headache is not a symptom. In terms of the risk factors, males showed higher awareness of tobacco and excessive alcohol as risk factors, while females were more knowledgeable on HPV infection.

In our study, there was an alarming number of subjects who perceived themselves as having poor knowledge of HNC (66.8%). It is noteworthy that various countries have shown low rates of awareness regarding HNCs, such as Jordan (45.6%) and the United Kingdom (56%).11 In contrast, some countries have reported higher rates of awareness, including Australia (79%), Sri Lanka (95%), the United States (84.5%), and Yemen (71.5%).12,13 It has been noted that the level of public awareness is higher in regions where HNCs are prevalent, such as India and Sri Lanka.12,13 It is plausible that the low level of knowledge and awareness in Saudi Arabia is due to the relative rarity of HNCs as well as insufficient public health education.14

Notably, our analysis revealed that 57.8% of study respondents incorrectly stated that headaches are not a symptom of HNCs, and only 19.4% appropriately recognize their pain and sore throat as symptoms. In 2015, a similar study showed that Saudi people have very low knowledge concerning identification of clinical features of HNCs.14 The authors deduced that less than 25% recognized red or white patches as early signs of oral cancer, while only 30% were aware that a non-healing ulcer was a symptom of cancer.14 Interestingly, similar findings have been observed in other countries, which indicates a lack of information provided by healthcare professionals.13,15,16 Of note, the lack of general recognition of the early signs of HNCs could prevent disease diagnosis and affect overall survival. Therefore, enhancing the general public’s education and sensibility towards HNCs will allow for prompt diagnosis and effective management.17

Our study revealed that there was insufficient knowledge concerning HNC risk factors. Alcohol and tobacco use were identified as potential risk factors by most of the study participants, while a smaller percentage were aware of the risks of HPV and sun exposure. This is consistent with a similar study that was conducted in Saudi Arabia, wherein 80% of the respondents recognized tobacco use as a risk factor, and only a small number were aware of the risk of old age, alcohol consumption, and sun exposure.14 Similarly, previous reports have shown that there is a higher general knowledge of tobacco as a risk factor in comparison with other possible risk factors.11,13 We hypothesize that the greater knowledge of tobacco use as a risk factor could be attributed to campaigns warning of the various dangers of smoking. This may support the promising role of similar campaigns to raise awareness of other potential negligent risk factors.

Several baseline demographics may affect the general knowledge and awareness of HNCs. In our study, older respondents were more aware of tobacco use and alcohol consumption as potential risk factors of HNCs. In addition, males had greater knowledge regarding tobacco use and excessive alcohol use as risk factors, while females were more knowledgeable of HPV infection as a possible risk factor. It has been reported by multiple studies that the level of knowledge on HNCs was affected by age and gender.11,14,18 However, in a published study, the authors reported no significant differences in the knowledge level between different age groups.14 Furthermore, participants with a diploma had greater knowledge regarding tobacco and excessive alcohol use as a potential risk factor. Similarly, in a Saudi study, there was a significant association between the level of knowledge and education status (p<0.01). Participants who had completed high school or university had the greatest knowledge levels, while illiterate respondents had the lowest knowledge scores.14 In addition, these findings were supported by the results of different studies.11,13,18 While this study included a large number of respondents, future large-scale studies are recommended to allow for further generalizability and reliability of our findings. Another limitation that may manipulate the study results was the format of the questions; different word selection may alter the meaning. Nonetheless, this study highlighted and provided basic data for one of the major public health concerns.

In conclusion, this study revealed that there was a lack of knowledge and awareness of the clinical features and risk factors of HNCs among the Saudi population. Thus, public health authorities are urged to introduce prompt preventive measures, such as periodic screening programs for HNCs. In addition, public educational campaigns would aid in enhancing knowledge and understanding of HNCs among the Saudi population.

Further and more importantly, mass media educational programs should promote public awareness of HNCs through television, radio, and newspapers. Such recommendations could assure earlier identification of HNCs among the general population as well as improve disease survival and treatment outcomes.