Article Figures & Data
Tables
Characteristics 2006-2008 (n=464) 2016-2018 (n=952) P-value Gender Male 184 (39.7) 367 (38.5) 0.6890 Female 280 (60.3) 585 (61.4) Median age (range) 54 (34-7) 56 (26-8) 0.3840 Marital status (n=1408) Married 337 (73.9) 654 (68.7) 0.0857 Single 43 (9.4) 117 (12.3) Separated 1 (0.2) 14 (1.5) Divorced 13 (2.8) 28 (2.9) Widow 62 (13.6) 139 (14.6) Level of education (n=1404) Illiterate 51 (11.3) 100 (10.5) <0.0001 Primary 73 (16.1) 162 (17.0) Intermediate 188 (41.6) 280 (29.4) Secondary 71 (15.7) 243 (25.5) Higher education 69 (15.3) 167 (17.5) Work status (n=1358) No job 328 (70.7) 752 (79.0) 0.0006 Job 136 (29.3) 200 (21.0) Disease type (n=1416), as reported by patients Solid tumor 342 (73.7) 770 (80.9) 0.0020 Hematological malignancy 122 (26.3) 182 (19.1) Treatment type Surgery 251 (54.09) 527 (55.36) 0.6541 Radiation 79 (17.03) 417 (43.80) <0.0001 Chemotherapy 423 (91.16) 780 (81.93) <0.0001 SCT 0 (0.00) 87 (9.14) <0.0001 Used CAM Yes 449 (96.8) 751 (78.9) <0.0001 No 15 (3.2) 201 (21.1) Values are presented as a number and (%). SCT: stem cell transplant, CAM: complementary and alternative medicine
Perceptions n (%) Difference p-value Cohort 1 Cohort 2 Cancer is contagious: Yes (sure, most of the time) 2 (0.4) 7 (0.7) 0.0071 Occasional (occasional, rarely) 0 (0.0) 15 (1.6) No 462 (99.6) 930 (97.7) Cancer is curable: Yes (sure, most of the time) 384 (89.5) 766 (80.5) <0.0001 Occasional (occasional, rarely) 35 (8.2) 109 (11.4) No 10 (2.3) 77 (8.1) Cause of cancer: Mythical causes* Jealousy/envy 138 (29.7) 53 (5.6) <0.0001 Depression 47 (10.1) 39 (4.1) <0.0001 Fate 115 (24.8) 193 (20.3) 0.0534 Evil eye 6 (1.3) 315 (33.1) <0.0001 Medication** 7 (1.5) 53 (5.6) 0.0004 Evil spirit 1 (0.2) 49 (5.1) <0.0001 Curse 1 (0.2) 16 (1.7) 0.0175 Surgery 1 (0.1) 2 (.04) 0.2516 Trauma 3 (0.6) 2 (.02) 0.3381 Stress 10 (2.2) 7 (0.7) 0.0213 Allergy 6 (1.3) 6 (0.6) 0.2233 Giving birth 3 (0.6) 5 (0.5) 0.7218 Scientific causes Diet 38 (8.2) 98 (10.3) 0.2071 Infection 7 (1.5) 43 (4.2) 0.0040 Genetic 7 (1.5) 34 (3.6) 0.0298 Smoking 6 (1.3) 43 (4.5) 0.0018 Exposure to radiation 5 (1.1) 37 (3.9) 0.0035 Environment 2 (0.4) 7 (0.7) 0.7262 Cause of cancer: (there is 88 missing values in cohort 2) Scientific causes† 63 (13.6) 224 (25.9) <0.0001 Mythical causes‡ 310 (66.8) 497 (57.5) Lack of knowledge§ 91 (19.6) 143 (16.5) Values are presented as a number and (%). Chi-square or Fisher exact test for categorical factors as appropriate. Results from fisher’s exact test were used whenever at least one of the cells has an expected count of <5 of the cut-off or significance level of p<0.05. *The authors considered all the reasons that doesn’t have strong scientific proof as mythical. **The authors agree that some of the medications may cause cancer but not all. Since the majority of medications do not cause cancer, so we classified by the majority. †Among the multiple answers of the patient if selected one scientific cause, then this case is included in this category. ‡If all of the reported cases by the patients are myths then he is included in this category. §If the patient reported I don’t know.
- Table 3
- Multivariate multinomial logistic regression analysis: predictors of non-scientific vs. scientific (conditional on the event that the outcome was one of those 2 categories).
Effects Beta Odds ratio Lower confidence interval Upper confidence interval P-value Age 0.00569 1.006 0.996 1.015 0.2412 Gender: female vs. male 0.4657 1.593 1.183 2.145 0.0021 Marital status: married vs. single -0.1652 0.848 0.615 1.168 0.3120 Educational level: educated vs. uneducated -0.4200 0.657 0.408 1.058 0.0842 Currently working: yes vs. no -0.4198 0.657 0.471 0.916 0.0133 Cancer type: hematological malignancy vs. solid tumor -0.1733 0.841 0.555 1.274 0.4140 CAM use: yes vs. no -0.2522 0.777 0.518 1.165 0.2219 Infectious disease: occasional vs. no -0.6215 0.537 0.158 1.822 0.3187 Infectious disease: yes vs. no -1.1878 0.305 0.059 1.565 0.1547 Disease can be cured: occasional vs. no 1.2805 3.599 1.544 8.387 0.0030 Disease can be cured: yes vs. no 0.6858 1.985 0.973 4.050 0.0594 Surgery: yes vs. no -0.0401 0.961 0.699 1.319 0.8043 Radiation: yes vs. no 0.0569 1.059 0.775 1.446 0.7204 Chemotherapy: yes vs. no 0.1824 1.200 0.812 1.774 0.3599 SCT: yes vs. no -0.00540 0.995 0.540 1.832 0.9862 Cohort 2 vs. cohort 1 -0.8646 0.421 0.297 0.598 <.0001 The results of the multinomial logistic regression where the cancer cause (scientific, mythical, and lack of knowledge) answer was modeled as the dependent variable with scientific as reference group and all the factors shown in the table were included as the independent variables. CAM: complementary and alternative medicine, SCT: stem cell transplant, vs.: versus
- Table 4
- Multivariate multinomial logistic regression analysis: predictors of lack of knowledge vs. scientific answer (conditional on the event that the outcome was one of those 2 categories).
Effects Beta Odds ratio Lower confidence interval Upper confidence interval P-value Age 0.0222 1.022 1.010 1.035 0.0006 Gender: female vs. male 0.4414 1.555 1.048 2.306 0.0282 Marital status: married vs. single -0.0883 0.915 0.602 1.393 0.6799 Educational level: educated vs. uneducated -0.2339 0.791 0.417 1.501 0.4738 Currently working: yes vs. no -0.2528 0.777 0.497 1.214 0.2673 Cancer type: hematological malignancy vs. solid tumor 0.2609 1.298 0.765 2.203 0.3336 CAM use: yes vs. no -0.8147 0.443 0.272 0.722 0.0011 Infectious disease: occasional vs. no -0.5145 0.598 0.109 3.278 0.5535 Infectious disease: yes vs. no -0.0172 0.983 0.181 5.329 0.9841 Disease can be cured: occasional vs. no 0.2897 1.336 0.482 3.703 0.5775 Disease can be cured: yes vs. no -0.1702 0.844 0.362 1.967 0.6937 Surgery: yes vs. no -0.1636 0.849 0.561 1.284 0.4383 Radiation: yes vs. no 0.3840 1.468 0.979 2.201 0.0630 Chemotherapy: yes vs. no -0.0773 0.926 0.561 1.527 0.7622 SCT: yes vs. no 0.0106 1.011 0.451 2.264 0.9794 Cohort 2 vs. cohort 1 -0.8422 0.431 0.273 0.679 0.0003 The results of the multinomial logistic regression where the cancer cause (scientific, mythical, and lack of knowledge) answer was modeled as the dependent variable with scientific as reference group and all the factors shown in the table were included as the independent variables. CAM: complementary and alternative medicine, SCT: stem cell transplant, vs.: versus
- Table 5
- Multivariate ordinal logistic analysis to correlate the probability of getting “cancer is contagious” answer with the demographic information. Probabilities modeled are cumulated over the lower ordered values (no, occasional, yes).
Effects Odds ratio Lower confidence interval Upper confidence interval P-value Age 1.022 0.993 1.051 0.1358 Gender: female vs. male 1.289 0.539 3.083 0.5677 Marital status: married vs. single 0.363 0.117 1.126 0.0794 Educational level: educated vs. uneducated 0.287 0.038 2.194 0.2291 Currently working: yes vs. no 9.986 1.283 77.740 0.0280 Cancer type: hematological malignancy vs. solid tumor 2.057 0.486 8.702 0.3270 Cancer cause: scientific vs. non-scientific 0.524 0.214 1.287 0.1588 Disease can be cured: occasional vs. no 1.007 0.158 6.431 0.9945 Disease can be cured: yes vs. no 1.548 0.338 7.099 0.5737 Surgery: yes vs. no 1.415 0.585 3.424 0.4412 Radiation: yes vs. no 1.225 0.508 2.955 0.6521 Chemotherapy: yes vs. no 1.295 0.462 3.636 0.6231 SCT: yes vs. no 1.825 0.203 16.418 0.5915 Cohort 2 vs. cohort 1 0.215 0.049 0.953 0.0430 SCT: stem cell transplant, vs.: versus
- Table 6
- Multivariate ordinal logistic analysis to correlate the probability of getting “cancer is curable” answer with the demographic information. Probabilities modeled are cumulated over the lower ordered values (no, occasional, yes).
Effects Odds ratio Lower confidence interval Upper confidence interval P-value Age 1.001 0.992 1.011 0.8027 Gender: female vs. male 0.988 0.722 1.350 0.9376 Marital status: married vs. single 0.804 0.587 1.102 0.1755 Educational level: educated vs. uneducated 0.808 0.517 1.264 0.3498 Currently working: yes vs. no 1.380 0.971 1.960 0.0727 Cancer type: hematological malignancy vs. solid tumor 1.010 0.661 1.541 0.9648 Cancer cause: scientific vs. non-scientific 0.621 0.423 0.913 0.0153 Disease can be cured: occasional vs. no 1.205 0.341 4.259 0.7720 Disease can be cured: yes vs. no 1.387 0.266 7.237 0.6980 Surgery: yes vs. no 0.791 0.574 1.091 0.1524 Radiation: yes vs. no 1.075 0.786 1.470 0.6514 Chemotherapy: yes vs. no 1.080 0.720 1.621 0.7083 SCT: yes vs. no 0.729 0.382 1.389 0.3359 Cohort 2 vs. cohort 1 2.303 1.586 3.344 <.0001 SCT: stem cell transplant, vs.: versus