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ISSN: 2161-0711
Journal of Community Medicine & Health Education

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Knowledge and Practice towards Lung Cancer among University Students

Redhwan Ahmed Al-Naggar*

Community Medicine Department, International Medical School, Management and Science University, Malaysia

Corresponding Author:
Redhwan Ahmed Al-Naggar
Community Medicine Department
International Medical School
Management and Science University, Malaysia
E-mail: [email protected]

Received Date: March 07, 2012; Accepted Date: March 28, 2012; Published Date: March 30, 2012

Citation: Al-Naggar RA (2012) Knowledge and Practice towards Lung Cancer among University Students. J Community Med Health Edu 2:134. doi:10.4172/jcmhe.1000134

Copyright: © 2012 Al-Naggar RA. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Objective: The objective of this study was to determine the knowledge and practice towards lung cancer among university students.

Methodology: Cross-sectional study was conducted among Management and Science University students (MSU). Two hundred and thirteen students were selected randomly from all faculties. The data were collected from the lectures halls, library and university café. Data analysis was conducted using SPSS version 13, t-test was used for univariate analysis. Multiple linear regressions were used for multivariate analysis.

Results: A total number of 213 university students participated in this study. The majority of them females, 22 years old and younger, Malays, single, from non-medical schools and with family monthly income 3000 Ringgit Malaysia (RM) and less (57.3%, 65.3%, 78.4%, 97.2%, 55.9%, 59.6%, and 66.7%; respectively). The majority of the participants mentioned that they knew about lung cancer (93%). Regarding the knowledge about risk factors towards lung cancer, they knew that the risk factors of lung cancer are: smoking (100%), eating chili and deep fried food (68.5%), air pollution (89.2%), alcohol (75.6%), occupational hazard (75.6%), passive smoking (90.1%), exercise reduce the risk of lung cancer (83.1%) and lung cancer is inherited (51.6%). Regarding the practice towards lung cancer prevention, the majority of the participants mentioned that they are not smokers neither alcohol drinkers (90.1%, 94.8%; respectively). Regarding the factors associated with knowledge about lung cancer, marital status, type of faculty, and type of semester significantly influence the knowledge of university students (p=0.014, p=0.001, p=0.028; respectively) in univariate analysis. For multivariate analysis, only types of faculty significantly influence the knowledge of the university students towards lung cancer (p=0.001).

Conclusion: The university students had good knowledge about risk factors. Types of faculty significantly influence the knowledge of the university students towards lung cancer.

Keywords

Knowledge; Practice; Lung cancer; University students

Introduction

Lung cancer is the leading cancer worldwide in terms of incidence and mortality [1]. Although lung cancer remains the leading cause of cancer-related mortality in the United States, its incidence is decreasing [2]. It may due to better prevention, awareness and early detection.

Tobacco use is the main risk factor for lung cancer [3]. Radon, arsenic, asbestos, heavy metals-chromium VI, nickel, cadmiumcoke oven and coal gasification fumes and soot are well-known lung carcinogens [4-6]. Several studies reported that high fat consumption increases the risk of lung cancer [7,8]. Exposure to incense smoke and exposure to fry pan fumes were associated with a higher risk for lung cancer due to the presence of combustion-related carcinogens [9-13]. Another study showed that heavy pesticide usage was associated with increase of lung cancer [14]. Another study showed significant correlations between cancer risk and the use of insecticides, fungicides, herbicides, nematicides and all types of pesticides [15]. Potent insecticides, such as pyrethroids, which account for more than 30% of global use, are known to be carcinogenic [16]. Occupational exposures in industrial facilities have been held to account for a further 9% to 15% of cases [17].

Several studies have reported an association between risk of lung cancer and proximity to certain industries, such as iron and steel foundries or chemical, petrochemical and coke oven plants [18-21]. Another study reported increased lung cancer mortality in the proximity of a combustion installation located in Asturias [22]. Urban air pollution, particularly due to traffic and heating related emissions has also come to be viewed as a risk factor for developing lung cancer [23-25]. Several studies reported a link between several air pollution indicators and cancer risk among urban residents [26-28]. An Italian study showed that an increased risk for lung cancer among city residents living in the most polluted areas versus those living in less polluted areas [29].

There have been many studies investigating the relation between nutrition and lung cancer [30-36]. Studies suggested that increased vegetable and fruit intake is associated with a lower risk for lung cancer. For instance, Koo [30] reported that consumption of carrots, leafy green vegetables, fresh fruits, bean curd and fresh fish was associated with a lower risk for lung cancer.

There is no previous study which measured the knowledge and practice towards lung cancer among university students in Malaysia. Therefore, this study aimed to fill the gap among university students in Malaysia. The objective of this study was to determine the knowledge and practice towards lung cancer among university students.

Methodology

Cross-sectional study was conducted among Management and Science University (MSU) students. Students from all faculties namely: the International Medical School (IMS), the Faculty of Business and Management Professional (FBMP), Faculty of Health and Life Science (FHLS) and Faculty of Informative Science and Engineering (FISE) were selected randomly and included in this study from semester one through semester six. The protocol of this study was approved by the ethics committee of Management and Science University (MSU). The self- administered questionnaires were distributed randomly to all faculties’ students. The inclusion criteria were students who are able to speak English, 18 years old and above. However the exclusion criteria were students, not able to communicate in English and below 18 years of age. The scoring system was created based on the correct answer each correct answer was given one score and the wrong answer given zero score and then sum all the scores. Those who have scores below 5 have a poor knowledge and more than 5 score have a good knowledge. Data analysis was conducted by SPSS version 13, t-test. Multiple linear regressions were used for multivariate analysis.

Results

A total number of 213 university students were participated in this study. The majority of them were females, 22 years old and younger, Malays, single, from non-medical schools and with family monthly income 3000 Ringgit Malaysia and less (57.3%, 65.3%, 78.4%, 97.2%, 55.9%, 59.6%, 66.7%; respectively) (Table 1). Regarding the factors associated with knowledge about lung cancer, marital status, type of faculty and type of semester significantly influenced the knowledge of university students (p=0.014, p=0.001, p=0.028; respectively) (Table 1).

Variable Categories Number (N) Percentage (%) p value
Sex Male
Female
91
122
42.7
57.3
0.148
Age ≤22
>22
139
74
65.3
34.7
0.54
Race Malay
Non-Malay
167
46
78.4
21.6
0.95
Marital status Single
Married
207
6
97.2
2.8
0.014
Faculty Medical
Non-Medical
94
119
44.1
55.9
0.001
Semester Juniors
Seniors
86
127
40.4
59.6
0.028
Monthly family income ≤3000
>3000
142
71
66.7
33.3
0.11

Table 1: Socio-demographic characteristics and associated factors of knowledge of university students towards lung cancer (n=213).

Regarding the knowledge about risk factors about lung cancer, the majority of the participants mentioned that they knew about lung cancer (93%) and they knew that the risk factors of lung cancer are: smoking (100%), eating chili and deep fried food (31.5%), air pollution (89.2%), alcohol (75.6%), occupational hazard (75.6%) passive smoking (90.1%), exercise reduce the risk of lung cancer (83.1%), and lung cancer is inherited (51.6%) (Table 2). Regarding the practice towards lung cancer prevention, the majority of the participants mentioned that they are not smokers neither alcohol drinkers (90.1%, 94.8%; respectively) (Table 2).

Variable Categories Number (N) Percentage (%)
know about lung cancer Yes
No
198
15
93
7
Smoking is a risk factor for lung cancer Yes
No
213
0
100
0
Chili and deep fried food are risk factors for lung cancer  Yes
No
67
146
31.5
68.5
Alcohol is a risk factor of lung cancer Yes
No
161
52
75.6
24.4
Air pollution is a risk factor for lung cancer Yes
No
190
23
89.2
10.8
Occupational exposure is a risk factor for lung cancer Yes
No
161
52
75.6
24.4
Passive smoking is a risk factor for lung cancer Yes
No
192
21
90.1
9.9
Exercise reduce lung cancer Yes
No
177
36
83.1
16.9
Lung cancer inherited Yes
No
103
110
48.4
51.6
Currently smoking Yes
No
21
192
9.9
90.1
Currently drinking alcohol Yes
No
11
202
5.2
94.8

Table 2: knowledge and Practice toward lung cancer among university students (n=213).

For multivariate analysis, only type of faculty significantly influenced the knowledge of the university students towards lung cancer. Those from medical school had higher knowledge with 0.37 higher point than those from non medical schools (p=0.001) (Table 3).

  B SE Beta p value
Gender Male (reference) Female 0.098 0.094 0.69 0.311
Marital status Single (reference) Married 0.348 0.275 0.048 0.206
Faculty Medical (reference) Non-Medical -0.372 0.095 0.270 0.001
Family history of lung cancer Yes (reference) No 0.244 0.162 0.099 0.135

Table 3: Prediction Model for factors associated with knowledge towards lung cancer among university students by Multiple Linear Regression.

Discussion

The participants in this study had a good knowledge in terms of lung cancer (93%) and the risk factors of lung cancer. This may due to the media attention to smoking and also to the anti-smoking program “Tak-nak” which is a very effective and with wider national spread. A Jordanian study reported that Knowledge of lung cancer was almost correct among university students [37]. Similar studies showed higher levels of knowledge related to smoking hazards among university students [38,39].

In this study, the majority of the participants (89.2%) mentioned that air pollution is one of the risk factors of lung cancer. Similar findings reported by Kofahi and Haddad [37] that 90.3% of the study participants were aware of the cancer risk from air pollution. Price and Everett [40] reported that the majority of the study participants were aware that air pollution is a lung cancer risk factor (79%).

In this study, about 31.5% of the study participants mentioned that eating chili and deep fried is the risk factor of lung cancer. Several studies reported that deep fried cooking and chili have been associated with an increased lung cancer risk [41-44].

Smoking is a well recognized risk factor in both men and women for lung cancer [45]. In this study, all the study participants knew that the risk factor of lung cancer is smoking (100%). Siahpush et al. [46] reported that smoking causes lung cancer. The effect of pipe and cigar use on the risk of lung cancer is similar to that of light cigarette smoking [47,48]. Similar study reported that the majority of the participants (82.1%) knew that smoking is a risk factor for lung cancer [49].

In this study, 90.1% of the study participants mentioned that second hand smoking is one of the risk factors of lung cancer. The causal association that has been established between secondhand tobacco smoking and lung cancer can explain 1.6% of lung cancers [50]. Results from a meta-analysis [51] and a comprehensive review [52] showed a relative risk between 1.14 to 5.20 in people who had never smoked but who lived with a smoker. A more recent study reported that passive smoking during childhood increased lung cancer risk in adulthood by 3.6 fold [53]. However, Kofahi and Haddad [37] reported that 58% of university students did not agree that secondhand smoke is a cancer risk.

In this study the majority of the study participants (75.6%) mentioned that alcohol is one of the risk factors of lung cancer. From a pooled analysis of 7 prospective studies with 399,767 participants and 3137 lung cancer cases, a slightly greater risk of lung cancer was indicated among people who consumed at least 30 g/d of alcohol than among those who abstained from alcohol [54].

In this study 75.6% of the study participants mentioned that occupational exposure is one of the risk factors of lung cancer. Many work settings could have exposed workers to carcinogens, leading to an increased risk of lung and other cancers. Crystalline silica and chrysotile asbestos are well known human carcinogens; as expected, workers exposed to silica dust and asbestos fiber are at a higher risk of developing lung cancer. Uranium miners and nuclear plant workers are also known to have an increased cancer risk because of exposure to radioactive particulate mass [55]. Similar findings reported from mainland China, Hong Kong and Singapore showed significant relationships between smoking habit and lung cancer [10,45,56]. At present, many occupations, industries, and specific chemical substances have been associated with a well established or suspected excess risk of lung cancer [57,58].

In this study 51.6% of the study participants mentioned that family history of lung cancer is one of the risk factors of risk factors. A reported family history of cancer or lung cancer increased the risk of lung cancer significantly in men and a similar trend in women. Most of the published literatures have shown a smoking-adjusted increased risk of lung cancer by about 2-4 fold associated with a family history of lung cancer [59-62]. The issue of genetic predisposition of lung cancer is being actively investigated by many researchers at present [63-65].

Majority of the students reported that exercise reduce the risk of lung cancer (83.1%). Regarding the practice towards lung cancer prevention, the majority of the participants mentioned that they are not smokers neither alcohol drinkers (90.1%, 94.8%; respectively).

Regarding the factors associated with knowledge about lung cancer, marital status, type of faculty, and type of semester significantly influence the knowledge of university students (p=0.014, p=0.001, p=0.028; respectively). For multivariate analysis, only types of faculty significantly influence the knowledge of the university students towards lung cancer (p=0.001). Medicine students had greater knowledge about lung cancer than did those in other specialties because of the emphasis of their curricula on health information, as was also noted by Abolfotouh et al. [66].

Finally, limitation of this study should be noted. Restricting the study to a single university limits generalizability to the total population of university students. Therefore, investigation of the perceptions of lung cancer and smoking with a larger sample representing all universities is worthwhile.

References

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