Knowledge, attitudes, beliefs and practices of schoolgoing adolescents living in Gauteng in relation to common cancers and cancer risks

Abstract

Aim: The overall aim of the study was to determine the extent of general knowledge, beliefs, attitudes and practices of Gauteng adolescents towards cancer. Objectives: The specific objectives were to: 1) ascertain cancer¬related knowledge, beliefs, attitudes and practices of school-going adolescents; 2) obtain previous information on cancer and reported family history of cancer; 3) investigate the relationships among knowledge, attitudes and behaviour; 4) investigate the effects of gender and of type of schools on cancer knowledge. Population and Method: This study was a cross-sectional survey of Knowledge, Attitudes, Beliefs and Practices (KABP), personal health behaviours and of demographic and psychological characteristics of a specific group of adolescents in Gauteng. A questionnaire survey was conducted, and a total of 2278 pupils in Grade 10, from 681 schools in Gauteng, participated. The questionnaire was designed to obtain information from the pupils on the following: gender, list of known cancers, family cancer history, previously received information on cancer, true and false statements regarding the aetiology, signs and symptoms of skin cancer, breast cancer, cervical cancer, head and neck cancer and lung cancer. It also consisted of 10 statements regarding pupils' attitude towards cancer and questions on practices related to risks of developing cancer (smoking, sunblock use and breast-feeding) to which pupils were asked to respond. Descriptive statistics were the first step in data analysis. Thereafter, integrated multivariate statistical procedures (e.g. analysis of co¬variance and factor analysis) were used to analyse the data further. Results: Demographic Information: There were 2278 pupils who completed the questionnaire of those who indicated their gender 1267 (55.6%) were females and 958 (42.1%) males. The pupils' age ranged from 13 to 24 years (average age = 16.5 years, standard deviation (sd) = 1.5). Pupils were from different types of schools formerly known as the Department of Education and Training (DET = 1120); Transvaal Education Department (TED = 663); House of Representatives (HOR = 53); House of Delegates (HOD = 40); and Independent Ordinary (10 = 340). Some pupils had previously received cancer information (48.6%) while others indicated that they had a family related history of cancer (23.6%). Significantly more females reported having received cancer information or having a history of cancer in the family than males (p < 0.001). Television (34.8%) and parents (19.2%) appeared to be the main sources of cancer information. Knowledge About Signs, Symptoms and Aetiology of Cancer: Average knowledge scores among the pupils were low. Females were more knowledgeable than males with regard to breast cancer (p < 0.001). Pupils who received cancer information or who reported a family history of cancer were more knowledgeable than those who did not (p < 0.001). The knowledge scores were significantly different between different types of schools; Transvaal Education Department (TED), also known today as public schools, tended to have better knowledge of the signs, symptoms and aetiology of the five cancers included in the questionnaire. Attitudes Towards Cancer Risks: Pupils indicated a favourable attitude towards possible cancer risks, meaning that they would avoid doing things that were seen as possible cancer risk factors. Factor Analysis demonstrated a negative correlation between Factor I (socially acceptable behaviour) and Factor II (socially unacceptable behaviour), meaning that pupils were able to identify the risk factors associated with cancer development even if they were stated in a positive way in the questionnaire. Pupils separated the attitudes into two groups either socially acceptable behaviour or socially unacceptable behaviour. Practices: Smoking - More males (26.9%) than females (10.9%) indicated that they smoke (p < 0.001). The number of pupils who indicated that smoking was important to them was 27%. Sunblock - More females (41.7%) used sunblock than males (34%) (p < 0.001). The amount of pupils who used sunblock were 38.2%. Pupils who used sunblock demonstrated higher knowledge scores regarding the signs, symptoms and aetiology of cancer. Conclusions: Pupils in grade 10 living in Gauteng are not well informed on the aetiology, signs and symptoms of cancer or cancer risks. Females are more informed than males with regards to cancer. Types of schools types differ with regards to cancer knowledge. School from the public sector (TED schools) showed higher knowledge scores than private schools (10 schools). Pupils who received cancer information previously or who reported a family history of cancer were more knowledgeable than other pupils. Recommendations: The implementation of Cancer Educational programmes should be considered by the Gauteng Education Department. Future development of educational programmes are needed to include cancer education into the current 'life-skills' training programmes.