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Journal of Peking University (Health Sciences) ›› 2020, Vol. 52 ›› Issue (2): 323-331. doi: 10.19723/j.issn.1671-167X.2020.02.021

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Awareness and knowledge of oral cancer among 1 483 residents in Beijing

Xing-hong ZHOU1,Ying HUANG1,Chao YUAN2,Shu-guo ZHENG2,Jie ZHANG1,△(),Jian-guo ZHANG1   

  • Received:2019-10-09 Online:2020-04-18 Published:2020-04-18
  • Contact: Jie ZHANG E-mail:zhangjie06@126.com

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Abstract:

Objective: To investigate the oral cancer awareness, its related knowledge among residents in Beijing.Methods: A questionnaire survey was conducted among Beijing residents (non-medical related personnel) on the knowledge of oral cancer and its prevention and treatment.Results: A total of 1 483 questionnaires were completed, including 663 males (44.6%) and 820 females (55.3%), ranging from 15 to 91 years. Lung cancer was the most mentioned as heard of (94.3%), followed by liver cancer (92.5%) and gastric cancer (92.4%), while oral cancer was the least heard of (47.7%). Family account (P=0.015), residence (P=0.028), income (P=0.024), frequency of brushing teeth (P<0.001), frequency of mouth self-examination (P<0.001) and chew betel nut chewing (P=0.015) were significantly associated with oral cancer awareness. Most respondents learned about oral cancer from TV programs (24.3%), phone news (22.0%), WeChat (11.3%) and chatting with friends or people around (14.6%). Only 34.9% knew that smoking was a risk factor of oral cancer, and this knowledge was associated with age (P=0.011), education level (P=0.007), frequency of brushing teeth (P<0.001), and frequency of mouth self-examination (P=0.002). Only 23.5% knew that drinking was a risk factor of oral cancer, and this knowledge was associated with education level (P=0.002), residence (P=0.022), frequency of brushing teeth (P=0.009), and frequency of mouth self-examination (P=0.005). Only 35.1% knew that betel nut chewing was a risk factor for oral cancer, and this know-ledge was associated with age (P=0.040), education level (P=0.002), family account (P=0.002), income (P=0.005), frequency of brushing teeth (P=0.001), frequency of mouth self-examination (P<0.001), and betel nut chewing (P=0.002). Only 35.7%, 21.6% and 16.9%, respectively, knew that long-term unhealed ulcers, white plaques and red plaques in the mouth were the early signs of oral cancer.Conclusion: This survey demonstrates a general lack of public awareness and knowledge about signs and symptoms of oral cancer, and its risk factors and treatment. Some residents have not formed good oral hygiene habits. Specific measures should be taken to improve the public awareness of oral cancer and related knowledge about prevention and treatment, such as the use of various new media for the public to promote their oral health knowledge, in order to reduce the incidence of oral cancer, improve early attendance rates and the patients' survival rates.

Key words: Mouth neoplasms, Surveys and questionnaires, Cognition, Beijing

CLC Number: 

  • R739.8

Table 1

Socio-demographic characteristic"

Variable n (%)
Gender
Male 663 (44.7)
Female 820 (55.3)
Age
15-29 years 653 (44.0)
30-44 years 522 (35.2)
45-59 years 189 (12.7)
≥60 years 119 (8.0)
Education
Primary or below 40 (2.7)
Middle high 93 (6.3)
High or technical school 202 (13.6)
University or college 892 (60.1)
Graduate or higher 256 (17.3)
Account
Rural 435 (29.3)
Urban 1 048 (70.7)
Residence
Downtown 233 (15.7)
Suburbs 657 (44.3)
Outer suburbs 528 (35.6)
Rural 65 (4.4)
Marital status
Married 791 (53.3)
Single 650 (43.8)
Widow/Divorced/Separated 42 (2.8)
Income
<20 000 yuan 509 (34.3)
20 000-40 000 yuan 301 (20.3)
40 000-60 000 yuan 267 (18.0)
>60 000 yuan 406 (27.4)
Medical insurance
Yes 1 371 (92.4)
No 112 (7.6)

Figure 1

Awareness of different cancers"

Table 2

Univariate analysis----factors associated with awareness rate, risk factors and early signs of oral cancern(%)"

Variable n Awareness rate Early signs Risk factors
Ulcer White plaques Red plaques Smoking Chewing betel nut Drinking
Total 707 (47.7) 530 (35.7) 320 (21.6) 251 (16.9) 518 (34.9) 520 (35.1) 348 (23.5)
Age
15-29 years 653 324 (49.6) 249 (38.1) 146 (22.4) 117 (17.9) 236 (36.1) 247 (37.8) 162 (24.8)
30-44 years 522 243 (46.6) 186 (35.6) 117 (22.4) 85 (16.3) 201 (38.5) 191 (36.6) 131 (25.1)
45-59 years 189 77 (40.7) 60 (31.7) 33 (17.5) 27 (14.3) 45 (23.8) 50 (26.5) 31 (16.4)
≥60 years 119 63 (52.9) 35 (29.4) 24 (20.2) 22 (18.5) 36 (30.3) 32 (26.9) 24 (20.2)
P 0.102 <0.001 0.040 0.874 0.011 0.040 0.200
Education
Primary or below 40 22 (55.0) 10 (25.0) 10 (25.0) 11 (27.5) 12 (30.0) 12 (30.0) 10 (25.0)
Middle high 93 35 (37.6) 23 (24.7) 12 (12.9) 11 (11.8) 20 (21.5) 18 (19.4) 12 (12.9)
High or technical school 202 85 (42.1) 54 (26.7) 40 (19.8) 34 (16.8) 55 (27.2) 51 (25.2) 38 (18.8)
University or college 892 437 (49.0) 340 (38.1) 192 (21.5) 150 (16.8) 328 (36.8) 336 (37.7) 220 (24.7)
Graduate or higher 256 128 (50.0) 103 (40.2) 66 (25.8) 45 (17.6) 103 (40.2) 103 (40.2) 68 (26.6)
P 0.080 <0.001 0.084 0.498 0.007 0.002 0.002
Account
Rural 435 186 (42.8) 137 (31.5) 75 (17.2) 60 (13.8) 134 (30.8) 123 (28.3) 92 (21.1)
Urban 1 048 521 (49.7) 393 (37.5) 245 (23.4) 191 (18.2) 384 (36.6) 397 (37.9) 256 (24.4)
P 0.015 0.022 0.012 0.015 0.119 0.002 0.174
Residence
Downtown 233 121 (51.9) 86 (36.9) 55 (23.6) 46 (19.7) 81 (34.8) 81 (34.8) 66 (28.3)
Suburbs 657 331 (50.4) 249 (37.9) 149 (22.7) 114 (17.4) 251 (38.2) 260 (39.6) 159 (24.2)
Outer suburbs 528 229 (43.4) 178 (33.7) 101 (19.1) 81 (15.3) 167 (31.6) 164 (31.1) 111 (21.0)
Rural 65 26 (40.0) 17 (26.2) 15 (23.1) 10 (15.4) 19 (29.2) 15 (23.1) 12 (18.5)
P 0.028 0.012 0.011 0.372 0.176 0.056 0.022
Income
<20 000 yuan 509 230 (45.2) 167 (32.8) 98 (19.3) 74 (14.5) 163 (32.0) 164 (32.2) 124 (24.4)
20 000-40 000 yuan 301 132 (43.9) 95 (31.6) 62 (20.6) 47 (15.6) 100 (33.2) 95 (31.6) 61 (20.3)
40 000-60 000 yuan 267 126 (47.2) 88 (33.0) 53 (19.9) 50 (18.7) 90 (33.7) 87 (32.6) 59 (22.1)
>60 000 yuan 406 219 (53.9) 180 (44.3) 107 (26.4) 80 (19.7) 165 (40.6) 174 (42.9) 104 (25.6)
P 0.024 <0.001 0.024 0.177 0.069 0.005 0.491
Frequency of brushing teeth
Once in the morning 199 62 (31.2) 47 (23.6) 28 (14.1) 19 (9.5) 43 (21.6) 42 (21.1) 26 (13.1)
Once in the evening 48 23 (47.9) 14 (29.2) 10 (20.8) 5 (10.4) 17 (35.4) 15 (31.3) 11 (22.9)
Twice a day 1 174 584 (49.7) 437 (37.2) 259 (22.1) 208 (17.7) 429 (36.5) 432 (36.8) 290 (24.7)
Over three times 62 38 (61.3) 32 (51.6) 23 (37.1) 19 (30.6) 29 (46.8) 31 (50.0) 21 (33.9)
P <0.001 <0.001 0.003 0.001 <0.001 0.001 0.009
Mouth self-examination
Never 332 124 (37.3) 81 (24.4) 44 (13.3) 38 (11.4) 80 (24.1) 76 (22.9) 57 (17.2)
Nearly every day 161 84 (52.2) 59 (36.6) 37 (23.0) 33 (20.5) 60 (37.3) 61 (37.9) 48 (29.8)
Three or four times a week 256 146 (57.0) 113 (44.1) 66 (25.8) 56 (21.9) 105 (41.0) 112 (43.8) 72 (28.1)
Occasionally 734 353 (48.1) 277 (37.7) 173 (23.6) 124 (16.9) 273 (37.2) 271 (36.9) 171 (23.3)
P <0.001 <0.001 <0.001 0.004 0.002 <0.001 0.005
Chewing betel nut
No 1 448 686 (47.4) 515 (35.6) 311 (21.5) 246 (17.0) 504 (34.8) 507 (35.0) 339 (23.4)
Yes 25 18 (72.0) 13 (52.0) 6 (24.0) 5 (20.0) 11 (44.0) 11 (44.0) 7 (28.0)
P 0.015 0.204 0.400 0.603 0.204 0.002 0.800

Table 3

Multiple Logistic regression analyses----factors associated with awareness of oral cancer"

Variable n (%) OR 95%CI P
Frequency of brushing teeth
Once in the morning 62 (31.2) 1
Once in the evening 23 (47.9) 1.845 0.960-3.548 0.066
Twice a day 584 (49.7) 1.839 1.304-2.594 0.001
Over three times 38 (61.3) 2.559 1.376-4.758 0.003
Mouth self-examination
Never 124 (37.3) 1
Nearly every day 84 (52.2) 1.455 0.977-2.168 0.065
Three or four times a week 146 (57.0) 1.804 1.272-2.560 0.001
Occasionally 353 (48.1) 1.347 1.018-1.781 0.037
Chewing betel nut
No 686 (47.4) 1
Yes 18 (72.0) 3.303 1.328-8.214 0.010

Figure 2

Source of information about oral cancer"

Table 4

Multiple Logistic regression analyses----factors associated with risk factors of oral cancer"

Variable n (%) OR 95%CI P
Smoking
Frequency of brushing teeth
Once in the morning 43 (21.6) 1
Once in the evening 17 (35.4) 1.695 0.843-3.406 0.139
Twice a day 429 (36.5) 1.574 1.075-2.305 0.020
Over three times 29 (46.8) 2.252 1.203-4.214 0.011
Mouth self-examination
Never 80 (24.1) 1
Nearly every day 60 (37.3) 1.496 0.975-2.294 0.065
Three or four times a week 105 (41.0) 1.743 1.198-2.535 0.004
Occasionally 273 (37.2) 1.526 1.112-2.093 0.009
Chewing betel nut
Account
Rural 123 (28.3) 1
Urban 397 (37.9) 1.447 1.101-1.902 0.008
Income
<20 000 yuan 164 (32.2) 1
20 000-40 000 yuan 95 (31.6) 1.039 0.755-1.428 0.816
40 000-60 000 yuan 87 (32.6) 0.985 0.708-1.369 0.927
>60 000 yuan 174 (42.9) 1.379 1.036-1.836 0.028
Frequency of brushing teeth
Once in the morning 42 (21.1) 1
Once in the evening 15 (31.3) 1.424 0.690-2.937 0.339
Twice a day 432 (36.8) 1.531 1.037-2.260 0.032
Over three times 31 (50.0) 2.266 1.203-4.270 0.011
Mouth self-examination
Never 76 (22.9) 1
Nearly every day 61 (37.9) 1.567 1.017-2.414 0.042
Three or four times a week 112 (43.8) 2.020 1.383-2.949 <0.001
Occasionally 271 (36.9) 1.560 1.132-2.149 0.007
Drinking
Frequency of brushing teeth
Once in the morning 26 (13.1) 1
Once in the evening 11 (22.9) 1.786 0.803-3.976 0.155
Twice a day 290 (24.7) 1.786 1.130-2.824 0.013
Over three times 21 (33.9) 2.482 1.237-4.979 0.010
Mouth self-examination
Never 57 (17.2) 1
Nearly every day 48 (29.8) 1.656 1.042-2.630 0.033
Three or four times a week 72 (28.1) 1.504 0.992-2.280 0.054
Occasionally 171 (23.3) 1.215 0.851-1.734 0.284

Table 5

Multiple Logistic regression analyses----factors associated with early signs of oral cancer"

Variable n (%) OR 95%CI P
Ulcer
Income
<20 000 yuan 167 (32.8) 1
20 000-40 000 yuan 95 (31.6) 1.014 0.739-1.392 0.932
40 000-60 000 yuan 88 (33.0) 1.008 0.727-1.399 0.960
>60 000 yuan 180 (44.3) 1.502 1.130-1.997 0.005
Frequency of brushing teeth
Once in the morning 47 (23.6) 1
Once in the evening 14 (29.2) 1.087 0.527-2.241 0.821
Twice a day 437 (37.2) 1.421 0.976-2.070 0.067
Over three times 32 (51.6) 2.264 1.205-4.256 0.011
Mouth self-examination
Never 81 (24.4) 1
Nearly every day 59 (36.6) 1.454 0.945-2.235 0.088
Three or four times a week 113 (44.1) 1.957 1.345-2.847 <0.001
Occasionally 277 (37.7) 1.559 1.137-2.138 0.006
White plaques
Account
Rural 75 (17.2) 1
Urban 245 (23.4) 1.461 1.050-2.032 0.024
Frequency of brushing teeth
Once in the morning 28 (14.1) 1
Once in the evening 10 (20.8) 1.415 0.622-3.219 0.407
Twice a day 259 (22.1) 1.321 0.841-2.076 0.227
Over three times 23 (37.1) 2.283 1.148-4.538 0.019
Mouth self-examination
Never 44 (13.3) 1
Nearly every day 37 (23.0) 1.672 1.003-2.789 0.049
Three or four times a week 66 (25.8) 1.989 1.267-3.122 0.003
Occasionally 173 (23.6) 1.865 1.268-2.744 0.002
Red plaques
Frequency of brushing teeth
Once in the morning 19 (9.5) 1
Once in the evening 5 (10.4) 1.007 0.354-2.865 0.989
Twice a day 208 (17.7) 1.673 0.998-2.802 0.051
Over three times 19 (30.6) 3.110 1.476-6.553 0.003
Mouth self-examination
Never 38 (11.4) 1
Nearly every day 33 (20.5) 1.591 0.938-2.697 0.085
Three or four times a week 56 (21.9) 1.783 1.118-2.845 0.015
Occasionally 124 (16.9) 1.378 0.923-2.058 0.117
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