Health Literacy and Knowledge of Oral Cancer: A Systematic Review and Meta-Analysis in the Iranian Population
Fahimeh Feili 1, Mohamadali Roozegar 1*
Journal of Angiotherapy 8(10) 1-6 https://doi.org/10.25163/angiotherapy.8109993
Submitted: 31 August 2024 Revised: 25 October 2024 Published: 26 October 2024
Abstract
Background: Health literacy, particularly disease-specific knowledge, is vital for early detection, timely treatment, and effective management of chronic illnesses. Oral cancer (OC), a significant public health concern, is influenced by risk factors such as tobacco use, alcohol consumption, and poor oral hygiene. Despite advancements in treatment, inadequate awareness hinders early diagnosis and effective intervention. This study systematically reviews the knowledge levels of Iranian adults regarding OC to identify gaps and recommend targeted educational strategies. Methods: A systematic review and meta-analysis were conducted to evaluate OC knowledge levels among Iranian adults. Relevant studies published between 2010 and 2024 were identified using comprehensive search strategies in scientific databases. Inclusion criteria encompassed original research articles with specific outcomes on OC knowledge. Data extraction included demographics, sample size, knowledge categories (poor, moderate, good), and assessment tools. Statistical heterogeneity was analyzed using the I² statistic, and pooled prevalence estimates were calculated using Comprehensive Meta-Analysis (CMA) software. Results: Five studies, encompassing 130 to 1,277 participants, were included. The meta-analysis revealed that 24.6% of participants exhibited poor knowledge [CI=10.9–46.4], 12.4% average knowledge [CI=12.1–12.6], and 4.4% good knowledge [CI=0.5–28.6]. Studies varied in their assessment tools and findings. For example, Amanpour et al. (2018) reported that 65% of participants recognized OC symptoms, while 57.2% identified risk factors. Azimi et al. (2019) found that 74.6% of participants had low knowledge of risk factors. Razavi et al. (2024) indicated that 50% demonstrated moderate knowledge, the highest among the studies reviewed. The heterogeneity highlights regional and methodological disparities in knowledge assessment. Conclusion: The findings underscore significant deficiencies in OC knowledge among Iranian adults, particularly regarding risk factors and symptoms. Socioeconomic and educational factors, along with inadequate public health initiatives, contribute to these gaps. Addressing these disparities through culturally tailored educational programs and enhanced health literacy resources is crucial for improving early diagnosis and outcomes. Future research should focus on the design and implementation of targeted interventions to bridge knowledge gaps and reduce the burden of OC in Iran.
Keywords: Oral cancer, Health literacy, Knowledge assessment, Risk factors, Iranian population
References
Abedini, S., Nooradin, S., Mohseni, S., Daryafti, H., Karimi, F., & Ezati-rad, R. (2021). Health literacy and health-promoting behaviors in southern Iran. Journal of Health Literacy, 6(2), 53–60.
Alcaraz, K. I., Wiedt, T. L., Daniels, E. C., Yabroff, K. R., Guerra, C. E., & Wender, R. C. (2020). Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy. CA: A Cancer Journal for Clinicians, 70(1), 31–46. https://doi.org/10.3322/caac.21577
Al-Maweri, S. A., Addas, A., Tarakji, B., Abbas, A., Al-Shamiri, H. M., Alaizari, N. A., et al. (2014). Public awareness and knowledge of oral cancer in Yemen. Asian Pacific Journal of Cancer Prevention, 15(24), 10861–10865. https://doi.org/10.7314/apjcp.2014.15.24.10861
Al-Maweri, S. A., Al-Soneidar, W. A., Dhaifullah, E., Halboub, E. S., & Tarakji, B. (2017). Oral cancer: Awareness and knowledge among dental patients in Riyadh. Journal of Cancer Education, 32(2), 308–313. https://doi.org/10.1007/s13187-017-1109-7
Amanpour, S., Raoof, M., Kakoei, S., Fardisi, S., Iranmanesh, A., & Torabi Parizi, M. (2018). Knowledge of adults’ reading oral cancer in south-east of Iran. Int J Epidemiol Res, 5(1), 19–23.
Ariyawardana, A., & Vithanaarachchi, N. (2005). Awareness of oral cancer and precancer among patients attending a hospital in Sri Lanka. Asian Pacific Journal of Cancer Prevention, 6(1), 58–61. https://doi.org/10.7314/apjcp.2005.6.1.58
Azimi, S., Ghorbani, Z., Tennant, M., Kruger, E., Safiaghdam, H., & Rafieian, N. (2019). Population survey of knowledge about oral cancer and related factors in the capital of Iran. J Cancer Educ, 34(1), 116–123.
Baccolini, V., Isonne, C., Salerno, C., Giffi, M., Migliara, G., Mazzalai, E., et al. (2022). The association between adherence to cancer screening programs and health literacy: A systematic review and meta-analysis. Preventive Medicine, 155, 106927.
Borji, M., Tarjoman, A., Abdi, A., & Otaghi, M. (2019). Efficacy of implementing home care using eye movement desensitization and reprocessing in reducing stress of patients with gastrointestinal cancer. Asian Pac J Cancer Prev, 20(7), 1967–1971.
Chou, C.-W., Lin, C.-R., Chung, Y.-T., & Tang, C.-S. (2023). Epidemiology of oral cancer in Taiwan: A population-based cancer registry study. Cancers, 15(7), 2175.
Cormier, E., Park, H., & Schluck, G. (2020). eMental health literacy and knowledge of common child mental health disorders among parents of preschoolers. Issues in Mental Health Nursing, 41(6), 540–551.
Coughlin, S. S. (2019). Social determinants of breast cancer risk, stage, and survival. Breast Cancer Research and Treatment, 177, 537–548. https://doi.org/10.1007/s10549-019-05244-w
de Mattos Camargo Grossmann, S., Sales, A. C. R., Reis, D. S., Guimarães, J. C., Silva, M. T., de Ceno, P. C. G., et al. (2021). Knowledge of oral cancer by a Brazilian population. Journal of Cancer Education, 36(5), 965–970. https://doi.org/10.1007/s13187-021-01909-7
Erfani, A., Aghamiri, S. H., & Karimi, R. (2024). Investigating the role of hyper density signal length in the middle cerebral artery on the degree of disability of arterial ischemic stroke patients. Arch Neurosci, 11(4), e150888.
Formosa, J., Jenner, R., Nguyen-Thi, M.-D., Stephens, C., Wilson, C., & Ariyawardana, A. (2015). Awareness and knowledge of oral cancer and potentially malignant oral disorders among dental patients in far North Queensland, Australia. Asian Pacific Journal of Cancer Prevention, 16(10), 4429–4434.
González-Ruiz, I., Ramos-García, P., Ruiz-Ávila, I., & González-Moles, M. Á. (2023). Early diagnosis of oral cancer: A complex polyhedral problem with a difficult solution. Cancers, 15(13), 3270.
Haghdoost, A. A., Rakhshani, F., Aarabi, M., Montazeri, A., Tavousi, M., Solimanian, A., et al. (2015). Iranian health literacy questionnaire (IHLQ): An instrument for measuring health literacy in Iran. Iranian Red Crescent Medical Journal, 17(6).
Hartner, L. (2018). Chemotherapy for oral cancer. Dental Clinics, 62(1), 87–97.
Hassona, Y., Scully, C., Ghosh, M. A., Khoury, Z., Jarrar, S., & Sawair, F. (2015). Mouth cancer awareness and beliefs among dental patients. International Dental Journal, 65(1), 15–21. https://doi.org/10.1111/idj.12148
Javadzade, S. H., Sharifirad, G., Reisi, M., Tavassoli, E., & Rajati, F. (2013). Health literacy among adults in Isfahan, Iran. Journal of Health System Research, 9(5), 540–549.
Kamal, F., Ghafary, E. S., Hamrah, M. H., Khalid, G. S., Hamrah, M. H., Hasam, Z., et al. (2024). Awareness and knowledge of tobacco use and its relation to oral cancer among patients visiting Stomatology Teaching Hospital. Cancer Management and Research, 1345–1352.
Keten, H. S., Isik, O., Guvenc, N., Ersoy, O., & Celik, M. (2017). Oral cancer knowledge among dental patients in a Turkish population. Journal of Cancer Education, 32(4), 817–821.
Khajouei, R., & Salehi, F. (2017). Health literacy among Iranian high school students. American Journal of Health Behavior, 41(2), 215–222.
Khorasani, E. C., Sany, S. B. T., Orooji, A., Ferns, G., & Peyman, N. (2020). Health literacy in Iranian women: A systematic review and meta-analysis. Iranian Journal of Public Health, 49(5), 860.
Mohammadi, H. R., Erfani, A., Jamshidbeigi, Y., Rahmatian, A., & Otaghi, M. (2024). Effect of using rituximab on disability in patients with multiple sclerosis. Journal of Medicinal and Pharmaceutical Chemistry Research, 6(12), 1854–1860.
Montazeri, A., Tavousi, M., Rakhshani, F., Azin, S. A., Jahangiri, K., Ebadi, M., et al. (2014). Health Literacy for Iranian Adults (HELIA): Development and psychometric properties. Payesh (Health Monitor), 13(5), 589–599.
Nourmohammadi, H., Motaghi, M., Borji, M., Tarjoman, A., & Soltany, B. (2019). The effects of reflexology on fatigue severity of patients with cancer. Asian Pac J Cancer Prev, 20(2), 391–394.
Pakfetrat, A., Falaki, F., Esmaily, H. O., & Shabestari, S. (2010). Oral cancer knowledge among patients referred to Mashhad Dental School, Iran. Arch Iran Med, 13(6), 543–548.
Ratnasekera, N., Perera, I., Arachchige, P. K., Perera, S., & Jayasekara, P. (2024). Prevalence and associated factors of psychological distress among patients with oral cancer in Sri Lanka. medRxiv. https://doi.org/10.1101/2024.06.21.24309294
Razavi, S. M., Tahani, B., Maleki, L., & Esfahani, D. B. N. (2024). Oral cancer knowledge among dental patients in Isfahan. Dent Res J (Isfahan), 21, 2.
Reddy, B. S., Doshi, D., Reddy, M. P., Kulkarni, S., Gaffar, A., & Reddy, V. R. (2012). Oral cancer awareness and knowledge among dental patients in South India. Journal of Cranio-Maxillofacial Surgery, 40(6), 521–524. https://doi.org/10.1016/j.jcms.2011.10.017
Ryman, C., Warnicke, C., Hugosson, S., Zakrisson, A.-B., & Dahlberg, K. (2024). Health literacy in cancer care–A systematic review. European Journal of Oncology Nursing, 102582.
Saglam, G., & Dag, A. (2024). Evaluation of oral cancer knowledge and awareness among patients at a periodontology clinic. Journal of Clinical Trials and Experimental Investigations, 3(1), 1–9.
Shrestha, A. D., Vedsted, P., Kallestrup, P., & Neupane, D. (2020). Prevalence and incidence of oral cancer in low-and middle-income countries: A scoping review. European Journal of Cancer Care, 29(2), e13207.
Silva, M. J., & Santos, P. (2021). The impact of health literacy on knowledge and attitudes towards preventive strategies against COVID-19: A cross-sectional study. International Journal of Environmental Research and Public Health, 18(10), 5421.
Tadbir, A. A., Ebrahimi, H., Pourshahidi, S., & Zeraatkar, M. (2013). Evaluation of levels of knowledge about etiology and symptoms of oral cancer in southern Iran. Asian Pac J Cancer Prev, 14(4), 2217–2220.
Tavakoly Sany, S. B., Doosti, H., Mahdizadeh, M., Orooji, A., & Peyman, N. (2021). The health literacy status and its role in interventions in Iran: A systematic and meta-analysis. International Journal of Environmental Research and Public Health, 18(8), 4260.
Umapathy, V. R., Natarajan, P. M., & Swamikannu, B. (2023). Review of the role of nanotechnology in overcoming the challenges faced in oral cancer diagnosis and treatment. Molecules, 28(14), 5395.
Zachar, J. J., Huang, B., & Yates, E. (2020). Awareness and knowledge of oral cancer amongst adult dental patients attending regional university clinics in New South Wales, Australia: A questionnaire-based study. International Dental Journal, 70(2), 93–99. https://doi.org/10.1111/idj.12522
Zhang, Y., Xu, P., Sun, Q., Baral, S., Xi, L., & Wang, D. (2023). Factors influencing the e-health literacy in cancer patients: A systematic review. Journal of Cancer Survivorship, 17(2), 425–440.
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