Health Literacy and Knowledge of Oral Cancer: A Systematic Review and Meta-Analysis in the Iranian Population

Fahimeh Feili ¹, Mohamadali Roozegar ^1*

This study underscores insufficient oral cancer knowledge in Iran, highlighting the need for tailored educational interventions to enhance health literacy.

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

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