Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Oct 15, 2022
Open Peer Review Period: Oct 14, 2022 - Oct 28, 2022
Date Accepted: Dec 9, 2022
(closed for review but you can still tweet)
Geographic, Demographic, and Socioeconomic Disparities and Factors Associated With Cancer Literacy in China: A National Cross-sectional Study
ABSTRACT
Background:
The enhancement of cancer literacy may reduce cancer burden through three-tiered prevention strategy. However, there is still a lack of nationwide surveys for cancer literacy in China.
Objective:
This study aims to evaluate cancer literacy in China, explore disparities, and provide scientific evidence for policy-makers.
Methods:
A cross-sectional survey was conducted in mainland China in 2021 using the multistage probability proportional to size sampling method. Both the reliability and validity of the questionnaire were evaluated. The survey results were adjusted by sampling weights and non-representativeness weights to match the actual population distributions. The Rao-Scott adjusted chi-square test was applied for test geographic, demographic, and socioeconomic disparities. Generalized linear model was used to explore potential factors.
Results:
A total of 80,281 participants aged 15-74 years were finally enrolled from 21 provinces, with an overall response rate of 89.32%. The national rate of cancer literacy was 70.05% (95% confidence intervals [CIs]: 69.52%-70.58%). The rates peaked regarding knowledge of cancer management 74.96% (95%CI: 74.36%-75.56%) but were lowest regarding basic knowledge of cancer 66.77% (95%CI: 66.22%-67.33%). Cancer literacy peaked in in East China (72.65%, 95%CI: 71.82%-73.49%), Central China (71.73%, 95%CI: 70.65%-72.81%), and North China (70.73%, 95%CI: 68.68%-72.78%), followed by Northeast (65.38%, 95%CI: 64.54%-66.22%) and South China (63.21%, 95%CI: 61.84%-64.58%), whereas Southwest (59.00%, 95%CI: 58.11%-59.89%) and Northwest China (57.09%, 95%CI: 55.79%-58.38%) showed a need for improvement. Demographic and socioeconomic disparities were also observed. Urban dwellers, the Han ethnic group, and population with higher education level or household income were associated with prior knowledge. The questionnaire showed good internal and external reliability and validity.
Conclusions:
It remains important for China to regularly monitor levels of cancer literacy, narrow disparities, and strengthen health education for dimensions with poor performance and for individuals with limited knowledge to move closer to the goal of Healthy China 2030.
Citation
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