Awareness level of cancer risk factors and warning signs among adults in Mansoura District, Egypt

Abstract

BACKGROUND: Cancer remains a leading cause of mortality worldwide, with prevention and early detection dependent on the public awareness of its risk factors and warning signs. However, knowledge of cancer-related symptoms and modifiable risk factors remains limited in many populations, particularly in low- and middle-income countries. Limited research exists examining general cancer awareness in Egypt's general population. OBJECTIVE: To assess public knowledge of cancer's early warning signs, risk factors, and prevention strategies in Mansoura, Egypt. METHODS: A descriptive cross-sectional study was conducted at five primary healthcare facilities in Mansoura from June to August 2025. We used a validated Arabic questionnaire to assess general cancer knowledge, awareness of cancer warning signs, and knowledge of its risk factors. Descriptive statistics and non-parametric tests (Mann-Whitney U and Kruskal-Wallis) were used to analyze the data. Statistical significance was set at p < 0.05. RESULTS: Three hundred ninety nine adult participants completed the questionnaire (60.7% female); most were aged 18-35 and demonstrated high general cancer knowledge, with 90.2% aware that regular check-ups aid early detection. However, awareness of specific warning signs was limited-only 33.3% recognized non-healing sores and 35.1% identified persistent cough as a warning sign. Knowledge of cancer risk factors was also inconsistent; while 89.5% identified smoking as a risk factor, only 13.5% recognized genetically modified foods as a risk factor. The median overall knowledge score was 28 out of 52. Educational attainment and association with the medical field were significant predictors of cancer knowledge across all domains (p < 0.001), while sex and residency showed no significant associations. The internet and social media were the primary sources of information (53.9%). CONCLUSION: While general cancer awareness was moderately high, knowledge of specific warning signs and modifiable risk factors remains limited. Targeted educational interventions, particularly among non-medical populations and those with lower educational attainment, are essential to improving cancer prevention and early detection.