Public awareness of oral cancer in Palestine: a web-based cross-sectional survey

Oral cancer remains a major global health concern with low survival in late stages. In Palestine, the burden is amplified by delayed detection and limited healthcare resources, yet public awareness has never been assessed. This study aimed to evaluate knowledge and awareness of oral cancer risk factors, symptoms, and preventive measures among Palestinian adults.

A cross-sectional, web-based survey was conducted between May and August 2025 using an anonymous bilingual (Arabic/English) questionnaire adapted from a validated Middle East-North Africa tool. Palestinian adults aged ≥ 18 years were eligible, excluding health-related professionals and students. Snowball sampling via social media produced 753 valid responses. Data were analyzed using descriptive statistics, chi-square tests, and multivariable logistic regression to identify predictors of good knowledge (≥ 4 correct responses per domain).

Participants were predominantly female (66.3%) and university educated (72.6%). Overall, 46.7% demonstrated good knowledge of risk factors, 32.5% of symptoms, and 53.7% of protective measures. Awareness was highest for tobacco (79.2%) and lowest for HPV infection (38.5%) and alcohol-containing mouthwash (34.1%). Females and university graduates consistently showed better knowledge across all domains (p < 0.001). Current smokers had significantly poorer awareness of risk and protective factors (p < 0.001). Logistic regression identified female gender (OR = 1.59-1.65) and university education (OR = 2.22) as independent predictors of higher knowledge, while current smoking predicted lower protective awareness (OR = 0.65). Receiving oral cancer education from a dentist was the strongest predictor of good knowledge across all domains (risk factors OR = 3.79; symptoms OR = 2.16; protective measures OR = 1.95; all p < 0.01).

The surveyed Palestinian sample demonstrated limited awareness of oral cancer, especially regarding symptoms and less-recognized risk factors. Dentist-led education markedly improves knowledge, suggesting that integrating standardized awareness materials into routine dental visits and community campaigns could strengthen early detection and national prevention efforts.