Cancer awareness and stigma in West Asian and North African Countries: A comparative cross-sectional survey

Cancer awareness and stigma are key barriers to early help-seeking in West Asia and North Africa (WANA), with direct implications for oncology nursing education and practice. We assessed public cancer awareness and cancer-related stigma and examined their relationship across eight WANA countries.

A comparative cross-sectional survey was conducted between mid-December 2024 and mid-March 2025 among Arabic-speaking adults (≥18 years) from Egypt, Iraq, Jordan, Libya, Qatar, Sudan, Syria, and Yemen, recruited via online and community-based convenience/snowball approaches. Participants completed the Cancer Awareness Measure (CAM) and Cancer Stigma Scale (CASS); internal consistency was acceptable (CAM α = 0.85; CASS α = 0.87, respectively). Missing data were handled using complete-case analysis.

The study included 1,311 adults (58.0% women; 75.9% urban). Most had never undergone cancer screening (87.1%) and had never discussed screening with a physician (85.8%). Mean (±SD) scores were 95.45 ± 19.56 (CAM) and 66.07 ± 18.09 (CASS). Awareness indicators were inversely associated with stigma; the strongest association was between perceived cancer incidence and overall stigma (r = -0.399, p < 0.001). In linear regression, higher CAM was associated with lower stigma (B = -0.181; β = -0.196, p < 0.001). In multiple regression, warning-sign awareness (β = -0.235) and perceived incidence (β = -0.345) were the strongest independent correlates of lower stigma (both p < 0.001).

Cancer awareness was inversely associated with stigma across WANA settings. Culturally tailored, nurse-led and multidisciplinary education should strengthen symptom recognition, screening communication, and population-level cancer literacy.