Awareness of Cancer Among Japanese Junior and Senior High School Students and Relevant Factors

The purpose of this study was to clarify cancer awareness among Japanese youths, identify relevant factors, and gain insight into effective educational interventions to prevent cancer and promote early detection in youths.

We conducted an anonymous, fact-finding questionnaire survey via the Internet, covering three modules of the Cancer Awareness Measure (cancer risk factors, cancer warning signs, and barriers to help-seeking), along with individual and environmental factors. Descriptive statistics were generated, and chi-squared tests and logistic regression analyses were performed to clarify the associations between cancer awareness and individual and environmental factors.

In total, 612 junior and senior high school students were enrolled. The median (interquartile range) total score was 7 (4-10) for cancer risk factors, 0 (0-5) for cancer warning signs, and 4 (2-7) for barriers to help-seeking. Less than half of the students correctly recognized risk factors specific to cancer, such as human papillomavirus, hepatitis B virus, and hepatitis C virus infections. As for barriers to help-seeking, many students pointed to emotional barriers such as fear (62.9%). Other major barriers to help-seeking were female gender (odds ratio [OR]=2.80, 95% confidence interval [CI]: 1.73, 4.53, p < 0.001), conversations with parents about cancer (OR=2.28, 95% CI: 1.28, 4.08, p = 0.005), and awareness of cancer warning signs (OR=1.04, 95% CI: 1.04, 1.81, p = 0.003).

Japanese adolescents do not have sufficient awareness of cancer. In cancer education, it is necessary to clearly highlight cancer-specific risk factors and warning signs in an easy-to-understand manner, explain the importance of early detection, and consider the content of cancer-related conversations between children and parents.