DOI: 10.1200/go-26-25000 ISSN: 2687-8941

Cancer Awareness and Knowledge Retention Following Educational Intervention Among Caregivers in a Rural Cancer Screening Setting

Subhadra Goala, John Murphy
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PURPOSE

Cancer screening uptake remains low in rural low- and middle-income countries (LMICs), where limited awareness contributes to late-stage diagnosis. Brief educational interventions can improve cancer knowledge, but retention is rarely assessed. We measured baseline knowledge, attitudes, and practices (KAP) regarding cancer risk factors, early symptoms, preventability, and screening among caregivers attending a tertiary cancer centre in rural northeast India, and evaluated retention 6–7 months after a single opportunistic education session.

METHODS

We conducted a prospective pre–post study at the screening outpatient department of Cachar Cancer Hospital and Research Centre, Assam, India. Caregivers ≥30 years old, never diagnosed with cancer, and not pregnant were sampled opportunistically. Nurses administered a 16-item Bangla questionnaire on risk factors, early signs and symptoms, preventability, and screening benefits, followed by an education session on locally common cancers (breast, cervical, oral). The same questionnaire was re-administered by telephone 6-7 months later. Paired pre–post comparisons used the McNemar test; analyses were performed in R 4.5.2.

RESULTS

Of 304 caregivers enrolled (median age 36 years, IQR 33-45; 77% male; 49% ≥secondary-school education), 174 (57.2%) completed follow-up. Baseline characteristics did not differ between completers and non-completers (all P > .05). Correct-response proportions rose significantly at follow-up for 15/16 items. The largest gains were in recognition of early symptoms—unexplained lump (50.0%→91.4%; +41.4 percentage points), nagging cough or hoarseness (52.9%→91.4%; +38.5), and a sore that does not heal (55.2%→93.1%; +37.9)—and in identifying preventable cancers when detected early (39.1%→88.5%; +49.4); all P < .001. Belief that cancer can be prevented rose from 62.6% to 86.2% (+23.6; P < .001). Two gaps persisted: knowing that mammography detects breast cancer was unchanged (18.4%→18.4%; P = 1.000), and recognition of HPV as the major cause of cervical cancer remained low despite increasing (11.5%→20.7%; P = .04).

CONCLUSION

A single opportunistic education session delivered to caregivers in a rural setting produced durable, broad-based knowledge gains 6-7 months later. Persistent gaps in mammography and HPV-related knowledge suggest targets for future interventions. Embedding brief education into routine caregiver encounters offers a low-cost, scalable model for rural LMIC cancer-control programs.

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