Awareness and attitudes of university students in Bangladesh toward cancer: Cross-sectional study

Abstract

Background: Early detection and awareness are critical in reducing the burden of cancer. However, a significant proportion of university students in Bangladesh remains inadequately informed about cancer risks and preventive measures. Objective: This study aimed to assess knowledge gaps and evaluate the attitudes of Bangladeshi university students toward cancer, its prevention, risk factors, and care for affected individuals. Methods: A descriptive, cross-sectional survey was conducted among 530 university students aged 20 to 35 years across Bangladesh. Data were collected using an ethically approved, structured internet-based questionnaire between December 2022 and March 2024. The questionnaire assessed socio-demographics, cancer knowledge, awareness of risk factors, personal or familial cancer experiences, and attitudes toward cancer care and policy. Descriptive statistics and chi-square tests were used to analyze categorical data, with a significance threshold of P<.05. Results: Most participants were aged 21–25 years (406/530, 76.6%) and female (320/530, 60.4%), with the majority enrolled in undergraduate programs (82.8%, 439/530). While 60.8% (322/530) considered themselves somewhat knowledgeable about cancer, only 11.9% (63/530) were very knowledgeable, and 93.6% (496/530) had never undergone any cancer screening. Despite this, 74.3% (394/530) had personal or familial exposure to cancer, with carcinoma reported by 52.8% (280/530) of those affected. Awareness of established risk factors was inconsistent—smoking (90.9%, 482/530) and radiation (86.6%, 459/530) were widely recognized, but only 38.9% (206/530) acknowledged aging, 35.3% (187/530) obesity, and 29.2% (155/530) infectious agents as risk factors. Reproductive factors were least recognized, with just 10.2% (54/530) identifying having more children as a risk factor. Gender differences were significant in cancer-related attitudes. For example, 51.5% (273/530) of female participants versus 33.4% (177/530) of male participants felt comfortable around patients with cancer (P=.01), and 57.2% (303/530) of female participants versus 35.8% (190/530) of male participants supported increased government funding for cancer care (P=.03). Furthermore, 55.1% (292/530) of females and 35.5% (188/530) of males stressed the need for enhanced cancer awareness programs (P=.05). Only 6.4% (34/530) of all participants reported undergoing any form of cancer screening, highlighting a disconnect between awareness and preventive action. Conclusions: This study reveals critical gaps in cancer awareness among university students in Bangladesh, with pronounced disparities in knowledge of nonmodifiable risk factors and significant gender-based differences in attitudes toward cancer care. These findings highlight the urgent need for targeted, gender-sensitive educational programs and policy interventions to promote preventive practices, early detection, and equitable cancer care. Such initiatives must emphasize lesser-known risk factors, reduce stigma, and foster more inclusive, culturally competent health education strategies to mitigate the growing cancer burden in Bangladesh.