A new study highlighted the success of an educational intervention to improve cancer literacy in middle and high school students living in Kentucky.
“Kentucky ranks first in the nation in overall cancer incidence and mortality and experiences over 26,000 new cancer cases each year and over 10,000 cancer-related deaths,” according to the study authors. “Rural eastern Kentucky residents face some of the highest cancer incidence and mortality rates in the country. Residents of rural counties in Kentucky, specifically the Appalachian region, are 8% more likely to die from a preventable or screenable malignancy.” The authors attribute this disparity to several variables, including:
- Inadequate exercise
- Poor diet
- A disproportionate number of residents living below the poverty line, thereby having less access to health care
- Low levels of education and therefore health literacy
Young people are at risk of taking part in things that may increase their cancer risk in particular, such as smoking and tanning, so improved cancer literacy may be a helpful intervention in this population to ultimately reduce cancer rates in the state of Kentucky.
The intervention took place during normal school hours, often during a science or health-related class. Middle and high school students filled out a 10-item pretest questionnaire before viewing a 30- to 45-minute PowerPoint presentation; they then filled out the same questionnaire.
The study’s findings were published in the Journal of Cancer Education.
Outcomes: Intervention Improves Results
A total of 349 students participated, most of whom were Caucasian (89.4%) and were not of Hispanic or Latin descent (91.3%)—similar to Kentucky demographics overall. The majority of participating students were female (68.7%); 80.5% of students were in 10th, 11th, or 12th grade.
On the pretest, students achieved an average of 56% correctly marked items, compared to 85% on the posttest. Median scores from pre- to posttest increased from 60% to 90%.
The following multiple-choice questions were asked on the pre- and posttest:
- What is cancer?
- What are the two major types of cancer?
- A benign tumor is cancerous.
- What are common cancer risk factors?
- What are some lifestyle choices that increase one’s likelihood of developing cancer?
- When cancer has metastasized is means it has:
- A biopsy of a tumor is done to:
- Cancer can impact populations or groups of people (for example, men versus women) differently?
- How does Kentucky compare to other states in cancer rates?
- What four types of research are being conducted on cancer?
The first question had the lowest percent responsiveness, the authors observed, indicating that most students were already aware of what cancer was prior to the intervention. In contrast, the highest percent responsiveness was observed in question nine (75.7%)—suggesting that this was not something with which students were familiar before the intervention. Questions one and five were both answered correctly by more than 80% of students on the pre- and posttests; these questions as well as four, six, seven, and eight were correctly answered by 70% of students on both tests.
“Thinking back on my own pre-college education, I do not recall learning in-depth about cancer in school,” Nathan Vanderford, PhD, MBA, assistant director for research at Markey and director of the Appalachian Career Training in Oncology Program, said in a press release. “From that perspective, the lower levels of cancer knowledge these students displayed at baseline are not too surprising. At the same time, given the increased information age we live in, there was some thought that perhaps students’ baseline levels would be higher.” Dr. Vanderford grew up in rural Tennessee.
The researchers concluded, “[Educational] interventions can help students understand the basics of cancer, which could aid decision-making around modifiable cancer risk factors and health-seeking behaviors. As such, we recommend that school systems integrate evidence-based cancer education modules into their science or health education curricula.”