Karem H. Alzoubi

The delayed presentation of cancer patients to healthcare facilities for diagnosis is a pressing issue, as late-stage cancer cases are often more challenging to treat effectively. In low-resource settings, such as those with limited access to healthcare facilities, the impact of inadequate awareness of cancer signs and symptoms can be particularly severe. Therefore, this study aimed to evaluate public knowledge of cancer signs and symptoms and risk factors in the context of Jordan. This cross-sectional study was conducted among participants from all settings. Data was obtained from an Arabic version of the cancer awareness measure (CAM), which was answered online. It described demographic data and knowledge of cancer prevalence, age-related risk, signs, symptoms, and risk factors in recall and recognition-type questions. Participants (n = 1998) completed the questionnaire with a Median age of 35 and an interquartile range of 24. About half (n = 1070) thought that cancer is unrelated to age. Most participants identified breast cancer as the most common cancer among women (81%). Awareness of cancer signs/symptoms significantly differed in the level of knowledge in favor of females. The symptom “unexplained weight loss” was most commonly recognized (66.3%) and “persistent difficulty swallowing” the least (42.6%). As for risk factors, “smoking” was the most identified (76.9%) and “eating less than 5 portions of fruits and vegetables a day” was the least (19%), and “doing <30 minutes of moderate physical activity 5 times a week” as a close second least (19.95%). Females identified “smoking,” “passive smoking,” “HPV infection,” and “having a close relative with cancer” as risk factors significantly more than males. Those with good economic status were more aware that smoking is a cancer risk factor by 1.51 times compared to those with poor economic status. To enhance early diagnosis and presentation in Jordan, there is a need for increased public awareness of the signs, symptoms, and risk factors of cancer. One effective strategy to achieve this goal is to conduct targeted public campaigns that cater to different population groups, such as the youth, to improve their understanding and ensure that the message resonates.

The present study aimed to evaluate disease activity and explore the factors associated with poor disease control among patients with rheumatoid arthritis (RA).<b> </b>This cross-sectional study was conducted at outpatient rheumatology clinics in two teaching hospitals in Jordan. Medication adherence was assessed using the validated five-item compliance questionnaire for rheumatology, and disease activity was assessed using the clinical disease activity Index score. Ordinal regression was performed to explore the factors associated with uncontrolled RA. Most of the participants (n=261) demonstrated moderate to high disease activity (71.2%). Seronegative RA (B=-0.882, CI [-1.584/-0.180], p<0.05) was significantly associated with lower disease activity, while medication non-adherence was significantly associated with poor RA control (B=1.023, CI [0.289-1.756], p<0.01). Future research should explore the factors associated with medication non-adherence. These factors should be targeted in future interventions to improve RA control, particularly in patients who suffer from high disease severity.