Participant demographics

The study included a total of 996 participants with varied demographic and health-related characteristics. Most participants were young adults aged 18–29 years (69.1%), followed by 17.7% aged 30–39. The gender distribution was almost equal, with 50.8% male and 49.2% female participants.

In terms of education, the majority held an undergraduate degree (63.0%), while 22.9% had completed secondary school, 7.0% had vocational education, and 7.1% held a postgraduate degree. Participants were from various governorates, with the largest group from Sana’a (46.3%), followed by Taiz (18.1%), Ibb (6.1%), Dhamar (4.7%), Amran (4.0%), Haja (3.7%), Hadramout (3.4%), and other regions comprising 13.6% of the sample.

A significant portion of participants (42.0%) worked in the healthcare sector, while 58.0% did not. Only a small percentage reported a personal history of cancer (2.1%), although 24.8% indicated a family history of cancer. Most participants (89.6%) reported no chronic health problems, while 10.4% had chronic health issues (Table 1).

Table 1 Sociodemographic characteristics of the participants (n = 996)Knowledge about cancer screening

The results indicate varying levels of knowledge among participants regarding cancer screening. Just over half of the participants (52.1%) reported awareness of what cancer screening is, while 47.9% indicated no awareness. When asked to self-assess their knowledge, 21.4% considered it good, 30.7% rated it as moderate, and 34.7% as poor, while 13.2% acknowledged knowing nothing about cancer screening (Table 2). Of note, these two items assess different aspects of knowledge: the first reflects concept recognition, whereas the second reflects self-perceived depth of knowledge. This explains why some participants who recognized the term still reported little or no knowledge about cancer screening.

Regarding specific types of cancer screening, 18.4% of participants reported knowledge of all types listed. Among those aware of only one type, 18.7% were familiar with skin cancer screening, followed by 15.7% who identified breast cancer screening (mammogram), 2.1% who were aware of lung cancer screening (low-dose CT scan), 1.6% who mentioned prostate cancer screening (PSA test), 1.4% who knew about colorectal cancer screening (colonoscopy, fecal occult blood test), and 1.3% who recognized cervical cancer screening methods (Pap smear, HPV test).

The benefits of cancer screening were generally understood, with 42.9% of participants recognizing all major benefits, including early detection for better treatment, screening importance for those with a family history, and cancer prevention for some types. Smaller percentages highlighted individual benefits: 18.0% cited early detection, 2.9% mentioned family history as a reason for screening, and 2.0% believed some cancers could be avoided through screening. Only 1.4% felt that cancer screening has no benefit.

When asked about cancer risk reduction factors, a significant portion (30.8%) identified all major factors, including a healthy diet, physical activity, reduced exposure to pollutants, smoking cessation, and screening for those with a family history. Others selected specific combinations, with the most frequent responses being a mix of diet, exercise, pollutant reduction, and smoking cessation (19.2%). Smaller groups noted individual factors such as healthy diet (4.6%), screening for those with a family history (5.1%), and smoking cessation (2.5%).

Furthermore, the data in Table 2 reveals that healthcare staff are the primary source of information about cancer screening for most participants, with 50.6% indicating they rely on healthcare professionals for this information. Family and friends serve as the main information source for 20.0% of participants, while 2.1% rely on health education companies, and 1.7% primarily use the internet or social media.

Additionally, 4.8% reported obtaining information from all sources listed, including healthcare staff, family/friends, internet/social media, and health education companies. Combinations of specific sources were also common: 17.8% receive information from healthcare staff and health education companies, 7.6% from healthcare staff and the internet/social media, and 5.3% from healthcare staff, internet/social media, and health education companies.

Out of the total participants, 695 (69.2%) had a good understanding of cancer screening, while 301 (30.2%) exhibited poor knowledge on these topics.

Table 2 Participants’ knowledge related to cancer screening (n = 996)Cancer screening practices

The analysis of participants’ practices toward cancer screening reveals that only 8.5% have ever undergone any type of cancer screening, while a significant 91.5% reported they have not. Among those who had undergone screening, the most common type was breast cancer screening (mammogram), accounting for 54.1%. Other types of screenings were less frequent: colorectal cancer screening (11.8%), skin cancer examination (4.7%), prostate cancer screening (3.5%), cervical cancer screening (Pap smear, HPV test) and lung cancer screening (low-dose CT scan), each at 2.4%. A small percentage (2.4%) had undergone a combination of cervical and colorectal cancer screenings, while 18.8% indicated “other” types of screenings (Table 3).

Participants who engaged in cancer screening cited personal health concerns as the most influential factor (15.3%), with recommendations from healthcare providers and a family history of cancer each accounting for 9.4% of motivators. Public health campaigns also played a role, influencing 9.4% of respondents. Notably, 12.9% were driven by a combination of these factors, with the most frequent grouping being a mix of doctor recommendations, family history, and personal health concerns (22.4%).

Conversely, among those who refrained from cancer screenings, the perception that such screenings were unnecessary was the most reported obstacle (16.0%). This was followed by financial constraints (11.2%), lack of awareness (8.5%), fear of results (6.4%), and time limitations (5.8%). Additionally, 38.5% pointed to other unspecified challenges.

Overall, personal health concerns and guidance from healthcare professionals significantly encourage screening participation, while misconceptions, financial barriers, and logistical challenges remain key deterrents (Table 3).

Table 3 Participants practice towards cancer screening (n = 996)Attitudes toward cancer screening

Table 4 indicates that participants overwhelmingly recognized the significance of regular cancer screenings for early detection and prevention, with 75.9% labeling them as very important and 21.2% as somewhat important. In contrast, a minor fraction, 2.2%, perceived them as not very important, while 0.7% considered them not important at all.

When asked about their trust in the effectiveness of cancer screenings for early cancer detection, 51.3% strongly agreed, while 39.3% agreed. A minority remained neutral (7.4%), and even fewer disagreed (1.3% strongly disagreeing, 0.7% strongly disagreeing).

Regarding comfort levels with the idea of undergoing regular cancer screenings, 42.1% felt very comfortable, and 34.6% felt somewhat comfortable. However, 5.9% reported being somewhat uncomfortable, and 2.8% felt very uncomfortable.

To enhance public participation in cancer screenings, 42.2% of participants suggested that comprehensive public education would be beneficial. Other suggestions included lowering costs (5.6%), creating more convenient screening locations (3.7%), and increasing doctor recommendations (2.1%). Additionally, 11.9% of participants believed that a combination of better public education, lower costs, and more convenient locations could improve participation, while 7.1% identified a combination of better public education and cost reduction as effective measures.

Table 4 Participants attitudes and beliefs towards cancer screening (n = 996)Influencing factors for knowledge

The analysis shown in Table 5 highlights significant factors influencing participants’ knowledge levels. Younger individuals aged 18–29 had the highest proportion of good knowledge (71.9%), decreasing in older groups, with those aged 40–49 at 62.8%. Males slightly outperformed females (71.7% vs. 67.8%). Education was a key factor, with postgraduate participants achieving the highest knowledge levels (80.3%) compared to vocationally educated individuals (60%). Singles exhibited the best knowledge levels (73.5%), while widows had the lowest (50%). Healthcare workers had significantly better knowledge (81.8%) than non-healthcare workers (61.1%). Cancer history and chronic illnesses had no significant impact on knowledge levels.

These findings were confirmed through chi-square tests and logistic regression. Age differences were not statistically significant overall (p = 0.143), but individuals aged 40–49 showed lower odds of good knowledge in univariate analysis (OR: 0.658, p = 0.043), which was not retained in the multivariate model. Knowledge levels did not significantly differ by gender (p = 0.171), with females showing slightly lower odds in the univariate analysis (OR: 0.828, p = 0.171). Education significantly influenced knowledge (p < 0.001). Participants with postgraduate education had the highest odds of good knowledge (adjusted OR: 2.328, p = 0.014), while secondary school education was the reference category. Single participants exhibited the highest knowledge levels (p = 0.002). Married individuals had significantly lower odds in both univariate (OR: 0.610, p = 0.001) and multivariate analysis (adjusted OR: 0.653, p = 0.006). Participants working in the healthcare sector showed significantly higher knowledge levels (p < 0.001), with an adjusted odds ratio of 0.399 (p < 0.001) for non-healthcare workers. Neither personal nor family history of cancer significantly impacted knowledge levels (p = 0.868 and p = 0.793, respectively). Presence of chronic health issues did not significantly affect knowledge levels (p = 0.723).

In summary, education, marital status, and employment in the healthcare sector emerged as critical determinants of knowledge, while other variables had limited or no significant influence.

Table 5 Significant factors influencing participants’ knowledge levels