Public awareness of cancer risk factors in the Moroccan population: a population-based cross-sectional study

Background: In Morocco, knowledge of cancer risk factors, a crucial element in the process of behavioral change, has never been evaluated. This study aims to provide information on the level of awareness of cancer risk factors among the Moroccan general population. Methods: A cross sectional survey was carried out in May 2008, using a stratified sampling method in a representative sample of the Moroccan adult population. The used questionnaire included social and demographic data as well as questions about 14 cancer related factors regarding passive or active smoking, alcoholic beverages, obesity, physical inactivity, food coloring, red meat, fat, salt, fruit, vegetables, olive oil, green tea, coffee, breast-feeding. Subjects had to choose between 3 propositions for each proposed factor (risk factor/Protective factor/Don't Know). The knowledge score was calculated by summing the correct answer for each proposed factor except coffee and food coloring. The answer was assigned 1 if it's correct or 0 if it was incorrect or the participant responded 'don't know. The maximum knowledge score was 12. Multivariate linear regression model was used to evaluate the determinants of knowledge score. Results: Among 2891 subjects who participated to the survey, 49.5% were men and 42% were from a rural area. The mean age was 41.6 +/- 15.2 years. The mean knowledge score of cancer related factors was 8.45 +/- 3.10 points. Knowledge score increased with educational level (beta = -0.65 if school year <= 6 versus >6) and housing category (beta = 1.80 in high standing housing vs rural housing). It was also higher in urban area, among never smokers and among people never consuming alcohol compared to others groups. Conclusion: These results provide valuable information necessary to establish relevant cancer prevention strategies in Morocco aiming to enhance and improve people's knowledge about risk factors especially in some target groups.