Does socioeconomic status influence oral cancer awareness? The role of public education.

BACKGROUND: Public awareness on oral cancer is thought to improve prevention and early diagnosis; however, the role of socioeconomic status in this awareness is not clear. AIMS: The aim was to investigate whether an association exists between socioeconomic status and oral cancer awareness in adults. METHODS: A multi-stage random sample of adults was investigated in Tehran in 2016-2017. The outcome was awareness of oral cancer and knowledge of risk factors and signs and symptoms using a self-administered questionnaire. The main exposures were self-reported socioeconomic status of 8 indicators of family assets and economic situation. Wealth index was created using principal component analysis, and participants were classified into 5 quintiles. Regression analysis was applied to test associations. RESULTS: Out of 1800 adults, 1312 completed questionnaires were returned (72.8% response rate). The mean age was 37.8 (standard deviation 9.0) years; about 60% were female. Statistical analysis revealed the higher the wealth index, the higher the score for oral cancer knowledge and awareness. Awareness and knowledge were significantly lower among participants in the poorest quintile: they had a knowledge score on oral cancer risk factors 1.58 points [95% confidence interval (CI): -2.19;-0.96] lower, and a knowledge score on oral cancer signs 1.34 points (95 CI: -1.98;-0.72) lower compared with the richest quintile. CONCLUSION: Socioeconomic inequalities were observed in oral cancer awareness in the Islamic Republic of Iran.