BACKGROUND: Oral cavity cancer is a growing concern, especially in developing countries like India, due to risk factors such as tobacco use, alcohol consumption, nutritional deficiencies, and spicy food intake. Early detection through screening and Mouth Self-examination (MSE) can significantly improve outcomes, but limited awareness and pain in advanced stages lead to delayed detection. This study aimed to assess the knowledge and practice of MSE among tobacco users in urban and rural populations.
METHODS: A comparative cross-sectional study was conducted involving tobacco users (smoking, smokeless, or both). An observational questionnaire-based approach was employed, with informed consent obtained from participants. A questionnaire in Hindi and English was used, consisting of demographic details and 13 close-ended questions.
RESULTS: The analysis revealed that individuals from urban areas (71.9%) exhibited significantly higher awareness of Mouth self- examination (MSE) compared to those from rural areas (1.9%). Chi-square analysis demonstrated that urban residents exhibited significantly higher awareness, understanding, confidence, desire for information, and positive attitudes towards Mouth Self-Examination (MSE) compared to rural residents. Multivariate analysis showed that education had a consistent and substantial impact on both knowledge and practice scores.
CONCLUSIONS: The study highlights substantial urban-rural disparities in mouth self- examination (MSE) awareness and attitudes, with urban residents demonstrating significantly higher levels. Targeted interventions and awareness campaigns are vital to bridge this gap and improve oral health practices, especially in rural areas.

Secondary prevention of skin cancer consists in early detection of malignant lesions through patients\' mole self-examination and medical examination. The objective of this study was to assess the self-reported  frequency of mole examination in a large, representative sample of the adult general population of 17 countries from all continents. Of a total of 17,001 participants, 4.8% had their moles checked by a dermatologist more than once a year, 11.3% once a year, 8.4% every 2-3 years, 12.4% once in a while, 10.3% once in lifetime, and 52.6% of participants had never performed a mole examination. Egypt was the country with the highest prevalence of people who performed a moles check more than once a year (15.9%), followed by Brazil and the USA. A higher frequency of mole checks was associated with sex (man vs woman), higher education, higher income, fair phototype, history of skin cancer, medical insurance, and sun-protective behaviours. Despite recommendations by health providers, it appears that the frequency of mole checks in the general population is still low. It is necessary for dermatologists to keep informing at-risk populations about the importance of moles check, with particular care regarding categories that less frequently adhere to secondary prevention measures.

We pioneered a smartphone-based digital platform for oral cancer self-examination, namely RISKOCA. It enabled anyone to self-submit their own oral images to evaluate the potential risk of oral lesions. Integrative artificial intelligence (AI) could immediately report if the image might have a type of oral cancer as well as the precise locations of the lesions. Participating specialist dentists would have to re-evaluate and confirm the results before sending back recommendation to the patients. High participation and satisfaction indicated the success of this pilot study. This project aims to promote oral public health and health surveillance, both nationally and globally.

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Breast cancer is the most common cancer among women worldwide. It is a major cause of cancer death, and its incidence rate has been gradually increasing in the Arab world, Saudi Arabia has a higher proportion of young females getting breast cancer than other countries. This study was conducted to investigate the knowledge, attitude, and practice regarding breast self-examination among females from 20 to 60 years old in Jazan Region, Saudi Arabia. Using A Community-based descriptive cross-sectional approach, data were gathered from 567 Saudi and non-Saudi women using structured interviews and then analyzed using the Statistical Package for Social Sciences (IBM) version 21.0 software program. Where the study indicated that around half of the participants (55.7%) had good total knowledge scores regarding breast self-examination, and most had positive attitudes. However, only 205 (36.2%) respondents practice it regularly. Moreover, the study reveals a significant association between respondents\' knowledge and attitudes toward breast self-examination (P = 0.05). These findings indicate moderate knowledge, poor breast self-examination practices, and a significant association between knowledge and attitudes. Therefore, conducting health education programs is necessary to raise awareness about breast self-examination (BSE) among Jazan women.
Le cancer du sein est le cancer le plus répandu chez les femmes dans le monde. Il s\'agit d\'une cause majeure de décès par cancer et son taux d\'incidence augmente progressivement dans le monde arabe. L\'Arabie saoudite compte une proportion plus élevée de jeunes femmes atteintes d\'un cancer du sein que les autres pays. Cette étude a été menée pour étudier les connaissances, l\'attitude et la pratique concernant l\'auto-examen des seins chez les femmes de 20 à 60 ans dans la région de Jazan, en Arabie Saoudite. À l\'aide d\'une approche transversale descriptive communautaire, les données ont été recueillies auprès de 567 femmes saoudiennes et non saoudiennes à l\'aide d\'entretiens structurés, puis analysées à l\'aide du logiciel Statistical Package for Social Sciences (IBM) version 21.0. L\'étude a indiqué qu\'environ la moitié des participantes (55,7 %) avaient de bons scores totaux de connaissances concernant l\'auto-examen des seins et que la plupart avaient des attitudes positives. Cependant, seuls 205 (36,2%) répondants le pratiquent régulièrement. De plus, l\'étude révèle une association significative entre les connaissances et les attitudes des répondants à l\'égard de l\'auto-examen des seins (P = 0,05). Ces résultats indiquent des connaissances modérées, de mauvaises pratiques d\'auto-examen des seins et une association significative entre les connaissances et les attitudes. Par conséquent, il est nécessaire de mener des programmes d’éducation sanitaire pour sensibiliser les femmes de Jazan à l’auto-examen des seins (ESB).

BACKGROUND: Testicular cancer is among the most common malignancies in men under the age of 50 years. Most testicular symptoms are linked to benign diseases. Men\'s awareness of testicular diseases and testicular self-examination behaviours are suboptimal. In this pilot feasibility study and process evaluation we examine the feasibility of conducting a future definitive randomised controlled trial (RCT) to test the effect of the Enhancing Men\'s Awareness of Testicular Diseases using Virtual Reality intervention (E-MATVR) compared to the Enhancing Men\'s Awareness of Testicular Diseases using Electric information control (E-MATE). The study protocol is registered on ClinicalTrials.gov (NCT05146466).
METHODS: Male athletes, engaged in Gaelic games, and aged 18 to 50 years were included. Recruitment was via FacebookTM, XTM (formerly TwitterTM), and posters. Participants were individually randomised to either E-MATVR or E-MATE. Data were collected at baseline (T0), immediately post-test (T1), and three months post-test (T2) using surveys. Qualitative interviews were conducted with participants and researchers.
RESULTS: Data were collected from 74 participants. Of those, 66 were retained. All E-MATVR participants and most E-MATE participants (n = 33, 89.2%) agreed/strongly agreed that the device was easy to use and that they were engaged to learn by the device. Most E-MATVR participants (n = 34, 91.9%) and all E-MATE participants agreed/strongly agreed that the time it took them to complete the intervention was reasonable. All 74 participants were extremely satisfied/somewhat satisfied with their overall participation in the study. E-MATVR was described as interactive, easy, fun, and close to real life. Initial difficulty using VR equipment, nausea, and technical issues were identified as challenges to engaging with E-MATVR. Recommendations were made to make VR more accessible, shorten the survey, and incorporate more interactivity. Across all participants, mean testicular knowledge scores (range 0-1) increased from 0.4 (SD 0.2) at T0 to 0.8 (SD 0.2) at T1. At T2, overall mean scores for participants were 0.7 (SD 0.2). Mean knowledge scores did not differ by trial arm at any timepoint. At T2, all E-MATVR participants and 29/32 E-MATE participants (90.6%) reported purposefully examining their testes within the past three months.
CONCLUSIONS: Findings are promising, highlighting the feasibility of using VR to promote young athletes\' awareness of testicular diseases. Considering the strengths, limitations, and lessons learned from this study, some modifications are required prior to conducing an RCT. These include but are not limited to shortening survey questions, incorporating more interactivity and visual content, and targeting more heterogenous male-dominated environments.

UNASSIGNED: Australia is known for its outdoor culture, with a large percentage of its population engaging in outdoor recreational activities, aquatic, non-aquatic and outdoor occupational activities. However, these outdoor enthusiasts face increased exposure to ultraviolet radiation (UVR), leading to a higher risk of skin cancer, including malignant melanoma (MM). Over the past 40 years, there has been a significant rise in skin cancer rates in Australia, with two out of three Australians expected to develop some form of skin cancer by age 70. Currently, skin cancer examinations are not endorsed in asymptomatic or low-risk individuals in Australia, with only high-risk individuals recommended to undergo regular skin examinations. Notably, the Melanoma Institute Australia suggests that one-half of patients identify MMs themselves, although this claim appears to be based on limited Australian data which may not reflect contemporary practice. Therefore this study sought to determine the percentage of patients who were able to self-identify MMs as lesions of concern when presenting for a skin cancer examination.
UNASSIGNED: Multi-site, cross-sectional study design incorporating a descriptive survey and total body skin cancer screening, including artificial intelligence by a skin cancer doctor.
UNASSIGNED: A total of 260 participants with suspect MM lesions were biopsied, with 83 (31.9%) found to be melanomas. Of the true positive MMs only a small percentage of participants (21.7% specificity) correctly had concerns about the suspect lesion being a MM. These MMs were located primarily on the back (44.4%), shoulder (11.1%) and upper leg (11.1%). There was no significant difference in the size between those participants aware of a MM versus those who were not (P = 0.824, 24.6 vs 23.4 mm2). Significantly more males identified lesions of concern that were MMs as compared to females (P = 0.008, 61.1% vs 38.9%, respectively). With regard to true negatives males and females were similar (52.1% vs 47.9%, respectively). With regard to false negatives (n = 65), a greater percentage of males than females did not recognize the MM as a lesion of concern (66.2% vs 33.8%, respectively). Participants were more likely to correctly identify an invasive MM as opposed to an in situ MM (27.3% versus 21.3%).
UNASSIGNED: Only a small percentage of participants in this study were able to self-identify either in situ or invasive MM as a lesion of concern with a tendency to identify the more advanced, thicker MMs. Given that MM is associated with a high mortality and cost of treatment, particularly when invasive, the inability of lay persons to identify these cancerous lesions will likely lead to delayed treatment and a possible adverse outcome. We believe the current melanoma screening practices in Australian general practice should be revisited to improve patient outcomes with regard to MM. Additionally, prevention campaigns should include images and primary risk factors for MM.

BACKGROUND: The theory of planned behavior (TPB) is recognized as an effective theory for behavior change. The aim of the present study was to investigate the impact of two TPB-based educational interventions on oral self-examination (OSE) behavior and the related TPB constructs among adults in Tehran, Iran, in 2022.
METHODS: This randomized controlled trial involved 400 healthy individuals recruited from 20 urban comprehensive health centers in the southern part of Tehran, Iran. The health centers were randomly assigned to two control (PowerPoint) and intervention (WhatsApp) groups (200 individuals in each group). In the control group (the recipient of the routine care), participants received a 20-minute lecture through a PowerPoint presentation and a pamphlet. In the intervention group (the recipient of an additional intervention alongside the routine care), participants were educated through messages and images on WhatsApp along with having monthly group discussions. Data was collected at baseline, as well as at 1- and 3-month follow-ups using a structured questionnaire. The outcomes assessed included OSE behavior and the related TPB constructs: intention, attitude, subjective norm, and perceived behavioral control. Linear and logistic generalized estimating equations (GEE) regression models were used to evaluate the impact of the interventions with STATA version 17.
RESULTS: Of the total participants, 151 (37.75%) were men. The mean ± standard deviation (SD) of ages in the PowerPoint and WhatsApp groups were 39.89 ± 13.72 and 39.45 ± 13.90, respectively. OSE and the related TPB constructs showed significant differences between the groups at the 1-month post-intervention assessment. The effect of PowerPoint was more significant in the short-term (one month), while both methods showed similar effectiveness after three months, specifically in relation to OSE and the TPB constructs. At the 3-month post-intervention assessment, there were significant increases in OSE (OR = 28.63), intention (β = 1.47), attitude (β = 0.66), subjective norm (β = 2.82), and perceived behavioral control (β = 1.19) in both groups (p < 0.001).
CONCLUSIONS: The present study provides evidence of the effectiveness of both educational interventions in improving OSE and the TPB constructs after three months. Therefore, both TPB-based educational methods can be recommended for designing and implementing interventions aimed at preventing oral cancer.
BACKGROUND: The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 04/03/2022 (registration number: IRCT20220221054086N1).

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OBJECTIVE: Outdoor workers are at increased risk for skin cancer and melanoma. This qualitative study aimed to explore outdoor workers\' perspectives and experiences of primary (i.e. sun protection) and secondary prevention, i.e. skin self-examination (SSE) of skin cancer.
METHODS: Purposive, snowball, and theoretical sampling was used to recruit outdoor workers in Kentucky and Indiana. Semi-structured interviews via telephone or videoconference of approximately 45 min were conducted with interviewer probes and questions about perceptions of cancer risk, prevention, and screening techniques conducted, perceived barriers and facilitators, and preferences for health dissemination venues. The recordings were transcribed verbatim and de-identified. Analysis involved constructivist grounded theory coding strategies. Using peer debriefing and consensus building around themes, the researcher established a codebook for all interviews to utilize within Dedoose software for systematizing and organizing data.
RESULTS: Eighteen interviews were conducted. Interviewees (N = 18) ranged in age from 35 to 78 yr, with 3 females. Outdoor industries included agriculture, maintenance, and grounds maintenance. Themes derived from the data showed the underlying factors and perceptions that influence outdoor workers to conduct primary and secondary cancer prevention activities. The level of alarm attributed to disease and the level of trust in information contribute to intentions to conduct activities. The intentions and trust toward healthcare institutions and providers drive the primary or secondary prevention behaviors. Cultural and contextual factors included masculinity and self-sufficiency, familial and occupational priorities, and community ties.
CONCLUSIONS: These data provide a basis for developing future communications and interventions to decrease skin cancer incidence in outdoor workers. They indicate that secondary prevention and building self-efficacy in conducting SSE should be emphasized in tandem or over primary skin cancer prevention methods in this population. Trusted local healthcare providers should primarily provide prevention information, and materials should utilize testimonials from the local community to best influence this population. Communications and training interventions are needed in this population to induce a proactive level of alarm about cancer and result in the performance of SSE.