Knowledge of Cancer Warning Signs among Outpatient Visitors at Koshi Hospital, Morang, Nepal

Abstract

Background & Objectives: Cancer remains a major global health burden, disproportionately affecting low- and middle-income countries like Nepal due to weak healthcare systems and limited awareness, often resulting in diagnosis at advanced stages. This study aimed to assess the knowledge about cancer warning signs among visitors attending the outpatient department of Koshi Hospital, Morang, Nepal.

Materials and Methods: A descriptive cross-sectional study was conducted among 385 adult outpatient visitors at Koshi Hospital between March and June 2025 using convenience sampling, after ethical clearance from the Institutional Review Committee of Purbanchal University School of Health Sciences. Data were collected via face-to-face interviews using a pretested questionnaire on sociodemographic characteristics and knowledge about nine cancer warning signs, analyzed in SPSS 28 software using independent t-tests, one-way ANOVA, and Welch's ANOVA.

Results: The mean age was 33.95 ± 12.39 years, and 212 (55.1%) were female. Knowledge was highest for a breast lump (303, 78.7%) and non-healing sore (295, 76.6%), while less than half of participants recognized unexplained weight loss (192, 49.9%), indigestion or difficulty in swallowing (182, 47.3%), and bowel and bladder changes (169, 43.9%) as warning signs. Knowledge scores were significantly higher among females (p= 0.007), participants with higher education (p= 0.001), students (p= 0.007), those earning Nepali rupees 21,000–40,000 monthly (p= 0.030) and those with a family history of cancer (p= 0.004).

Conclusions: Most participants recognized the visible warning signs of cancer. Knowledge was significantly associated with sex, education, occupation, income, and family history. Targeted health education programs, particularly for men, less-educated individuals, and lower-income groups, are needed to improve early recognition of these warning signs.