Abstract
Background
Cancer is a major global health problem; therefore, increasing awareness among health sciences students is important for early diagnosis and preventive behaviors. This study aimed to determine the cancer awareness levels of students studying at the Faculty of Health Sciences.
Methods
This quantitative and descriptive study included 233 students from the Faculty of Health Sciences. Data were collected using a questionnaire containing the participants’ descriptive characteristics and the Cancer Awareness Scale. Descriptive statistics, independent samples t-tests, one-way ANOVA, and multiple linear regression analyses were used.
Results
The students’ mean total score on the Cancer Awareness Scale was 45.51 ± 8.42, indicating a moderate level of overall awareness. Among the sub-dimensions, the lowest score was found in the “early warning signs of cancer” dimension, while awareness of risk factors and screening programs was also limited. Female students had significantly higher awareness levels than male students (p < 0.05). Students who exercised regularly, paid attention to healthy nutrition, and received cancer-related information from health professionals or coursework had significantly higher awareness scores (p < 0.05). No significant differences were found according to age, family history of cancer, alcohol consumption, or perceived health status (p > 0.05). In multivariate analysis, female gender (β = 0.268, p < 0.001), studying in the physiotherapy department (β = 0.188, p = 0.008), and regular exercise (β = 0.171, p = 0.013) remained independent predictors of higher cancer awareness.
Conclusions
Overall, students’ cancer awareness was found to be at a moderate level; however, this awareness was not homogeneous across subdimensions, and there were notable deficiencies particularly in knowledge regarding early warning signs and age-related cancer risk. These findings indicate that although cancer awareness is present among students, it does not yet reach a sufficient level of depth. Therefore, it is recommended to strengthen practical training activities in health sciences curricula aimed at improving cancer awareness, and to place greater emphasis on screening programs and recognizing early warning signs.
Keywords: Awareness, Cancer, Health sciences students, Health education
Background
Cancer remains one of the leading causes of morbidity and mortality worldwide, and its growing global burden places a significant strain on healthcare systems. Each year, millions of new cases are diagnosed, with a substantial proportion detected at advanced stages. However, early diagnosis and effective screening programs play a critical role in cancer prevention and improving survival rates [1, 2].
Early detection is one of the most effective strategies in cancer control, as cancers diagnosed at an early stage are associated with substantially higher survival rates [3–5]. Awareness of cancer symptoms, risk factors, and screening methods plays a key role in timely healthcare utilization and early diagnosis. Cancer awareness includes recognizing early warning signs, understanding cancer risk factors, and developing knowledge about screening programs. Adequate awareness supports timely healthcare utilization, early diagnosis, and improved treatment outcomes [1].
University students often perceive themselves as being at low risk for cancer, which may contribute to their insufficient awareness. Previous studies have reported that students’ cancer awareness is limited but can be enhanced through planned health education interventions [6]. Awareness gained at an early age can enable students to take the lead in promoting positive health behaviors within society in the future.
Health institutions, educational systems, and media platforms play important roles in increasing cancer awareness. Awareness campaigns, university-based health education, and digital media may improve young adults’ access to reliable health information and support awareness of early detection and screening programs [7, 8].
Although previous studies have investigated cancer awareness among university students, most have focused on general student populations or specific cancer types. Limited research has evaluated multidimensional cancer awareness among first-year health sciences students, who represent future healthcare professionals and are at a critical stage for developing preventive health awareness and behaviors. In addition, evidence regarding the relationship between cancer awareness, lifestyle behaviors, and information sources remains insufficient. Therefore, this study aimed to assess cancer awareness levels and associated factors among health sciences students.
This study aimed to evaluate the level of cancer awareness among first-year health sciences students and to examine its association with sociodemographic characteristics and lifestyle-related factors.
Materials and methods
This study was conducted as a cross-sectional and descriptive research design.
Setting and duration of the study
This study was conducted at the Faculty of Health Sciences, Halic University, between October 1, 2025, and October 31, 2025.
Population and sample
The study population consisted of 500 first-year students enrolled in the Faculty of Health Sciences at Halic University. The required sample size was calculated using the formula for a known population, assuming a 95% confidence level, 5% margin of error, and p = 0.50, which yielded a minimum sample size of 218 participants. To increase statistical power and reduce potential sampling error, data were collected from 233 students. Participants were recruited using a non-probability convenience sampling method. Students who were present in classrooms during the data collection period and met the inclusion criteria were invited to participate. Data collection continued until the target sample size was reached.
Inclusion criteria
Being between 18 and 19 years of age,
Being a first-year student at the Faculty of Health Sciences,
Voluntarily agreeing to participate in the study,
Completing the questionnaire accurately and fully.
Exclusion criteria
Participants who incompletely filled out the questionnaire forms were excluded from the study.
Data collection tools
Students who participated in the study were asked to complete two instruments: the Personal Information Form and the Cancer Awareness Assessment Scale. The Personal Information Form consisted of 15 questions related to participants’ individual characteristics and health related behaviors. The items were developed based on a review of the relevant literature [7, 9, 10].
Cancer Awareness Scale
The Cancer Awareness Scale was developed between 2007 and 2008 through a collaboration between Cancer Research UK, University College London, King’s College London, and the University of Oxford to assess public awareness of cancer and support the development of awareness interventions [11]. The Turkish adaptation and validity reliability study of the scale for the adolescent population was conducted by Zeybek and Özbiçakçı [12]. The scale consists of 47 items and includes seven subdimensions: warning signs, help-seeking behavior, barriers to help-seeking, risk factors, the relationship between age and cancer, the most common cancer types, and Ministry of Health cancer screening programs. The total score of the scale ranges from 11 to 77.
Open-ended items are scored according to the number of correct responses, while recognition and multiple-choice items are scored as correct or incorrect. Likert-type items are scored based on response options. Since no established cut-off values exist for the scale, higher scores were interpreted as indicating greater cancer awareness, whereas lower scores reflected insufficient awareness. Higher total scores indicate a higher level of cancer awareness. In the adaptation study conducted by Zeybek and Özbiçakçı (2024), the Cronbach’s alpha coefficient of the scale was reported as 0.72, with subscale alpha values ranging from 0.62 to 0.74. In the present study, the internal consistency of the scale was re-evaluated, and the Cronbach’s alpha coefficient was found to be 0.87 for the overall scale, indicating high reliability.
Data analysis
Data were analyzed using IBM SPSS Statistics 22.0 software. Descriptive statistics (frequencies, percentages, means, and standard deviations) were used to summarize participant characteristics and scale scores. Parametric statistical methods were used in the analysis. The normality of the total Cancer Awareness Scale score was assessed using the Shapiro–Wilk test (W = 0.994, p = 0.529) and the Kolmogorov–Smirnov test (D = 0.052, p = 0.539). In addition, skewness (0.06) and kurtosis (0.17) values were both within the acceptable range of ± 1.5, confirming that the data were normally distributed [13]. The homogeneity of variances was verified using Levene’s test prior to independent samples t-tests (all p > 0.05). Therefore, parametric tests were applied.
Differences in scale scores according to sociodemographic characteristics were examined using independent samples t-test and one-way ANOVA. Effect sizes were reported as Cohen’s d for t-tests and eta-squared (η²) for ANOVA. Post hoc analyses (Tukey test) were conducted where appropriate to control for Type I error inflation due to multiple comparisons. To identify independent predictors of cancer awareness while controlling for potential confounders, a multiple linear regression analysis was performed. Variables that were significant in bivariate analyses (gender, department, regular exercise) were entered simultaneously into the regression model alongside theoretically relevant variables (healthy eating, smoking, social security, information source). Unstandardized (B) and standardized (β) regression coefficients, 95% confidence intervals, and model fit statistics (R², adjusted R², F) are reported. Multicollinearity was assessed using Variance Inflation Factor (VIF); all VIF values were below 3.0, indicating no multicollinearity concern.
Ethics approval and consent to participate
Ethical approval was obtained from the Halic University Social and Humanities Research Ethics Committee (Date: May 7, 2025 / No: 4), and institutional permission was granted (Date: June 10, 2025 / No: 140061). Informed consent was obtained from all participants. Permission to use the scale was obtained from the owner of the scale by email. The research has been prepared in accordance with the Declaration of Helsinki.
Results
According to Table 1, most participants were female (91.4%), single (99.1%), and aged 18–19 years. The largest proportion of students were enrolled in nursing and midwifery departments, and nearly all reported no prior cancer education (97.0%). In addition, 29.2% had a family history of cancer. Regular exercise and healthy eating behaviors were reported by a limited proportion of participants. Only 27.0% reported regular exercise, while 49.4% stated that they paid attention to healthy nutrition. Smoking and alcohol use were reported by 21.9% and 30.0% of students, respectively. Nearly all participants (97.4%) had never participated in a cancer screening program (Table 1).
Table 1.
Distribution of students according to descriptive characteristics
| Groups | n | % |
|---|---|---|
| Gender | ||
| Male | 20 | 8.6 |
| Female | 213 | 91.4 |
| Age | ||
| 18 | 105 | 45.1 |
| 19 | 128 | 54.9 |
| Marital Status | ||
| Married | 2 | 0.9 |
| Single | 231 | 99.1 |
| Department You Studied In | ||
| Nursing | 89 | 38.2 |
| Midwifery | 74 | 31.8 |
| Nutrition and Dietetics | 45 | 19.3 |
| Physiotherapy | 25 | 10.7 |
| Cancer Education Status | ||
| Yes | 7 | 3.0 |
| No | 226 | 97.0 |
| Family History of Cancer | ||
| Yes | 68 | 29.2 |
| No | 165 | 70.8 |
| Smoking Status | ||
| No | 182 | 78.1 |
| Yes | 51 | 21.9 |
| Alcohol Use Status | ||
| I’ve never used it. | 163 | 70.0 |
| Yes | 70 | 30.0 |
| Exercise Regularly | ||
| Yes | 63 | 27.0 |
| No | 170 | 73.0 |
| Eating Habits | ||
| I pay attention to healthy eating. | 115 | 49.4 |
| I don’t pay attention. | 118 | 50.6 |
| Social Security Status | ||
| SGK (Social Security Institution) | 120 | 51.5 |
| Private Insurance | 29 | 12.4 |
| None | 84 | 36.1 |
| Evaluating Your Health | ||
| Average | 89 | 38.2 |
| Very Good | 20 | 8.6 |
| Participation in the Screening Program | ||
| Yes | 6 | 2.6 |
| No | 227 | 97.4 |
| Sources of Information | ||
| Healthcare Professionals | 22 | 9.4 |
| Lessons | 22 | 9.4 |
| Family Friends | 41 | 17.6 |
| Social Media and TV | 148 | 63.5 |
| Presence of a Healthcare Professional in the Family | ||
| Yes | 89 | 38.2 |
| No | 144 | 61.8 |
| Cancer Symptoms* | ||
| Hair loss | 45 | 19.3 |
| Weakness | 35 | 15.0 |
| Pain | 26 | 11.2 |
| Body lump | 20 | 8.6 |
| Nausea and vomiting | 16 | 6.9 |
| Bruising | 15 | 6.4 |
| Fatigue | 12 | 5.2 |
| Loss of appetite | 9 | 3.9 |
| Weight loss | 22 | 9.4 |
| Shortness of breath | 5 | 2.1 |
| Skin sores | 4 | 1.7 |
| Headache | 2 | 0.9 |
* More than one selected item
According to Table 2, the mean total Cancer Awareness Scale score was moderate (45.51 ± 8.42). Examination of the subdimensions revealed that students had low awareness of the early warning signs of cancer, while their awareness of risk factors and the most common cancer types was at a moderate level. Awareness regarding the relationship between age and cancer was found to be very limited, as the majority of students were not aware that cancer risk increases with age.
Table 2.
Average cancer awareness scores
| Frequency | Mean | SD | Min | Max | Scale range | |
|---|---|---|---|---|---|---|
| Cancer Awareness Total | 233 | 45.51 | 8.42 | 25 | 72 | 11–77 |
| Warning Signs | 233 | 4.60 | 2.44 | 0 | 9 | 0–9 |
| Risk Factors | 233 | 32.39 | 6.88 | 11 | 55 | 11–55 |
| Cancer and Age | 233 | 0.02 | 0.14 | 0 | 1 | 0–1 |
| Most Common Cancers | 233 | 2.93 | 1.68 | 0 | 6 | 0–6 |
| Ministry of Health Screening Programs | 233 | 5.56 | 2.17 | 3 | 9 | 3–9 |
Higher scores indicate higher levels of cancer awareness. The total scale score ranges from 11 to 77
SD Standard deviation, Min Minimum, Max Maximum
According to Table 3, the majority of Health Sciences students (79.8%) demonstrated a moderate level of cancer awareness. Only 6.9% of the participants were found to have a low level of awareness, while 13.3% were classified in the high awareness group. Cut-off values were based on the original validation study of the Cancer Awareness Scale.
Table 3.
Distribution of participants according to cancer awareness levels
| Cancer Awareness Groups | Score Range | n | % |
|---|---|---|---|
| Low Awareness | 11–32 | 16 | 6.9 |
| Moderate Awareness | 33–54 | 186 | 79.8 |
| High Awareness | 55–77 | 31 | 13.3 |
According to Table 4, cancer awareness scores among Health Sciences students showed significant differences according to several sociodemographic characteristics. Female students had significantly higher total cancer awareness scores than male students, and this difference was particularly evident in the risk factors (p = 0.013) and Ministry of Health screening programs subdimensions (p = 0.028). Regarding academic departments, a significant difference was observed in the warning signs subdimension (p = 0.021), with nursing and physiotherapy students demonstrating higher awareness levels than nutrition and dietetics students. Students who exercised regularly had higher total awareness scores (p = 0.016), while those who paid attention to healthy nutrition demonstrated greater awareness of cancer risk factors (p = 0.039). Students with social security coverage also showed higher awareness regarding screening programs compared to those without coverage (p = 0.039). In terms of information sources, students who obtained cancer-related information from healthcare professionals or coursework demonstrated higher awareness of warning signs (p = 0.005) and screening programs (p = 0.018) compared to those relying on media sources.
Table 4.
Differentiation of cancer awareness scores according to descriptive characteristics
| Features | n | Cancer Awareness Total | Warning Signs | Risk Factors | Cancer and Age | Most Common Cancers | Screening Programs | |
|---|---|---|---|---|---|---|---|---|
| Mean ± SD |
Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | |||
| Gender | Male | 20 | 40.10 ± 7.68 | 3.80 ± 1.94 | 28.75 ± 6.46 | 0.00 ± 0.00 | 3.00 ± 2.05 | 4.55 ± 2.01 |
| Female | 213 | 46.03 ± 8.32 | 4.68 ± 2.48 | 32.74 ± 6.84 | 0.02 ± 0.15 | 2.93 ± 1.65 | 5.66 ± 2.16 | |
| t | -3.065 | -1.538 | -2.504 | -0.690 | 0.178 | -2.209 | ||
| p= | 0.002 | 0.125 | 0.013 | 0.491 | 0.883 | 0.028 | ||
| Department | 1Nursing | 89 | 44.93 ± 8.45 | 4.98 ± 2.40 | 31.55 ± 7.70 | 0.02 ± 0.15 | 2.85 ± 1.74 | 5.53 ± 2.16 |
| 2Midwifery | 74 | 45.80 ± 7.66 | 4.35 ± 2.27 | 32.76 ± 5.92 | 0.03 ± 0.16 | 2.97 ± 1.53 | 5.69 ± 1.96 | |
| 3Nutrition and Dietetics | 45 | 44.76 ± 8.46 | 3.84 ± 2.26 | 32.36 ± 6.15 | 0.02 ± 0.15 | 3.13 ± 1.77 | 5.40 ± 2.39 | |
| 4Physiotherapy | 25 | 48.16 ± 10.17 | 5.36 ± 3.03 | 34.40 ± 7.60 | 0.00 ± 0.00 | 2.76 ± 1.88 | 5.64 ± 2.48 | |
| F= | 1.116 | 3.302 | 1.225 | 0.218 | 0.375 | 0.184 | ||
| p= | 0.343 | 0.021 | 0.301 | 0.884 | 0.771 | 0.907 | ||
| Post hoc (Tukey): | 1 > 3. 4 > 3 | |||||||
| Smoking | No | 182 | 45.74 ± 8.98 | 4.65 ± 4.07 | 32.33 ± 6.85 | 0.02 ± 0.15 | 3.01 ± 1.66 | 5.73 ± 2.16 |
| Yes | 51 | 44.73 ± 10.20 | 4.41 ± 4.36 | 32.63 ± 7.09 | 0.02 ± 0.14 | 2.69 ± 1.76 | 4.98 ± 2.11 | |
| t | 0.910 | 0.856 | -0.272 | 0.103 | 1.196 | 2.200 | ||
| p= | 0.364 | 0.393 | 0.786 | 0.918 | 0.233 | 0.029 | ||
| Do Regular Exercise? | Yes | 63 | 47.71 ± 8.53 | 5.22 ± 2.31 | 33.59 ± 6.79 | 0.02 ± 0.13 | 2.87 ± 1.62 | 6.02 ± 2.14 |
| No | 170 | 44.71 ± 8.25 | 4.37 ± 2.46 | 31.95 ± 6.89 | 0.02 ± 0.15 | 2.96 ± 1.71 | 5.40 ± 2.17 | |
| t | 2.448 | 2.388 | 1.615 | -0.357 | -0.344 | 1.935 | ||
| p= | 0.015 | 0.018 | 0.108 | 0.722 | 0.731 | 0.054 | ||
| Eating Habits | I Pay Attention | 115 | 46.86 ± 8.65 | 4.80 ± 2.41 | 33.34 ± 6.93 | 0.03 ± 0.16 | 3.02 ± 1.59 | 5.68 ± 2.17 |
| I Don’t Pay Attention | 118 | 44.21 ± 8.01 | 4.41 ± 2.47 | 31.47 ± 6.75 | 0.02 ± 0.13 | 2.86 ± 1.78 | 5.46 ± 2.18 | |
| t | 2.426 | 1.230 | 2.081 | 0.479 | 0.730 | 0.775 | ||
| p= | 0.016 | 0.220 | 0.039 | 0.632 | 0.466 | 0.439 | ||
| Social Security | 1Social Security Institution | 120 | 46.10 ± 8.27 | 4.79 ± 2.50 | 32.53 ± 6.81 | 0.04 ± 0.20 | 2.83 ± 1.61 | 5.92 ± 2.11 |
| 2Private Insurance | 29 | 43.97 ± 9.18 | 4.69 ± 2.17 | 30.79 ± 6.52 | 0.00 ± 0.00 | 3.34 ± 1.91 | 5.14 ± 2.25 | |
| 3None | 84 | 45.23 ± 8.38 | 4.30 ± 2.44 | 32.76 ± 7.12 | 0.00 ± 0.00 | 2.95 ± 1.71 | 5.21 ± 2.17 | |
| F= | 0.829 | 1.033 | 0.925 | 2.425 | 1.117 | 3.296 | ||
| p= | 0.438 | 0.358 | 0.398 | 0.091 | 0.329 | 0.039 | ||
| Post hoc (Tukey): | 1 > 3 | |||||||
| Sources of Information | 1Healthcare Professionals | 22 | 46.18 ± 10.08 | 6.05 ± 2.57 | 30.73 ± 7.88 | 0.05 ± 0.21 | 2.68 ± 1.39 | 6.68 ± 2.21 |
| 2Lessons | 22 | 48.41 ± 8.85 | 5.41 ± 2.50 | 33.86 ± 7.12 | 0.00 ± 0.00 | 2.86 ± 1.91 | 6.27 ± 2.16 | |
| 3Family Friends | 41 | 45.17 ± 8.30 | 4.51 ± 2.43 | 32.54 ± 7.09 | 0.00 ± 0.00 | 2.80 ± 1.90 | 5.32 ± 2.27 | |
| 4Social Media and TV | 148 | 45.09 ± 8.12 | 4.29 ± 2.34 | 32.9 ± 6.66 | 0.03 ± 0.16 | 3.02 ± 1.64 | 5.36 ± 2.08 | |
| F= | 1.063 | 4.365 | 0.767 | 0.729 | 0.383 | 3.422 | ||
| p= | 0.366 | 0.005 | 0.513 | 0.536 | 0.766 | 0.018 | ||
| Post hoc (Tukey): | 1 > 3. 1 > 4. 2 > 4 | 1 > 3. 1 > 4 | ||||||
| Presence of a Healthcare Professional in the Family | Yes | 89 | 46.35 ± 9.13 | 5.00 ± 2.33 | 33.11 ± 7.48 | 0.01 ± 0.11 | 2.70 ± 1.61 | 5.53 ± 2.23 |
| No | 144 | 45.01 ± 7.94 | 4.35 ± 2.48 | 31.95 ± 6.48 | 0.03 ± 0.16 | 3.08 ± 1.72 | 5.59 ± 2.14 | |
| t | 1.183 | 1.973 | 1.252 | -0.844 | -1.707 | -0.212 | ||
| p= | 0.238 | 0.050 | 0.212 | 0.399 | 0.089 | 0.832 | ||
F One-way ANOVA, t Independent samples t-test, Post hoc Tukey test
Effect size analysis revealed that the gender difference in total cancer awareness scores was medium in magnitude (Cohen’s d = 0.72). The effect of regular exercise (Cohen’s d = 0.36) and healthy eating habits (Cohen’s d = 0.32) were small. Eta-squared values for ANOVA comparisons were small for department (η² = 0.014), social security status (η² = 0.007), and information source (η² = 0.014), indicating that practical significance should be interpreted with caution.
The multiple linear regression model was statistically significant (F(12, 220) = 2.772, p = 0.002) and explained 13.1% of the variance in total cancer awareness scores (R² = 0.131, adjusted R² = 0.084). When potential confounders were controlled simultaneously, female gender (β = 0.268, p < 0.001) and studying in the physiotherapy department compared to nursing (β = 0.188, p = 0.008) and regular exercise (β = 0.171, p = 0.013) remained significant independent predictors of higher cancer awareness. Other variables including department (midwifery, nutrition), healthy eating, smoking, social security status, and information source did not independently predict awareness after controlling for other variables (all p > 0.05). Multicollinearity was not a concern (all VIF < 3.0) (Table 5).
Table 5.
Multiple linear regression analysis of predictors of total cancer awareness score
| Variable | B | SE | β | t | p | 95% CI | VIF |
|---|---|---|---|---|---|---|---|
| Gender (ref: male) | 8.043 | 2.068 | 0.268 | 3.888 | < 0.001 | [3.97, 12.12] | 1.20 |
| Department (ref: nursing) | |||||||
| Midwifery | 0.562 | 1.318 | 0.031 | 0.427 | 0.670 | [-2.03, 3.16] | 1.35 |
| Nutrition and Dietetics | 0.203 | 1.554 | 0.010 | 0.130 | 0.896 | [-2.86, 3.26] | 1.35 |
| Physiotherapy | 5.104 | 1.909 | 0.188 | 2.674 | 0.008 | [1.34, 8.87] | 1.25 |
| Regular Exercise (ref: no) | 3.238 | 1.287 | 0.171 | 2.516 | 0.013 | [0.70, 5.78] | 1.17 |
| Healthy Eating (ref: no) | 1.621 | 1.154 | 0.096 | 1.405 | 0.162 | [-0.65, 3.89] | 1.19 |
| Smoking (ref: non-smoker) | -1.135 | 1.366 | -0.056 | -0.831 | 0.407 | [-3.83, 1.56] | 1.15 |
| Social Security (ref: SGK) | |||||||
| Private Insurance | -1.202 | 1.808 | -0.047 | -0.665 | 0.507 | [-4.77, 2.36] | 1.28 |
| No Insurance | -0.798 | 1.181 | -0.046 | -0.676 | 0.500 | [-3.12, 1.53] | 1.15 |
| Information Source (ref: healthcare prof.) | |||||||
| Lessons | 2.768 | 2.463 | 0.096 | 1.124 | 0.262 | [-2.09, 7.62] | 1.86 |
| Family/Friends | 0.953 | 2.183 | 0.043 | 0.436 | 0.663 | [-3.35, 5.26] | 2.48 |
| Social Media/TV | 0.521 | 1.881 | 0.030 | 0.277 | 0.782 | [-3.19, 4.23] | 2.94 |
Bold p-values indicate statistical significance (p < 0.05). Reference categories are indicated in parentheses
B unstandardized coefficient, SE standard error, β standardized coefficient, CI confidence interval, VIF variance inflation factor
Model: R = 0.362, R² = 0.131, Adjusted R² = 0.084, F(12, 220) = 2.772, p = 0.002
Discussion
This study evaluated cancer awareness levels, preventive behaviors, and factors associated with awareness among health sciences students. Overall cancer awareness was moderate, whereas awareness regarding early warning signs and national cancer screening programs remained limited. These findings suggest that although students possess basic cancer-related knowledge, this knowledge may not be sufficient to support preventive health behaviors.
Cancer screening behaviors and related characteristics
Only 2.6% of students reported participation in any cancer screening program. This finding should be interpreted cautiously because most participants were 18–19 years old and therefore outside the recommended age range for many national cancer screening programs. Nevertheless, awareness during young adulthood remains important, as this developmental period plays a critical role in shaping future preventive health behaviors and professional attitudes toward health promotion [14–16].
Similar studies among university students have also reported that cancer awareness does not necessarily translate into preventive health behaviors [17–19]. Consistent with previous research, the present study demonstrates a clear gap between students’ awareness levels and their actual engagement in cancer screening practices. This discrepancy reinforces the notion that knowledge, while necessary, is not a sufficient determinant of preventive health behaviors in isolation. Previous studies have indicated that psychosocial and structural barriers such as low perceived susceptibility to cancer, fear and anxiety, limited motivation, and inadequate engagement with healthcare services may negatively influence screening behaviors [20, 21]. In addition, reliance on informal information sources such as social media and television may contribute to superficial understanding of cancer-related issues and limited translation of knowledge into behavior [22–24]. Students’ tendency to primarily recognize visible symptoms rather than early nonspecific warning signs has also been reported in earlier studies [25], supporting the notion that awareness often remains at a basic or surface level. These results indicate that cancer screening behaviors are shaped not only by individual knowledge but also by a combination of multidimensional structural and psychosocial factors.
The gap observed between awareness and preventive behavior may also be interpreted within the framework of the Health Belief Model. According to this model, knowledge alone is often insufficient to promote preventive behaviors unless individuals also perceive themselves to be at risk, believe in the benefits of preventive action, and feel capable of accessing healthcare services [26]. Given the young age of the participants, low perceived susceptibility to cancer may partially explain the limited engagement in screening behaviors despite moderate awareness levels.
Cancer awareness scores and levels
In this study, the mean Cancer Awareness Scale score among Health Sciences students indicated a moderate level of awareness (45.51 ± 8.42), with most participants (79.8%) classified in the moderate category. Although this reflects a basic understanding of cancer, it suggests that awareness is not at a level sufficient to consistently support preventive behavioral change. These findings are consistent with previous studies reporting similarly moderate awareness levels among university students across different settings, including those in health related disciplines where awareness is often limited to surface level knowledge [17, 27, 28].
Analysis of subdimensions revealed lower levels of awareness, particularly in early warning sign recognition. This finding is consistent with previous studies showing that young adults often have difficulty identifying early and nonspecific cancer symptoms [29, 30]. Limited recognition of early warning signs may delay help-seeking behaviors and represents an important public health issue. These results underscore the need to strengthen applied, case based educational approaches within health sciences curricula to improve early symptom recognition.
Awareness of risk factors was moderate, indicating partial but not fully consolidated knowledge of behavioral and environmental determinants of cancer. Previous studies among health sciences students have also reported deficiencies in accurately identifying cancer risk factors [31–33]. This persistent gap may reduce the effectiveness of future health professionals in implementing and promoting cancer prevention strategies.
Low awareness regarding age as a risk factor reflects the persistent perception of cancer as a disease primarily affecting older adults, a misconception widely documented in the literature [34, 35]. This belief may contribute to reduced engagement with preventive health information during young adulthood and potentially delay the development of future screening behaviors. Awareness levels regarding the most common cancer types and the national screening programs implemented by the Ministry of Health were also limited. Previous studies have similarly shown that young adults often have insufficient knowledge regarding screening programs and common cancer types [36–38]. Limited awareness in these areas may restrict students’ ability to promote early detection awareness both for themselves and within the wider community.
Differences in cancer awareness levels according to descriptive characteristics
The findings of this study suggest that cancer awareness is influenced by factors beyond knowledge level alone, including gender, academic department, lifestyle behaviors, social security status, and sources of information. These results indicate that interventions aimed at improving cancer awareness should consider both individual and contextual determinants [39, 40].
Female students demonstrated higher cancer awareness scores compared to male students, a finding consistent with previous research [41–43]. However, this result should be interpreted cautiously due to the gender imbalance in the study sample. Existing literature suggests that this difference may be related to greater health consciousness, higher engagement with preventive health services, and more proactive health-seeking behaviors among female individuals [39].
Academic department was another significant factor, with nursing and physiotherapy students showing higher awareness, particularly in early warning sign recognition. This finding suggests that clinically oriented education and practice based training may enhance awareness of cancer symptoms and strengthen preventive health competencies among health sciences students [19, 43, 44].
Lifestyle-related behaviors also showed a consistent association with awareness levels. Students who did not smoke and those who engaged in regular physical activity had higher awareness scores, particularly in screening-related and early warning sign subdimensions [45–47]. These findings suggest that engagement in healthy behaviors may cluster with greater health consciousness and increased attention to preventive health information.
Students who reported paying attention to healthy eating demonstrated higher awareness of cancer risk factors. Previous studies have suggested that maintaining a balanced diet may be associated not only with reduced cancer risk but also with improved understanding of health related information [48, 49]. In addition, students with social security coverage showed higher awareness of screening programs, indicating that access to healthcare services may facilitate greater exposure to preventive health information and services [40].
When evaluated in terms of information sources, students receiving cancer-related information from courses and healthcare professionals had higher awareness than those relying on social media or television. This suggests that structured, expert-led sources are more effective in supporting accurate cancer awareness, whereas informal media may provide less reliable information [50–52].
In the multivariate analysis, female gender, studying in the physiotherapy department, and regular exercise remained independent predictors of cancer awareness. These findings suggest that both educational exposure and individual health related behaviors may contribute to awareness beyond basic sociodemographic characteristics. However, the relatively low proportion of explained variance indicates that additional psychosocial, cultural, and environmental determinants may also influence cancer awareness.
Taken together, the findings indicate that cancer awareness among health sciences students is influenced by multiple interacting individual and contextual factors.
Limitations of the study
This study has several limitations. First, the cross-sectional design limits the ability to establish causal relationships between cancer awareness and associated factors. Second, the study was conducted at a single faculty and included only first-year health sciences students, which may limit the generalizability of the findings to students from other academic years, institutions, or disciplines. In addition, the predominance of female participants may have influenced gender-based comparisons and reduced the representativeness of the sample. Since the data were collected through self-reported questionnaires, the findings may also have been affected by recall bias and social desirability bias. Although multivariate regression analysis was performed, the model explained only a limited proportion of the variance in cancer awareness, suggesting that additional psychosocial, cultural, and environmental factors may also contribute to awareness levels. Despite these limitations, the study provides important insights into cancer awareness among future healthcare professionals.
Conclusion
This study demonstrated that the overall level of cancer awareness among health sciences students was moderate; however, awareness was not equally distributed across subdimensions, with particularly limited awareness regarding early warning signs, age-related cancer risk, common cancer types, and national screening programs. Cancer awareness was associated with several individual and contextual factors, including gender, academic department, lifestyle behaviors, social security status, and sources of information.
Students who received clinically oriented education, adopted healthy lifestyle behaviors, and obtained information from reliable sources demonstrated higher awareness levels. These findings emphasize the importance of strengthening cancer awareness initiatives within health sciences education. Integrating practical training, case based learning, and evidence-based health education into university curricula may help improve awareness of cancer prevention, early detection, and screening practices among future healthcare professionals.
From a public health perspective, improving cancer awareness during early university education may contribute not only to individual preventive health behaviors but also to the development of future healthcare professionals capable of promoting cancer prevention, early detection, and community-based health promotion initiatives.
Recommendations
Evidence-based cancer prevention, early warning signs, and national screening programs should be more comprehensively integrated into undergraduate health sciences curricula.
Clinical scenarios, case based learning, and simulation methods should be used to foster awareness that translates into preventive behavior.
Students should be encouraged to access reliable and expert-based information sources.
University-based programs promoting healthy lifestyle behaviors should be integrated with cancer awareness education.
Multidisciplinary public health campaigns and behavioral interventions targeting young adults should be implemented within universities to strengthen long-term engagement in cancer prevention and early detection practices.
Acknowledgements
We would like to thank all our patients who participated in this study for their support and mutual exchange of information.
Authors’ contributions
YÖG; contributed in conceptualization, data curation, analysis, investigation, methodology, project coordination, visualization, and writing the original draft. BAK; contributed in conceptualization, analysis, methodology, validation, and reviewing and editing the manuscript. All authors read and approved the final manuscript.
Funding
This research has not received a specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Data availability
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Declarations
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.