Knowledge, Attitudes, and Practices Regarding Oral Cancer Among Patients with Oral Cancer in Hunan Province, China: A Cross-Sectional Study.

Abstract

Purpose: This study aimed to assess oral cancer-related knowledge, attitudes, and practices (KAP) among patients in Hunan Province, thereby providing a scientific basis for precise prevention, control, and effective intervention strategies against oral cancer.

Methods: A cross-sectional survey was conducted in two tertiary hospitals in Hunan Province, China. A Chinese KAP questionnaire collected sociodemographic characteristics and assessed knowledge, attitudes, and practices.

Results: A total of 326 patients were included; most were male (89.9%), married (88.7%), and rural residents (55.8%). Median scores were 7.0 (IQR 6.0-8.0) for knowledge, 53.0 (IQR 48.0-56.5) for attitude, and 31.0 (IQR 28.0-34.0) for practice; total KAP score was 91.0 (IQR 84.0-96.0). Structural equation modeling showed K→A (β=0.499, P=0.020) and A→P (β=0.571, P<0.001); the indirect effect of knowledge on practice via attitude was significant (β=0.285, P=0.024) with 83.6% mediation (P<0.001). In multivariable analysis, attitude predicted practice (B=0.425, P<0.001); absence of hypertension was associated with higher practice (B=1.348, P=0.023), whereas ≥2-generation family history of oral cancer was associated with lower practice (B=-4.510, P=0.008). KAP domains were positively correlated, strongest for attitude-practice (r=0.518, P<0.01).

Conclusion: Participants demonstrated insufficient knowledge, positive attitudes, and suboptimal practices. Attitude fully mediated the knowledge-practice relationship, indicating that improving attitudes may be pivotal for behavior change. A feasible clinical implication is to implement structured, hospital-based education plus follow-up reinforcement, prioritizing patients with comorbid hypertension and those with strong family-history burden of oral cancer.