Oral Cancer Screening Intentions of Residents in Eastern Taiwan

Authors: Chi-Shan Chen, Mao-Chou Hsu, Feng-Chuan Pan

Abstract:

The incidence of oral cancer in Taiwan increased year by year. It replaced the nasopharyngeal as the top incurrence among head and neck cancers since 1994. Early examination and earlier identification for earlier treatment is the most effective medical treatment for these cancers. Although the government fully subsidized the expenses with tremendous promotion program for oral cancer screening, the citizen-s participation remained low. Purpose of this study is to understand the factors affecting the citizens- behavior intensions of taking an oral cancer screening. Based on the Theory of Planned Behavior, this study adopted four distinctive variables in explaining the captioned behavior intentions.700 questionnaires were dispatched with 500 valid responses or 71.4% returned by the citizens with an age 30 or above from the eastern counties of Taiwan. Test results has shown that attitude toward, subjective norms of, and perceived behavioral control over the oral cancer screening varied from some demographic factors to another. The study proofed that attitude toward, subjective norms of, and perceived behavioral control over the oral cancer screening had positive impacts on the corresponding behavior intention. The test concluded that the theory of planned behavior was appropriate as a theoretical framework in explaining the influencing factors of intentions of taking oral cancer screening. This study suggested the healthcare professional should provide high accessibility of screening services other than just delivering knowledge on oral cancer to promote the citizens- intentions of taking the captioned screening. This research also provided a practical implication to the healthcare professionals when formulating and implementing promotion instruments for lifting the screening rate of oral cancer.

Keywords: Theory of planned behavior, oral cancer, cancer screening

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1329510

References:

[1] World Health Organization (WHO) (2010). World health statistics. Retrieved June 20, 2011 from the World Wide Web: http://www.who.int/en/.
[2] Department of Health (DOH) (2010). Death Statistics, 2009. Retrieved on 2011/7/02 at http://www.doh.gov.tw/CHT2006/DM/DM2_2 .aspx? now_fod_list_no=10238&class_no=440&level_no=1.
[3] Blot, W. J., McLaughlin, J. K., & Winn, D. M. (1988). Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Research, 48(11), 3282-3287.Ajzen, I. (1985). Action-control: From cognition to behavior. In J. Kuhl & J. Beckman (Eds.), From intentions to actions: A theory of planned behavior (11-39). Berlin, New York: Springer-Verlag.
[4] Choi, S. Y. & Kahyo, H. (1991). Effect of cigarette smoking and alcohol consumption in the aetiology of cancer of the oral cavity, pharynx and larynx. International Journal of Cancer, 49(3), 381-386.
[5] Ko, Y. C., Chiang, T. A., & Chang, S. J. (1992). Prevalence of betel quid chewing habit in Taiwan and related sociodemographic factors. Journal of Oral Pathology Medicine, 21(6), 261-64.
[6] Ko, Y. C., Huang, Y. L., Lee, C. H., Chen, M. J., Lin, L. M., & Tsai, C. C. (1995). Betel quid chewing, cigarette smoking and alcohol consumption related to oral cancer in Taiwan. Journal of Oral Pathology & Medicine 24(10), 450-453.
[7] Vokes, E. E., Weichselbaum, R. R., Lippman, S. M., & Hong, W. K. (1993). Head and neck cancer. The New England Journal of Medicine, 328(3), 184-194.
[8] Wu, H. P., Hsu, L. P., & Chen, P. R. (2001). Treatment of laryngeal cancer at Buddhist Tzu Chi General Hospital. Tzu Chi Medical Journal, 13(4), no pagination.
[9] Ho, P. S., Ko, Y. C. Yang, Y. H. Shieh, T. Y. & Tsai, C. C. (2002).The incidence of oropharyngeal cancer in Taiwan: An endemic betel quid chewing area. Journal of Oral Pathology Medicine, 31(4), 213-219.
[10] Lin, Z. M., Hsu, L. P., Huang, T. T., Tu, C. E., & Chen, P. R. (2004). Head and neck cancers of aborigines in eastern Taiwan. Formosan Journal of Medicine, 8(6), 766-772.
[11] Trivedy, C. R., Craig, G., &Warnakulasuriya, S. (2002). The oral health consequences of chewing Areca Nut. Addiction Biology, 7(1), 115-125.
[12] Shiu, M. N., Chen, T. H. H., Chang, S. H, & Hahn, L. J. (2000). Risk factors for leukoplakia and malignant transformation to oral carcinoma: a leukoplakia cohort in Taiwan. British Journal of Cancer, 82(11), 1871-1874.
[13] Boffetta, P., & Hecht, S. (2008).Smokeless tobacco and cancer. Lancet Oncology, 9(2), 667-675.
[14] Jayalekshmi, P. A., Gangadharan, P., Akiba, S., Nair, R. R. K., Tsuji, M., & Rajan, B. (2009). Tobacco chewing and female oral cavity cancer risk in Karunagappally cohort, India. British Journal of Cancer, 100(5), 848-852.
[15] Altieri, A., Bosetti, C., & Gallus, S. (2004). Wine, beer and spirits and risk of oral and pharyngeal cancer: a case-control study from Italy and Switzerland. Oral Oncology, 40(9), 904-9.
[16] Wilkie, S. (2005). Oral cancer: Presumptions of innocence can prove deadly. Access, 19(3), 24-28.
[17] McCullough M. J., & Farah C. S, (2008). The role of alcohol in oral carcinogenesis with particular reference to alcohol-containing mouthwashes. Australian Dental Journal, 53(4), 302-305.
[18] Ajzen, I. (1988). Attitudes, personality, and behavior. Chicago, IL: The Dorsey Press.
[19] Montano, D. E., & Taplin, S. H. (1991). A test of an expanded theory of reasoned action to predict mammography participation. Social Science and Medicine, 32(6), 733-741.
[20] Netemeyer, R. G., Andrews, J. C., & Durvasula, S. (1993). A comparison of three behavioral intention models: The case of Valentine-s day gift-giving. Advances in Consumer Research, 20(1), 135-141.
[21] Blue, C. L. (1995). The predictive capacity of the theory of reasoned action and the theory of planned behavior in exercise research: An integrated literature review. Research in Nursing and Health, 18(2), 105-121.
[22] Millstein, S. G. (1996). Utility of the theories of reasoned action and planned behavior for predicting physician behavior: A prospective analysis. Health Psychology, 15(5), 398-402.
[23] Sheppard, B. H., Hartwick, J., & Warshaw, P. R. (1988). The theory of reasoned action: A meta-analysis of past research with recommendations for modifications and future research. Journal of Consumer Research, 15(3), 325-343.
[24] Schifter, D. B., & Ajzen, I. (1985). Intention, perceived control, and weight loss: An application of the theory of planned behavior. Journal of Personality and Social Psychology, 49(3), 843-851.
[25] Ajzen, I., & Madden, T. J. (1986). Prediction of goal-directed behavior: Attitudes, intentions and perceived behavioral control. Journal of Experimental Social Psychology, 22(5), 453-474.
[26] Nash, R., Edwards, H., & Nebauer, M. (1993). Effects of attitudes, subjective norms and perceived control on nurses- intention to assess patients- pain. Journal of Advanced Nursing, 18(6), 941-947.
[27] Conner, M., & Norman, P. (1994). Comparing the health belief model and the theory of planned behaviour in health screening. In D. R. Rutter & L. Quine (Eds.), Social psychology and health: European perspectives (1-24). Aldershot: Avebury.
[28] Fishbein, M. (1967). Attitude and the prediction of behavior. In M. Fishbein (Eds.), Readings in attitude theory and measurement (477-492). New York: Wiley.
[29] Ajzen, I. (1991). The theory of planning behaviour. Organizational Behavior and the Human Decision Process, 50 (2), 179-211.
[30] Lee, B., & Green, R. T. (1991). Cross-cultural examination of the Fishbein behavioral intentions model. Journal of International Business Studies, 22(2), 289-305.
[31] Fishbein, M. & Ajzen, I. (1975). Beliefs, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.
[32] Ajzen, I., & Driver, B. L. (1992). Application of the theory of planned behavior to leisure choice. Journal of Leisure Research, 24(3), 207-224.
[33] Taylor, S. E., & Todd, P. A. (1995). An integrated model of waste management behavior: A test of household recycling and composting intentions. Environment and Behavior, 27(5), 603-630.
[34] Ajzen, I. (2002). Constructing a TPB Qyestionnaire: Conceptual and Methodological Considerations. Retrieved June 12, 2011, from the World Wide Web: http://www-unix.oit.umass.edu/~aizen/index.html..
[35] Bandura, A. (1992). On rectifying the comparative anatomy of perceived control: Comments on ÔÇÿCognates of personal control-. Applied and Preventive Psychology, 1(2), 121-126.
[36] Sutton, S. (1998). Explaining and predicting intentions and behavior: How well are we doing? Journal of Applied Social Psychology, 28(15), 1318-1339.
[37] Bagozzi, R. P., & Kimmel, S. K. (1995). A comparison of leading theories for the prediction of goal-directed behaviours. British Journal of Social Psychology, 34(4), 437-461.
[38] Armitage, C. J., & Conner, M. (2000). Social cognition models and health behaviour: A structured review. Psychology and Health, 15(2), 173-189.
[39] Armitage, C. J., Norman, P., & Conner, M. (2002). Can the Theory of Planned Behaviour mediate the effects of age, gender and multidimensional health locus of control? British Journal of Health Psychology, 7(3), 299-316.
[40] Armitage, C. J., & Conner, M. (2001). Efficacy of the the theory of planned behaviour: A meta -analytic review. British Journal of Health Psychology, 40(4), 471-499.
[41] Hausenblas, H. A., Carron, A.V., & Mack, D. E. (1997). Application of the theory of reasoned action and planned behavior to exercise behavior: A meta-analysis. Journal of Sport and Exercise Psychology, 19(1), 36-51.
[42] Frost, S., Myers, L. B., & Newman, A. P. (2001). Genetic screening for Alzheimer-s disease: What factors predict intentions to take a rest? Behavior Medicine, 27(3), 101-109.
[43] Hrubes, D., & Daigle, J. (2001). Predicting hunting intentions and behavior: An application of the theory of planned behavior. Leisure Sciences, 23(3), 165-178.
[44] Kalafatis, S. P., Pollard, M., East, R., & Tsogas, M. H. (1999). Green marketing and Ajzen-s theory of planned behavior: A cross-market examination. Journal of Consumer Marketing, 16(5), 441-460.
[45] Cunningham, G. B., & Kwon, H. (2003). The theory of planned behaviour and intentions to attend a sport event. Sport Management Review, 6(2), 127-145.
[46] Mathieson, K. (1991). Predicting user intentions: Comparing the Technology Acceptance Model with The Theory of Planned Behavior. Information System Research, 2(3), 173-191.
[47] Venkatesh, V., Morris, M. G., & Ackerman, P. L.(2000). A longitudinal field investigation of gender differences in individual technology adoption decision-making processes. Organizational Behavior and Human Decision Processes, 83(1), 33-60.
[48] Saunders-Goldson, S., & Edwards, Q. (2004). Factors associated with breastfeeding intentions of African-American women at mlitary health care facilities. Military Medicine, 169(2), 111-116.
[49] Nigg, C. R., Lippke, S., & Maddock, J. E. (2009). Factorial invariance of the theory of planned behavior applied to physical activity across gender, age, and ethnic groups. Psychology of Sport and Exercise, 10(2), 219-225.
[50] Keeney, S., McKenna, H., Fleming, P., & McIlfatrick, S. (2010). Attitudes to cancer and cancer prevention: What do people aged 35-54 years think? European Journal of Cancer Care, 19(6), 769-777.
[51] Baggozi, R. P., & Yi, Y. (1988). On the evaluation for structural equation models. Journal of the Academy of Marketing Science, 16(1), 74-97.
[52] Rhodes, R. E., Blanchard, C. M., & Blacklock, R. E. (2008). Do physical activity beliefs differ by age and gender? Journal of Sport & Exercise Psychology, 30(3), 412-423.
[53] Hsieh, C. L. (2007). Factors associated with knowledge, attitude, and behavior of oral cancer in general population. Show Chwan Medical Journal, 7(1-2), 21-32.