Elementary schools in Jordan have included health education material in curricula to promote healthy lifestyles among younger school children. However, the relation between healthy lifestyles and the prevention of chronic diseases such as cancer has not been an explicit component in school curricula of younger age groups. We sought to explore the level of knowledge among 6th grade students as well as their attitudes with respect to cancer. This comes as part of a pilot project to develop an educational series on cancer prevention that aims to meet knowledge gaps specific to the community of students in this age group in Jordan.

Methods: A questionnaire composed of items measuring knowledge about cancer and cancer prevention through healthy practices, attitudes towards cancer, and intentions to engage in healthy behaviors was developed. Questionnaires previously used in similar age groups elsewhere were used as a reference. Our questionnaire was reviewed and approved by the Ministry of Education - School Health & Nutrition Department. Sixth graders in a convenience sample of four schools selected by the Ministry of Education completed the self-administered questionnaire.

Results: Ninety-six 6th graders from four schools answered the baseline survey, but 28% of the surveys were excluded from the analysis (data quality problems) leaving 69 student participants. In the original sample of 96 students, 48 (69.6%) were girls. Among the 69 student participants, 67 (97.1%) had heard of cancer, but fewer than 44 (63.8% knew it was not a contagious disease. Regarding fear, 29 (42%) would not play with a cancer patient. Concerning prevention of the most prevalent cancers in Jordan as research has shown that certain risk factors increase the chance that a person will develop cancer. The most common risk factors are smoking, Poor diet, lack of physical activity, or being overweight, 25 (36.2%) knew breast cancer was preventable, and 28 (40.6%) and 24 (34.8%) knew this regarding lung and colorectal cancers, respectively. About 40 (57.8%) students identified healthy dietary behaviors (e.g., low fat, low sugar), but only six could identify the ideal frequency for exercise (60 minutes daily). Fifty-eight (84.1%) agreed that cigarettes harmed the health. However, only 21 (30.4%) found it easy to avoid exposure to secondhand smoke. Nine (13%) reported smoking water pipes, but only one reported smoking cigarettes. Forty-eight (69.6%) and 47 (68.1%) agreed that daily physical activity and healthy eating were important, respectively. Fifty-two (75.4%) students found it easy to eat healthy at home, but only 37 (53.6%) found it easy to do so at school. Finally, 63 (91.3%) students wanted to learn more about cancer.

Conclusion: Although a significant number of our sample of students has heard about cancer and students exhibit some knowledge regarding healthy practices, our results show that knowledge gaps exist with regard to the nature of cancer as a noncontagious disease, the preventability of specific cancers, and the link between specific risk factors and cancer.