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J Cancer Educ. 2019 Mar 28. doi: 10.1007/s13187-019-01516-3. [Epub ahead of print]

Cancer Awareness and Barriers to Medical Treatment Among Syrian Refugees and Lebanese Citizens in Lebanon.

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Yale University, New Haven, CT, USA.
Santa Clara University, Santa Clara, CA, USA.
University of California San Diego, San Diego, CA, USA.
University of Miami, Coral Gables, FL, USA.
Yale School of Public Health, 60 College Street, Ste 405, New Haven, CT, 06510, USA.


The Syrian conflict has forced over a million refugees into Lebanon, which now faces the challenge of providing healthcare for this large, vulnerable population. Syrian refugees and Lebanese citizens suffer from an immense burden of cancer and encounter many barriers to obtaining healthcare. An increase in cancer awareness could prompt earlier diagnosis and treatment. This study aims to evaluate the level of cancer awareness and barriers to medical treatment among Syrian refugees and Lebanese citizens in Lebanon. A descriptive cross-sectional survey design was used. Four hundred seventeen Syrian refugees and 319 Lebanese citizens seeking healthcare in Lebanon completed the Cancer Awareness Measure. The mean age of Syrian refugees and Lebanese citizens was 33.8 years (SD 11.9) and 41.7 years (SD 16.3), respectively. Syrian refugees and Lebanese citizens were only able to recognize a low number of cancer symptoms (mean 4.2 (out of 9), SD 2.4 and 3.9, SD 2.3, respectively) and risk factors (mean 5.1 (out of 11), SD 2.6 and 5.2, SD 2.9, respectively). Barriers to seeking medical care were prevalent. The most commonly reported barrier among both samples was having no medical insurance or funds to cover the cost of treatment (78.9% and 67.7%, respectively). A comprehensive restructuring of the Lebanese healthcare system and a massive influx of resources are required for Syrian refugees and Lebanese citizens to obtain adequate access to cancer treatment. To encourage early diagnosis and treatment, much more work is needed to overcome barriers and enhance knowledge of cancer.


Barriers to medical treatment; Cancer; Cancer awareness; Cancer education; Health; Lebanon; Refugees


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