Awareness towards Cancer Attributable to Infections (CAI): A Lebanese study with a special focus on young adults, and adults

Q: What was the main objective of the Lebanese CAI awareness study?

To determine the level of awareness about cancer attributable to infections (CAI) in Lebanon, with emphasis on young adults and adults.

Q: How was the survey conducted and what topics did it cover?

A valid, reliable questionnaire was distributed over two months via social media and professional platforms, and it included socio-demographic information plus awareness related to CAI.

Q: Which CAI awareness and vaccine findings were reported?

About 43.4% recognized HBV/HCV as causes of liver cancer, 34.9% recognized HPV as a cause of cervical cancer, and only 27.7% reported receiving the HBV vaccine while 11.8% reported receiving the HPV vaccine.

Sep 22, 2026

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Infections are a growing worldwide risk factor for cancer, yet Lebanon has limited evidence on how well people understand the infection–cancer connection. This descriptive cross-sectional survey assessed awareness toward cancer attributable to infections (CAI) among young adults and adults in multiple Lebanese districts. Results show uneven knowledge across CAI types and low vaccine coverage, with awareness varying by gender, nationality, education, occupation, and mid-level family income. The findings support targeted education for more effective prevention and early detection.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages57

Reading Time2 h 24 min

AccessFree to download

Summary

Introduction

Methods

Results

Conclusion

Methods

Study design

Study procedure

Data analysis and presentation

OPEN ACCESS J PREV MED HYG 2025; 66: E554-E610 NoN comuNicable diseases Awareness towards Cancer Attributable to Infections (CAI): A Lebanese study with a special focus on young adults, and adults FARAH ZEINEH1, SALIM MOUSSA1 1 Medical Laboratory Technology Department, Beirut Arab University, Beirut, Lebanon Keywords CAI • Vaccine • Awareness level • Socio-demographics • Middle East • Young adults • Adults Summary Introduction. Around two million cancer cases per year are caused by infections. Currently, there is a lack of studies assessing awareness of the link between infections and cancer in Lebanon. This knowledge is essential for the effective prevention, early detection, and management of these cancers. Thus, the aim of this study was to determine the level of awareness of cancer attributable to infections (CAI) in Lebanon especially among young adults, and adults. Methods. A cross-sectional, descriptive research study was conducted for two months in Beirut, Beqaa, Mount Lebanon, South Lebanon, and North Lebanon. A valid and reliable survey was distributed to participants. The survey was divided into two sections: socio-demographic information and awareness of CAI. Result. Approximately 43.4% of participants knew that hepatitis B virus (HBV) and hepatitis C virus (HCV) cause liver cancer. Around 34.9% knew that human papillomavirus (HPV) causes cervical cancer. About 33.5% knew that stomach cancer is caused by Helicobacter pylori. Around 20% were aware of the association between Kaposi sarcoma-associated herpesvirus (KSHV) and Kaposi sarcoma, Epstein-Barr virus (EBV) and human T-cell lymphotropic virus type 1 (HTLV-1) and lymphoma. Around 27.7% of them had received the HBV vaccine. Only 11.8% of them had received the HPV vaccine. Conclusion. In Lebanon, young adults, and adults did not demonstrate the same level of awareness regarding the various types of CAI. Awareness levels increased among females, Lebanese individuals, healthcare workers, highly educated individuals, and those with a middle family income. Introduction Infection is emerging as a major risk factor for cancer worldwide. The International Agency for Research on Cancer (IARC) considers certain viruses, bacteria, and parasites to be carcinogenic to humans. Helicobacter pylori and the tumor viruses: human papillomavirus (HPV), and hepatitis B (HBV) and C (HCV) viruses, were among the top infectious agents associated with cancer cases based on the latest GLOBOCAN 2020 ([http://gco.iarc.fr/](http://gco.iarc.fr/)). China, Egypt, South Africa, Romania, and some countries in South America had the highest rates of cancer attributable to infections (CAI)(≥ 27.8 per 100 000) . In contrast, Australia, northern Europe, Canada, the United States of America (USA) and most of the countries in the Middle East and North Africa (MENA) region, such as Lebanon, had a low rate of CAI (< 15.8 per 100 000) . Infectious agents related to cancer can alter survival pathways and disrupt host cell genomic integrity through a variety of mechanisms, leading to malignancy rather than death [1, 2] . For example, the E6 and E7 oncoproteins produced by HPV could degrade the tumor suppressor p53 and pRb proteins, respectively, thereby disrupting cell cycle control and initiating cancer development [3] . Another example, the contribution of the Epstein-Barr virus nuclear antigen 1 (EBNA1) to tumorigenesis of infected epithelial cells [4] . Screening for pathogens associated with cancer would be a proactive strategy to reduce cancer incidence by eliminating the presence of these infections. Eradication of Helicobacter pylori is highly effective in preventing gastric cancer [5, 6] . Improvements in antiviral therapies for hepatitis B and C have reduced the incidence of liver cancer, as demonstrated by the successful use of directacting antivirals (DAAs) against HCV [7]. Unfortunately, available effective therapies don’t cover all CAI types, and many are s

FAQs

What was the main objective of the Lebanese CAI awareness study?

To determine the level of awareness about cancer attributable to infections (CAI) in Lebanon, with emphasis on young adults and adults.

How was the survey conducted and what topics did it cover?

A valid, reliable questionnaire was distributed over two months via social media and professional platforms, and it included socio-demographic information plus awareness related to CAI.

Which CAI awareness and vaccine findings were reported?

About 43.4% recognized HBV/HCV as causes of liver cancer, 34.9% recognized HPV as a cause of cervical cancer, and only 27.7% reported receiving the HBV vaccine while 11.8% reported receiving the HPV vaccine.

Sep 22, 2026

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