Development and Validation of a Cancer Awareness Questionnaire for Malaysian Undergraduate Students of Chinese Ethnicity

  • Loo, Jo Lin (Department of Nutrition and Wellness, Faculty of Applied Sciences, UCSI University) ;
  • Ang, Yee Kwang (Department of Nutrition and Wellness, Faculty of Applied Sciences, UCSI University) ;
  • Yim, Hip Seng (Department of Nutrition and Wellness, Faculty of Applied Sciences, UCSI University)
  • Published : 2013.01.31


Objectives: To describe the development and validation of a cancer awareness questionnaire (CAQ) based on a literature review of previous studies, focusing on cancer awareness and prevention. Materials and Methods: A total of 388 Chinese undergraduate students in a private university in Kuala Lumpur, Malaysia, were recruited to evaluate the developed self-administered questionnaire. The CAQ consisted of four sections: awareness of cancer warning signs and screening tests; knowledge of cancer risk factors; barriers in seeking medical advice; and attitudes towards cancer and cancer prevention. The questionnaire was evaluated for construct validity using principal component analysis and internal consistency using Cronbach's alpha (${\alpha}$) coefficient. Test-retest reliability was assessed with a 10-14 days interval and measured using Pearson product-moment correlation. Results: The initial 77-item CAQ was reduced to 63 items, with satisfactory construct validity, and a high total internal consistency (Cronbach's ${\alpha}$=0.77). A total of 143 students completed the questionnaire for the test-retest reliability obtaining a correlation of 0.72 (p<0.001) overall. Conclusions: The CAQ could provide a reliable and valid measure that can be used to assess cancer awareness among local Chinese undergraduate students. However, further studies among students from different backgrounds (e.g. ethnicity) are required in order to facilitate the use of the cancer awareness questionnaire among all university students.


  1. Redeker C, Wardle J, Wilder D, Hiom S, Miles A (2009). The launch of cancer research UK's “Reduce the Risk” campaign: Baseline measurements of public awareness of cancer risk factors in 2004. Eur J Cancer, 45, 827-36.
  2. San TA, Sari D, Turkistanli EC (2005). Knowledge, attitudes, risk factors, and early detection of cancer relevant to the school teachers in Izmir, Turkey. Prev Med, 40, 636-41.
  3. Sheikh I, Ogden J (1998). The role of knowledge and beliefs in help seeking behaviour for cancer: a quantitative and qualitative approach. Patient Educ Couns, 35, 35-42.
  4. Siklosi KR, Gallagher CG, McKone EF (2010). Development, validation, and implementation of a questionnaire assessing disease knowledge and understanding in adult cystic fibrosis patients. J Cyst Fibros, 9, 400-5.
  5. Simon AE, Waller J, Robb K, Wardle J (2010). Patient delay in presentation of possible cancer symptoms: The contribution of knowledge and attitudes in a population sample from the United Kingdom. Cancer Epidemiol Biomarkers Prev, 19, 2272-7.
  6. Stubbings S, Robb K, Waller J, et al (2009). Development of a measurement tool to assess public awareness of cancer. Br J Cancer, 101, 13-7.
  7. Uauy R, Solomons N (2005). Diet, nutrition, and the life-course approach to cancer prevention. J Nutri, 135, 2934-45.
  8. Waller J, Robb K, Stubbings S, et al (2009). Awareness of cancer symptoms and anticipated help seeking among ethnic minority groups in England. Br J Cancer, 101, 24-30.
  9. World Cancer Research Fund/American Institute for Cancer Research (2007). Food, nutrition, physical activity, and the prevention of cancer: a global perspective. AICR, Washington DC.
  10. Adlard J, Hume MJ (2003). Cancer knowledge of the general public in the United Kingdom: survey in a primary care setting and review of the literature. Clin Oncol, 15, 174-80.
  11. Aron A, Aron EN, Coups EJ (2006). Statistics for psychology (4th edn). Pearson Education Inc., New Jersey.
  12. Cancer Research UK (2008). Cancer awareness measure (CAM) toolkit (version 2), cancer research UK, University College London, Kings College and University of Oxford.
  13. Cohen RJ, Swerdlik ME (2005). Psychological testing and assessment: An introduction to test and measurement (6th edn). McGraw Hill, Illinois.
  14. Costello AB, Osborne JW (2005). Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Pract Asses Res Eval, 10, 1-9.
  15. de Nooijer J, Lechner L, de Vries H (2002). Early detection of cancer: knowledge and behaviour among Dutch adults. Cancer Detect Prev, 26, 362-9.
  16. Keeney S, McKenna H, Fleming P, McIlfatrick S (2011). An exploration of public knowledge of warning signs for cancer. Eur J Oncol Nurs, 15, 31-7.
  17. Linsell L, Forbes LJL, Burgess C, et al (2010). Validation of a measurement tool to assess awareness of breast cancer. Eur J Cancer, 46, 1374-81.
  18. Lopez ML, Iglesias JM, Cueto GM, et al (2006). Attitude to primary prevention advice of the European Code against cancer in relatives of cancer patients: Implications for the development of preventive programmes. Psicothema, 18, 478-84.
  19. Medeiros R, Ramada D (2011). Knowledge differences between male and female university students about human papillomavirus (HPV) and cervical cancer: implications for health strategies and vaccination. Vaccine, 29, 153-60.
  20. National Cancer Registry (NCR), Malaysia (2007). National cancer registry report: Malaysia cancer statistics - data and figure 2007. Ministry of Health, Malaysia.
  21. Pallant J (2011). SPSS survival manual: A step by step guide to data analysis using SPSS (4th edn). Allen and Unwin, Australia.
  22. Perez-Contreras I, Allen B, Ruiz-Velasco S, et al (2004). Levels and correlates of knowledge about cancer risk factors among 13,293 public school students in Morelos, Mexico. Prev Med, 39, 286-99.

Cited by

  1. Cancer Awareness among University Students in Turkey vol.15, pp.10, 2014,