Knowledge, willingness, and reported prior prostate cancer testing among men in Palestine: a cross-sectional online survey
5 affiliations
- 1Faculty of Medicine, Al-Quds University
- 2Research Scope
- 3Faculty of Medicine, Arab American University
- 4Faculty of Medicine, Palestine Polytechnic University
- 5Faculty of Medicine, An-Najah National University
Abstract
Background: Evidence on prostate cancer (PCa) knowledge and PSA-related testing behavior in Palestine remains limited. We assessed general awareness, factual knowledge, willingness to undergo PSA testing if offered, reported prior PSA testing/prostate examination, and factors associated with prior testing.
Methods: We conducted a cross-sectional online survey from 19 November to 21 December 2025 among adult men aged 18 years or older recruited from Palestinian communities. The full cohort comprised 1,047 consenting participants. The exported dataset contained two incompatible response formats for the 12 factual knowledge items; composite knowledge analyses were therefore limited to 568 respondents with complete, unambiguous single Yes/No responses. Knowledge was scored from 0 to 12 using the study answer key. Willingness and prior testing were analyzed as binary outcomes. Multivariable logistic regression assessed factors associated with prior testing.
Results: Mean age was 28.7 ± 12.4 years and 78.6% were aged 18–39 years. Overall, 80.0% had heard of PCa, 26.1% had heard of PSA testing, 31.2% were willing to undergo PSA testing if offered, and 5.6% reported prior PSA testing and/or prostate examination. Among the 568 scorable knowledge respondents, mean knowledge was 7.07 ± 1.84 of 12 and 89.1% had limited knowledge (<80% correct); KR-20 was 0.235. Adequate knowledge was associated with lower willingness (12.9% vs 32.8%; p=0.002) but not prior testing (3.2% vs 6.1%; p=0.526). In the full cohort, older age (aOR 1.08 per year; 95% CI 1.05-1.10), healthcare background (aOR 2.10; 95% CI 1.17-3.77), and first-degree family history (aOR 2.22; 95% CI 1.01-4.86) were independently associated with prior testing. Among never-tested participants, the leading reported barriers were low perceived personal risk (55.3%) and lack of physician/healthcare-provider recommendation (43.1%); multiple responses were allowed.
Conclusions: In this predominantly young online sample, general awareness exceeded detailed factual knowledge, while willingness and reported prior testing were low. The divergence between knowledge and behavior should be interpreted cautiously because knowledge analyses used a restricted subset and the shortened scale had low internal consistency. Findings support culturally appropriate, risk-adapted clinician-patient communication and further validation of locally adapted measurement tools.
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BibTeX
@article{salama2026knowledge,
title = {{Knowledge, willingness, and reported prior prostate cancer testing among men in Palestine: a cross-sectional online survey}},
author = {Karam Salama and Islam Staiti and Moath Hammad and Said Abu-Hajleh and Ahmed Mousa and Baha Kamel and Ahmad Salah and Osaid Heleseh and Aktham Al-safi and Bashar Al Jaraysa and Bashar Jamal and Momen AbuSaada and Majd Marwan Zaghal and Salahaldeen Deeb and Alhareth M. Amro and Mustafa Nakhala},
journal = {Frontiers in Oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1889495},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1889495/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Knowledge, willingness, and reported prior prostate cancer testing among men in Palestine: a cross-sectional online survey
AU - Karam Salama
AU - Islam Staiti
AU - Moath Hammad
AU - Said Abu-Hajleh
AU - Ahmed Mousa
AU - Baha Kamel
AU - Ahmad Salah
AU - Osaid Heleseh
AU - Aktham Al-safi
AU - Bashar Al Jaraysa
AU - Bashar Jamal
AU - Momen AbuSaada
AU - Majd Marwan Zaghal
AU - Salahaldeen Deeb
AU - Alhareth M. Amro
AU - Mustafa Nakhala
PY - 2026
DA - 2026/10/07
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1889495
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1889495/full
AB - Background: Evidence on prostate cancer (PCa) knowledge and PSA-related testing behavior in Palestine remains limited. We assessed general awareness, factual knowledge, willingness to undergo PSA testing if offered, reported prior PSA testing/prostate examination, and factors associated with prior testing. Methods: We conducted a cross-sectional online survey from 19 November to 21 December 2025 among adult men aged 18 years or older recruited from Palestinian communities. The full cohort comprised 1,047 consenting participants. The exported dataset contained two incompatible response formats for the 12 factual knowledge items; composite knowledge analyses were therefore limited to 568 respondents with complete, unambiguous single Yes/No responses. Knowledge was scored from 0 to 12 using the study answer key. Willingness and prior testing were analyzed as binary outcomes. Multivariable logistic regression assessed factors associated with prior testing. Results: Mean age was 28.7 ± 12.4 years and 78.6% were aged 18–39 years. Overall, 80.0% had heard of PCa, 26.1% had heard of PSA testing, 31.2% were willing to undergo PSA testing if offered, and 5.6% reported prior PSA testing and/or prostate examination. Among the 568 scorable knowledge respondents, mean knowledge was 7.07 ± 1.84 of 12 and 89.1% had limited knowledge (<80% correct); KR-20 was 0.235. Adequate knowledge was associated with lower willingness (12.9% vs 32.8%; p=0.002) but not prior testing (3.2% vs 6.1%; p=0.526). In the full cohort, older age (aOR 1.08 per year; 95% CI 1.05-1.10), healthcare background (aOR 2.10; 95% CI 1.17-3.77), and first-degree family history (aOR 2.22; 95% CI 1.01-4.86) were independently associated with prior testing. Among never-tested participants, the leading reported barriers were low perceived personal risk (55.3%) and lack of physician/healthcare-provider recommendation (43.1%); multiple responses were allowed. Conclusions: In this predominantly young online sample, general awareness exceeded detailed factual knowledge, while willingness and reported prior testing were low. The divergence between knowledge and behavior should be interpreted cautiously because knowledge analyses used a restricted subset and the shortened scale had low internal consistency. Findings support culturally appropriate, risk-adapted clinician-patient communication and further validation of locally adapted measurement tools.
SN - 2234-943X
ER -