• Lin-Sen Feng, Qing-Li Li, Qing Yang, Yu-Lu Zhu, Fu-Lin Yin, Qi-Yao Wang, Wen-Jue Zhong, Xiao-Qian Wu, Ruo-Yu Yan, and Zheng-Jiao Dong.
• The Sixth Affiliated Hospital of Kunming Medical University (The People's Hospital of Yuxi City), Yunnan, China.
• Ann. Med. 2023 Jan 1; 55 (2): 22995742299574.

BackgroundTo investigate the cognition of cancer warning symptoms and cancer risk factors among Chinese college students, analyze the influencing factors, and explain the correlations between cancer cognition and cancer symptom discrimination, cancer fear and psychological distress.MethodsChinese college students were recruited in this cross-sectional study funded by a summer social practice activity in Yunnan Province, China. Cognition rates of cancer warning symptoms and cancer risk factors were evaluated using Cancer Warning symptoms Cognition Questionnaire (CWSCQ) and Cancer Risk Factors Cognition Questionnaire (CRFCQ), respectively. Factors associated with cognition of cancer warning symptoms, and factors associated with cognition of cancer risk factors were evaluated using multiple linear regression analysis. Interactions between cancer cognition, cancer symptom discrimination, psychological distress, and cancer fear were evaluated by structural equation modeling.ResultsThere were 846 effective samples, with an effective rate of 80.9%. The cognition rates of cancer warning symptoms were from 47.9% to 84.4%, which were affected by cancer symptom discrimination, education, attitudes towards cancer screening, living expenses, drinking history, and ways to obtain cancer knowledge (p < 0.05). The cognition rates of cancer risk factors were from 46.3% to 91.3% in participants, which were affected by education, cancer symptom discrimination, psychological distress, attitudes towards cancer screening, life satisfaction, cancer history in relatives and friends, ways to obtain cancer knowledge, smoking history, and nursing history for cancer patients (p < 0.05). Cancer cognition and cancer symptom discrimination showed intermediary effects on psychological distress and cancer fear (p < 0.001).ConclusionsThe overall cancer cognition situation among Chinese college students is not optimistic, which highlights the necessity of improving the cancer health literacy among Chinese college students. With the increasing morbidity and mortality rates of cancer, it is necessary to raise awareness of early detection, and early treatment of cancer among the general public. Health education interventions are helpful to improve cancer health literacy.

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