Prevalence and Determinants of Red Flag Symptoms of Cancer among Adults in rural areas of Puducherry, India: A Community-Based Cross-Sectional Study

Abstract

Background: Cancer is a leading cause of morbidity and mortality globally. Majority of cases in India are diagnosed in an advanced stage due to low awareness and lack of screening. Early identification of cancer at community level can facilitate early diagnosis and treatment. This study aimed to determine the prevalence of red flag symptoms of cancer among adults in rural Puducherry, and to examine its associated factors.

Methods: A community-based cross-sectional study was conducted among adults aged ≥30. A total of 418 participants were recruited using multistage random sampling. Data were collected through a validated semi-structured questionnaire, which captured sociodemographic details, cancer risk factors, and red flag cancer symptoms in the past two months. Prevalence was reported with 95% confidence interval (CI). Log-binomial regression was used to identify predictors of red flag symptoms.

Results: The prevalence of at least one red flag symptom of cancer was 15.8% (95%CI: 12.4%–19.6%). Persistent unexplained pain (6.9%) and changes in bowel habits (6.5%) were the most frequently reported symptoms. Higher prevalence of red flag symptoms were seen in male compared to females (aPR: 1.63, 95%CI: 1.09–2.44), socioeconomic class III (aPR: 3.46, 95%CI: 1.90–6.30) and class IV (aPR: 2.22, 95%CI: 1.09–4.51) compared to class I and participants with a NCD risk of CBAC score >4 than those with lower risk (aPR: 3.06, 95% CI: 1.43–6.54).

Conclusion: Nearly one-sixth of the rural adult population reported cancer-related red flag symptoms, highlighting the need for targeted community-level screening and awareness initiatives to facilitate early cancer detection.