CHAPTER I

INTRODUCTION

Background of the study

Need for the study

Statement of the problem

Objectives

Operational definitions

Assumptions

Hypothesis

Limitations

Summary

1
 CHAPTER 1
INTRODUCTION
Cancer is a generic term for a large group of diseases that can affect any part of
the body .Other terms used are malignant tumours and neoplasm . One defining feature of
cancer is the rapid creation of abnormal cells that grow beyond their usual boundaries , and
which can then invade adjoining parts of the body and spread to other organs , the latter
process is referred to as metastasizing. Metastases are the major cause of death from cancer.
Cancer is one of the most significant non- communicable health problem throughout the
world and its prevalence is increasing rapidly.

World health organization estimated that global burden rises to 14.1 million new
cases and 8.2 million cancer deaths in 2012.the most common cases of cancer death are
cancers of ;

Lung (1.59 million deaths )

Liver (745,00 deaths)
Stomach (723,000 deaths )
Colorectal (694,000 deaths)
Breast (521,000 deaths )
oesophageal (4000,000 deaths)

More than half of all cancers ( 56,8 % ) and cancer deaths (64.9 %) in 2012
occurred in less developed regions of the world and these proportions will increase further by
2025.

Cancer is the third greatest cause of death with 0.4 million deaths per annum
and is thus a major public health problem in India . It is estimated that there are 2 million
cancer patients in India with 0.7 million new cases each year.

Among men , the 5 most common sites diagnosed for cancer in 2012 were lung
,prostate , colorectal ,stomach and liver cancer .Among women the 5 most common sites
diagnosed were breast ,colorectal ,lung ,cervix and stomach caner .

Awareness of public about warning signs of cancer is essential to reduce the

prevalence of cancer in the society. The warning signs of cancer are,

2
 CAUTION UP

C Change in bowel or bladder habits.

A A sore that does not heal.

U Unusual bleeding or discharge from any body orifice.

T Thickening or a lump in breast or elsewhere.

I - Indigestion or difficulty in swallowing.

O obvious change in wart or mole .

N Nagging cough or hoarseness .

U Unexplained weight loss .

P pernicious anaemia .

The death from cancer increases due to poor knowledge on it .Early detection and
prevention of any type of cancer enhances its effective management and reduce the mortality
and morbidity rate .

The world health organization celebrating world cancer day on feb 4th and it is a major
burden world wide .

Colorectal cancer is also known as bowel cancer is the development of cancer

from the colon or rectum .

3
 NEED AND SIGNIFICANCE OF THE STUDY

Cancer has become a common disease now a days . It is one of the most

commonly occurring non communicable disease and is third cause of mortality in

developing countries . The death accounting for 8.2 million in 2012 .

Cancer is a generic term for a large group of diseases that can affect any part of

the body .Other terms used are malignant tumours and neoplasm .One defining feature of

cancer is the rapid creation of abnormal cells that grow beyond their usual boundaries and

which can then invading adjoining parts of the body and spread to other organs , the later

process is referred to as metastasizing .Metastases are the major cause of death from cancer .

The most common causes of cancer death are cancers of;

Lung ( 1.59 million deaths )

Liver (745,000 deaths )

Stomach (725,000 deaths )

Colorectal (694,000 deaths )

Breast (521,000 deaths )

Oesophageal (400,000 deaths )

In 2012 there were 14 million new cases and 8.2 million cancer related death

were occurred. The number will increases 22 million by 2020 . 60 % Worlds new cases occur

in Africa , Asia ,Central or North America .

ICMR report in 2016 says that India will have 17 lakhs new cancer by 2020

and over 8.8 lakh deaths due to caner by 2020 , with ca breast ,ca lung and ca cervix topping

the list .Among females ca breast topped with estimated 1.5 lakhs new cases in 2016 and

males oral cancer .

4
 All living cells in the history have a chance of cancer occur the aetiologies of

70-90% are environmental. The most important among the environmental exposure are

lifestyle related factors such as dietary practices, reproductive and sexual practices. Rightful

changes in the lifestyle and by detecting early warning signs can reduce mortality and

morbidity.

A descriptive study was conducted at Mysore, India (2015) a study about

awareness of cancer among 453 sample in several educational institute. The result was the pre

university students have little knowledge, the under graduates have some knowledge and post

graduates have more knowledge about cancer.

According to Cancer Registry Data 35000 new cases every year in Kerala. The

projection for Kerala as per the year 2014 PBCR ( Public Basic Cancer Registry ) Trivandrum

data in the year 2014 is that 55,857 new cases of cancer are reported. As for mortality, an

estimated 21,285 are dying of cancer every year in Kerala. The crude cancer incidence among

males in Kerala is projected to be 172(per one lakh population) while for female it is 166.5.

Among males cancer of lip and oral cavity topping the list where as in female cancer of breast

is topping the list in Kerala.

A descriptive study was conducted at Amrita college of Nursing , Amrita

Institute of Medical Science Ponnekkara , Kochi, Kerala in 2015 a study to assess the public

awareness of cancer warning signs among rural population in 200 sample.

The result of the study is that poor knowledge regarding warning signs of cancer

among the age group of 18-25 years and higher knowledge among the age group 38-

57 years.

A descriptive study is conducted by Awat Feizi a study to assess awareness

level about warning signs of cancer and its determinants in an Iranian general population

among 502 samples.

5
 The result of the study found that a small (18.8%) proportion of the respondents

had high level of knowledge and 54.5% had moderate awareness and 26.7% had low level of

awareness regarding cancer warning signs. The result revealed that in general, the level of

knowledge about warning signs of cancer among studied sample was low. The middle aged

people recognized more signs than those who were younger or older.

These studies can offer opportunities to create awareness regarding risk factors

of colon cancer and warning signs of cancer among young adults as it found that they have

poor knowledge on it. It helps to prevent incidence of cancer and reduce the mortality and

morbidity rate. Hence there is a need for conducting a study regarding the risk factors of colon

cancer and warning signs of cancer among young adults is an essential aspects of public

health care.

6
 CHAPTER II

REVIEW OF LITERATURE

I. Studies related to impact of schoolbag weight.

a. Studies related to impact on musculoskeletal system

b. Studies related to impact on cardiovascular system

c. Studies related to impact on respiratory system

II. Studies related to weight reduction strategies.

7
 CHAPTER II

REVIEW OF LITERATURE
Literature of review is defined as a broad , comprehensive , in depth , systematic and critical review of

scholarly publication and published printed or audio visual material and personal communication .

( Dr .Suresh . k .Sharma Nursing research and statistics .)

Review of literature of present study under following heading :

Study related to prevalence of cancer

Study related to knowledge regarding warning signs of cancer

STUDIES RELATED TO PREVALENCE OF CANCER

1
A descriptive study was conducted in Korea : Incidence , mortality ,survival and prevalence in 2012

conducted by Korea central cancer registry , National cancer centre , Goyang Korea ; National cancer

control institute ,by Kyd wonnjung , MS1,2.

The aim of the study was to report nation wide cancer statistics in Korea ,

including incidence ,mortality ,survival and prevalence and their trends .Incidence data from 1993 2012

were obtained from the Korea National cancer incidence data base and vital status was followed through

December 31 , 2013 . Mortality data from 1983 2012 were obtained from statistics of Korea .
8
The result of this is the total of 224,177 cancer cases and 73 ,759 cancer death

were reported in 2012 and there were 1,234 ,879 prevalent cases identified in Korea as of January 1 , 2013

the past 14 years (1999 2012 )overall incidence rate have increased by 3.3 % per years. The incidence rate

of liver and cervical cancer have decreased , while those of the thyroid ,breast ,prostate ,colorectal cancer

have increased .Notably , incidence of thyroid cancer have increased by 22.3% per years in both census and

has been the most common cancer since 2009 , the mortality for all cancer combined decreased by 2.7 % per

8
years from 2002 2012 .Five years relative survival rate of patient diagnosed in the last five years (2008

2012 )have improved by 26.9% combined with those from 1993 -1995 .

STUDIES RELATED TO KNOWLEDGE REGARDING WARNING SIGNS OF CANCER

3
A descriptive study was conducted among the general population living in Debhram

,Iran which is to assess to knowledge regarding warning sign of cancer and determinants among 2500

peoples aged 18 years and over were interviewed . The result of the study is that the individual with higher

knowledge level is 18 .8 % and the individual with poor awareness level is 26.7 % and individual with

mixed situation in terms of awareness level is 54.5 %.

4
A descriptive study was conducted in Nigeria (2010) to assess the knowledge

regarding warning signs of cancer among 473 samples of general population selected purposively by using

probability sampling method through interview schedule . This result showed that 40.3% had poor

knowledge , 14.1% had good knowledge and 45.6% had fair knowledge of warning signs of cancer.

6
A descriptive study is conducted by awat feizi .A study to asses awareness level about

warning signs of cancer and its determents in an Iranian general population among 502 samples .The result

of the study found that a small (18.8 % ) proportion of the respondents had high level of knowledge and 54.5

% had moderate awareness and 26.7 % had low level of awareness regarding cancer warning signs .The

results revealed that in general ,the level of knowledge about the warning signs of cancer among the studied

sample was low .The middle aged people recognize more signs than those who were younger or older .

22
A descriptive study was conducted in Indoor (2009) to assess the knowledge

regarding warning signs of cancer among 100 samples in several educational institute selected purposively

by using probability sampling method by using interview schedule . The result showed that 55.1% had poor

knowledge, 15.1% had moderate knowledge and 29.8% had good knowledge of warning signs of cancer.

18
A descriptive study was conducted in Jaipoor (2006) to assess the knowledge

regarding early warning signs of cancer among 650 samples of general population selected using probability

9
sampling method through self administered questionnaires . This result showed that 60% had poor

knowledge , 20% had good knowledge and 20% had fair knowledge about early warning signs of cancer.

23
A descriptive study was conducted at Amrita college of nursing , Amrita institute of

medical science Ponnekara ,Kochi , Kerala in 2015 a study to assess the public awareness of cancer warning

signs in rural population among 200 samples . The result of the study is that poor knowledge regarding

warning signs of cancer among the age group 18- 25 and higher knowledge among the age group 38-57 .

STUDIES RELATED TO RISK FACTORS OF COLON CANCER

6 A cross sectional study was conducted on Italy (2012) to assess the characteristics and

risk factors of colorectal neoplasms among 2819 adult(<50 years) selected purposively by using stratified

random sampling method by using invitrobiophysiological measurement . The result revealed that prevalence

of colorectal adenoma and advanced adenoma were 19.7% and 1.5% respectively.

9
A descriptive study was conducted in Poland (2014) to assess the knowledge regarding

risk factors of colorectal cancer among 16000 young adults was selected purposively consecutive sampling

techniques by using structured questionnaires .This study showed that a strong evidence of poor knowledge

of risk factors o0f colon cancer among young adults attending district hospital in Wejherowo. The result

showed that 45.3% had poor knowledge and 15.1% had good knowledge and 40.6% had fair knowledge of

risk factors of colon cancer.

10
A cohort study was conducted in Denmark (2014) to investigate the association

between inflammatory bowel disease and risk of colon cancer. The total samples was 1318955 adults .Of

these, 81,263 adults were diagnosed with inflammatory bowel disease with study period , and 2736 adults

had a border line colon cancer .The result showed that history of IBD was associated with an increased risk

of colon cancer . The histotype specific analysis revealed significant variation in risk as IBD was only

associated with an increased risk of border line colon cancer.

10
 5
A cross sectional study was conducted in Malaysia (2011) to assess the awareness of

risk factors of colon cancer using a self administered questionnaire 87 adults were selected by convenient

sampling technique. Data were analysed by using statistical package for the social sciences (SPSS) .Version

20.0 for descriptive statistics and pearson chi-square test for association between socio demographic data

and awareness . The result show that 74.7% participant answered correctly for the risk factors of increasing

age , although 94.3% were unaware of increased risk of adult . A majority , 71.3% had a low level of

awareness of colon cancer risk factor. The study conducted that awareness of colon cancer risk among young

adult is low . The result show a need for improved public understanding about colon cancer risk and

provision of important information for health professionals about initiative needed for future awareness ,

prevention and screening programme.

12
A cohort study was conducted in American population (2007) to assess the

knowledge regarding risk factors of colon cancer among 17,633 white American men, largely of

Scandinavinan and German descent , who respond to a mailed questionnaire in 2007 . Over the compaine

study period 75 % had poor knowledge , 15% had good knowledge 10% had fair knowledge about risk

factors of colon cancer.

14
A hospital based descriptive study was conducted in North east India (2013) to find

out the incidence of colon cancer . The data were collected from hospital based cancer registry of regional

cancer centre . Retrospective analyses were performed . A total of 2925 cases of colon cancer were identified

. Some 43.5% of cases of colorectal cancer were illiterate . The result conclude that improvement of colon

cancer patient education can contribute to increase the proportion of early stage diagnosis in our population.

13
A descriptive study was conducted in Kerala (2009) to assess the knowledge regarding

risk factors and treatment regimen of colon cancer among 300 adults selected purposively by using

probability sampling method through interview schedule . This study result showed that the obesity also

increase the risk factors of colon cancer .The study revealed that the number of males , elderly people and

smokers was much bigger among patient with colon abnormalities than among healthy people . The over

11
weight (BMI reaching from 25.01 to 29.9 kg/m2 ) and obesity (BMI 30 kg/m2) , where independent risk

factors associated with colorectal cancer.

13
A descriptive study was conducted in Kerala (2009) to assess the knowledge

regarding prevalence of colon cancer among 1000 subject selected by consecutive sampling by using a

knowledge questionnaire . The study indicated that prevalence of colorectal cancer ranged from 3-4% to 6-

7.1%

12
 CHAPTER III

METHODOLOGY

Research methodology is a systematic way of doing research to solve a problem .It involves the steps ,

procedures and strategies gathering and analyzing the data in research investigations .It is a science of

how research is done scientifically .

This chapter deals with methodology adopted for the study. It includes research

approach , research design ,variable under study ,setting of the study ,population , sample and

sampling technique , criteria for sample selection ,development and description of the

RESEARCH APPROACH

Research approach is a systematic ,control ,empirical and critical investigation of natural

phenomena guided by theory and hypothesis about the presumed correlations among the phenomena .

The research is based on the broad based procedure for collection of data in a particular situation .

The present study was aimed at assessing the knowledge regarding the risk factors of

colon cancer and warning signs of cancer among young adult (men) who were in the age group 18-25

years. Research approach selected for the study was Quantitative Approach.

RESEARCH DESIGN

Research design is a blueprint to conduct research study which involves the description of

research approach, study setting, sampling size, tool and method of data collection and analysis to

answer specific research question or testing the research hypothesis.

In this study, non-experimental descriptive survey research design was used to assess the

knowledge regarding risk factors of colon cancer and warning signs of cancer among young adult.

13
VARIABLES UNDER STUDY

Variables are qualities, properties or characteristics of persons, things of situation that

change or vary. Variables under study are ;

Demographic Variable

Demographic variables are the attribute of the subjects that are measured during the study

and used to describe the sample.

Demographic variables in the study were age, gender, religion, education occupation,

marital status, type of family, income of the family, exercise habit, family history of colon cancer,

dietary habit and source of information.

Setting of the study

Setting is the physical location where researcher do the study and collect data.

The study was conducted in Sree Budha college of Engineering in Patoor.

Population

Population is the complete set of individuals or objects that possess some common

characteristics of interest to the researcher.

In the study , the population comprised of young adult ( both men and women ) who were in the

age group between 18-25 yrs in Sreebudha college of engineering in pattor .

Sample and Sampling Technique

Sample is a representative unit of a target population .

In this study, the samples were 60 young adults (both men and women) who were in age group

of between 18-25 yrs in Sreebudha college of engineering pattor who fulfilled both inclusion and

exclusion criteria .

14
 Sampling is the process of selecting sample from the target population to represent the entire

population.

In the study ,convenient sampling technique was use to select the samples.

Criteria for sample selection

INCLUSION CRITERIA
The criteria that specify the characteristics of the subjects in the population are referred to as the

inclusion criteria .

Young Adults (both men and women) who were :

In the age group between 18-25 years

Residents of Sreebudha college of engineering patoor.

Able to understand English or Malayalam.

Willing to participate in the study

Available during the study period.

EXCLUSION CRETERIA

The criteria that specify the characteristics that a study population does not possess are

referred to as exclusion criteria.

Young Adults (both men and women)who were:

Not available at the time of data collection .

Not willing to participate in the study.

Not able to understand Malayalam or English.

Having the history of any cancer.

15
TOOL/TECHNIQUE

Data collection instruments are the procedure or instruments used by the researchers to

observe or measure the key variables in the research problem. The data from the samples was collected

using :

Tool:-Section A:Socio-demographic proforma

Technique : structured knowledge questionnaire.

Section B:-structured knowledge questionnaire.

Technique :structured knowledge questionnaire

Development and description of the tool

A Tool is the instrument used to gather data from the study subjects. It was prepared on the

basis of objectives of the study. The tools used in this study were:

Tool : structured Knowledge Questionnaire

It consists of two section:

Section A : socio-demographic proforma

Section B : structured knowledge questionnaire

Technique : structured knowledge questionnaire

Section A : socio demographic proforma

This was design to elicit the demographic information from the participants, consisted of

10 items .This include age ,gender ,religion ,year of study , type of the family , income of the family

,geographical data ,dietary habits , family history of cancer and source of information .

Section B : structured knowledge questionnaire

This section consist of closed ended questions of 30 items to asses the knowledge

of young adults regarding warning signs of cancer and risk factors of colon cancer .Each question was

given four options carrying one correct answer . The respondents were instructed to select the possible

option and tick ( ) for the most appropriate answer .

Each right answer carries a score of 1 and wrong answer carries a score of 0.

16
Table 2 : interpretation of knowledge scores.

NO. Score Score Score (%) Level of knowledge

1 0-12 0-40 poor

2 13-18 41-60 Average

3 19-30 61-100 Good

Content validity

Validity is a measure of truth or accuracy of a claim and is an important concern throughout the

research process. It refers to a whether a measurement instrument accurately measures what it is

supposed to measure.

Content validity was obtained from 3 experts in the field of Medical Surgical Nursing. The

suggestions made by the experts were incorporated in the tool and information booklets.

Reliability of the Tool

Reliability of an instrument is the degree of consistency with which it measures the attribute it

is supposed to be measuring .

The reliability of the tool was calculated by using Split Half Method .

()()
r=
()2 ()

METHOD OF ADMINISTRATION OF TOOL

Self administered questionnaire

This chapter dealt with the research approach, research design, variables, setting of the study,

population, sample and sampling technique, criteria for sample selection, development and description

of tool, content validity, reliability of the tool, pilot study, data collection process and plan for data

analyzes. The succeeding chapter deals with analysis and interpretation.

17
 PLAN FOR PILOT STUDY

A pilot study is a small scale version, or trial of proposed study conducted to define the

methodology.

The pilot study was conducted at Archana college of engineering , Pandalam .Prior to the

study, permission was obtained from the principal of college .10 young adult were selected by

convenient sampling technique . After instruction of investigator, written consent from the subjects

were obtained and study was conducted. Findings of the study revealed that it was feasible and

practicable to conduct the study and the samples were found to be co-operative, the questionnaire was

relevant and the time and cost of the study was within the limit.

DATA COLLECTION PROCESS

Data collection process is the gathering of the information to address a research problem .

Phase 1: For conducting main study, prior permission was obtained from the principal of the college

Phase 2: Data collection was done on April 6 - 2017 . The researchers selected 60

adults(both men and women)who were in the age group of 18-25 years. The investigators familiarized

themselves with subjects and explained the purpose of the study to them; confidentiality was assured

to all subjects.

Phase 3: An informed consent was taken from the subjects .A structured knowledge questionnaire

was administered to the subjects and collected soon after filling.

Phase 4: An information booklet is provided to increase awareness of the knowledge regarding risk

factors of colon cancer and warning signs of cancer.

18
 PLAN FOR DATA ANALYSIS

Data analysis is the process of organizing and synthesizing the data so as to answer research

and test hypothesis.

Data was analyzed using descriptive and inferential statistics.

Descriptive statistics

Descriptive statistics deals with enumeration, organization and graphical representation of data.

It is also used to organize and summarize data to draw meaningful interpretation.

Baseline data containing sample characteristics and was analyzed by using :

Frequency and percentage distribution were used to describe socio demographic variables.

Mean and standard deviation was used to analyze the knowledge level of young adults

regarding risk factor of colon cancer and warning signs of cancer.

Inferential statistics

Inferential statistics provides the procedure to draw an inference about that condition that exit

on a large set of observations that is, an entire population from study of a part of the sample set.

Chi-square test was used to find out the association between demographic variables and

knowledge of young adults regarding risk factor of colon cancer and warning signs of cancer.

Summary

This chapter dealt with the research approach, research design, variables, setting of the study,

population, sample and sampling technique, criteria for sample selection, development and description

of tool, content validity, reliability of the tool, pilot study, data collection process and plan for data

analyzes.

The succeeding chapter deals with analysis and interpretation.

19
 CHAPTER IV

DATA ANALYSIS AND INTERPRETATION

Section 1: Distribution of subjects according to socio-demographic variables

Section 2: Analysis of level of knowledge regarding

Section 3: Association between level of knowledge and select socio-

Demographic variables

DATA ANALYSIS AND INTERPRETATION

Analysis and interpretation of data is the most important phase of the research

process which involves the computation of the certain measures along with searching for pattern of

relationship that exists among data groups. Data collection is followed by data analysis and

interpretation of data were analyzed and interpreted in accordance with study objectives .

Analysis is referred to as a method of organizing data in such a way

that research question can be answered and hypothesis can be tested .

(Suresh K Sharma)

This chapter presents analysis and interpretation of data obtained

from 60 samples in order to affect the knowledge regarding risk factors of colon cancer and warning

signs of cancer in a selected college by descriptive and inferential statistics.

Objectives of the study

20
 1. To assess the existing level of knowledge regarding risk factors of colon cancer and warning signs

of cancer among young adult

2. To find out the association between the knowledge regarding risk factors of colon cancer and

warning signs of cancer and selected socio-demographic variables.

3. To develop and distribute an information booklet on risk factors of colon cancer and warning signs

of cancer.

Organization of the study findings

Data were organized and presented under the following headings:

Section I: Distribution of subject according to socio-demographic Variable.

Section II: Analysis of level of knowledge regarding warning signs of Cancer and risk factors of
colon cancer .

Section III : Association Between the level of knowledge and selected Socio-demographic variable

21
 Part I

Section 1: DISTRIBUTION OF SUBJECTS ACCORDING TO SOCIO

DEMOGRAPHIC VARIABLES
The demographic variables of the subjects were described in terms of Age, Gender,
Religion ,Year of study ,Type of family ,Income , Geographical data ,Dietary habits ,Family history of
cancer and Source of information regarding cancer .

80%
70%
60%
Percentage

50%
40%
30% 18-20yrs

20% 20 -22yrs

10% 22-24yrs

0%
18-20yrs
20 -22yrs
22-24yrs
Age in years

Figure 1 :-Cylindrical diagram showing percentage distribution of young

adult according to their age .
The data presented in figure one depicts that out of 60 samples one third (23% )
of the samples were in the age group of 18 -20 years ,one by two (72% )of them were in the
age group of 20-22 years and one by fourth (5%)of them were in the age group of 22-24
years.

22
 88%
90%
80%
70%
60%
Male
Percentage

50%
Female
40%
30%
12%
20%
10%
0%
Male Female
Gender

Figure 2 :- pyramidal diagram showing percentage distribution of young

adults according to their gender.

The data depicted in the figure 2 shows that out of 60 samples one fourth
(12 %) of the samples were males and one \two (88% ) of them were females.

23
 25% 23%

20%
Percentage

15%

Hindhu
10% Christian
7% 7%
Muslim
5%

0%
Hindhu Christian Muslim

Religion

Figure 3:- :- pyramidal diagram showing percentage distribution of young

adults according to their gender.
The data depicted in the figure 3 shows that out of 60 samples one /four (7%) of
the samples were Hindu, one /two(23%) were Christians and one/fourth(7%) of them were
Muslims.

24
 60% 57%

50%
33%

Percentage
40%

30%
Second year
20%
Third year
10% 10% fourth year
0%

Second year
Third year
fourth year

Year of study

Figure 4:- Cone diagram showing percentage distribution of young adults

according to their year of study.
The data depicted in the figure 4 shows that out of 60 samples 30(33%)
belonged to second year, one/two(57%) belong to third year and one/fourth(10%) belong to
fourth year.

25
 Types of family
Nuclear Joint Extended

2%
13%

85%

Figure 5:- Pie diagram showing percentage distribution of young adults

according to types of family.
The data depicted in the figure 5 shows that out of 60 samples one/two
(85%) belonged to nuclear family, one/fourth (13%) belonged to joint family and
one/fourth(2%) belonged to extended family.

26
 Income of family

23%
Less than or equal to5000/-
35%
5000-10,000/-

10,000-15,000

Greater than 15,000/-

18%

23%

Figure 6:-Doughnut diagram showing percentage distribution of young

adults according to the income of family.
The data depicted in the figure 6 shows that out of 60 samples one/third
(23%)of them having income or equal to 5000/-, one /fourth (18%)of them having income
5000-10,000/- , one/third (23%)of them having income 10,000-15,000/-and 30 of them having
income greater than 15,000/-.

27
 58%

60% 41%
50%

Percentage
40%
30%
20% Urban
10% Rural
0%
Urban
Rural

Geographical data

Figure 7:- Column diagram showing percentage distribution of young adult

according to geographical data.
The data depicted in the figure shows that out of 60 samples one
/two (41%) of them were from urban area and one/two (58%) of them were from rural areas.

28
 Dietary habit

3.30%

Vegetarian
Non-vegetarian

96.60%

Figure 8:-Pie diagram showing percentage distribution of young adults

according to dietary habit.
The data depicted in the figure8 shows that out of 60 samples
one/fourth (3.3%) of the samples were vegetarians and one/two (96.9%) of them were Non
vegetarians.

29
 Family history of cancer

32%

Yes
No

68%

Figure 9:- Doughnut diagram showing percentage distribution of young

adults according to family history of cancer.
The data depicted in the figure 9 shows that out of 60 samples
60 samples 30 (32%) of the samples having family history of cancer and one/two (68%) of the
samples not having the family history of cancer.

30
 35% 33%
30%
25%

Percentage
23%
20% 18% Peer group
15% 18%
7% Internet
10%
5% TV
0% News paper
Peer group Health personnels
Internet TV
News
paper Health
personnels
Source of distribution

Figure 10:- Distribution of sample according to source of information

The data depicted in the figure 10 shows that out of
60 sample one/fourth (7%) of samples had information from Peer group, half of samples 33%
had information from Internet, one/fourth (18%) of the samples had information from
Television, one/fourth (23%) of sample had information from Newspaper and one/fourth
(18%) of the samples had information from Health personnel.

31
Section II: This Section deals with association between the knowledge of the

young adults regarding Risk Factors Of Colon cancer and warning signs of

cancer and selected Demographic variables .

Table 2: Association of knowledge regarding risk factors of colon cancer

and warning signs of cancer

SL No. Demographic 2 Value df Inference

variables

1. Age 3.62 4 NS

2. Gender 18.48 2 S

3. Religion 0.298 4 NS

4. Year of study 6.78 4 NS

5. Type of family 0.353 2 NS

6. Income 2.862 6 NS

7. Geographical 3.99 2 NS

data

8. Dietary habits 0.736 2 NS

9. Family history 3.09 2 NS

of cancer

10. Source of 10.47 8 NS

information

32
 CHAPTER V

RESULTS

1. OBJECTIVES

2. HYPOTHESIS

3. RESULTS

33
 RESULTS

The description of research is the extremity of a research project, which enable

the researcher to Reduce, Summarize, Organize, Evaluate and Interpret and Communicate
numerical interpretation.

This chapter deals with the results collected from 60 young adults in
accordance with objectives of the study.

OBJECTIVES OF THE STUDY

1. To assess the knowledge regarding risk factors of colon cancer and warning signs of
cancer among young adults in a selected college.
2. To find out the association of knowledge regarding risk factors of colon cancer and
warning signs of cancer among young adults in a selected college.
3. To develop and distribute an information booklet on risk factor of colon cancer and
warning signs of cancer.

HYPOTHESIS

H0 : There is no significant association of mean knowledge of score and selected

demographic variables.

H1: There is a significant association between mean knowledge score and selected
variables.

RESULTS

The major findings of the study are presented as follows Demographic variables.

The data presented in figure one depicts that out of 60 samples one third (23% ) of the
samples were in the age group of 18 -20 years ,one by two (72% )of them were in the
age group of 20-22 years and one by fourth (5%)of them were in the age group of 22-
24 years.

34
 The data depicted in the figure 2 shows that out of 60 samples one fourth (12 %) of the
samples were males and one \two (88% ) of them were females.

The data depicted in the figure 3 shows that out of 60 samples one /four (7%) of the
samples were Hindu, one /two(23%) were Christians and one/fourth(7%) of them were
Muslims.
The data depicted in the figure 4 shows that out of 60 samples 30(33%) belonged to
second year, one/two(57%) belong to third year and one/fourth(10%) belong to fourth
year.
The data depicted in the figure 5 shows that out of 60 samples one/two (85%)
belonged to nuclear family, one/fourth (13%) belonged to joint family and
one/fourth(2%) belonged to extended family.
The data depicted in the figure 6 shows that out of 60 samples one/third (23%)of them
having income or equal to 5000/-, one /fourth (18%)of them having income 5000-
10,000/- , one/third (23%)of them having income 10,000-15,000/-and 30 of them
having income greater than 15,000/-.
The data depicted in the figure shows that out of 60 samples one /two (41%) of them
were from urban area and one/two (58%) of them were from rural areas.
The data depicted in the figure8 shows that out of 60 samples one/fourth (3.3%) of the
samples were vegetarians and one/two (96.9%) of them were Non vegetarians.
The data depicted in the figure 9 shows that out of 60 samples 60 samples 30 (32%) of
the samples having family history of cancer and one/two (68%) of the samples not
having the family history of cancer.
The data depicted in the figure 10 shows that out of 60 sample one/fourth (7%) of
samples had information from Peer group, half of samples 33% had information
from Internet, one/fourth (18%) of the samples had information from Television,
one/fourth (23%) of sample had information from Newspaper and one/fourth

(18%) of the samples had information from Health personnel.

35
 CHAPTER VI

DISCUSSION, SUMMARYAND CONCLUSION

Discussion

Summary

Conclusion

Nursing Implication

Limitations

Recommendations

36
 CHAPTER VI

DISCUSSION, SUMMARY AND CONCLUSION

The study intends to find out the knowledge regarding risk factors of colon cancer and

warning signs of cancer among young adults . The findings of the study were discussed with

reference to the objectives stated in this chapter one with the finding of other studies.

DISCUSSION:

The present study aimed at assessing the knowledge regarding risk factors of colon cancer and

warning signs of cancer among young adults of SREE BUDDHA COLLEGE OF ENGINEERING.

This chapter discusses the present study and compares the finding with other studies. This chapter

deals with discussion based on objectives.

OBJECTIVES -1:

To assess the knowledge regarding risk factors of colon cancer and warning signs of cancer

among young adults.

37
 In this study the knowledge regarding risk factors of colon cancer and warning signs of cancer

among young adults reveals that more than 1/3 (37%) have average knowledge ,less than 1/4th (3%)

have poor knowledge and more than (60%) of them had good knowledge.

The findings of the present study were supported by a study conducted at

AMRITHA COLLEGE OF NURSING, Amritha Institute of Medical Science ponnekara , kochi

kerala in 2015. To assess the public awareness of cancer, warning signs of cancer in rural population

among 200 samples. The result of the study is that poor knowledge regarding warning signs of cancer

among 18-25 and higher knowledge among the age group 38-57

. The findings of the present study were supported by a study conducted in kerala 2009 to assess the

knowledge regarding prevalence of colon cancer among 1000 subjects selected by consecutive

sampling by using a knowledge questionnaire. The study indicated that prevalence of colon cancer

ranged from 3-4% to 6-7.1%.

OBJECTIVES-2:

Find out the association of knowledge regarding risk factors of colon cancer and warning

signs of cancer among young adults with selected socio demographic variables

. In this study reveals that association of knowledge regarding risk factors of colon cancer and

warning signs of cancer among young adults with selected socio demographic variables was

calculated by using

chi-square values for gender is (18.48) was greater than that of table value (5.99) with degree

of freedom of 2 at 0.05 level of significance. Hence the null hypothesis is rejected and

research hypothesis for this is accepted. So it can be concluded that there was a significant

association between the knowledge with gender and there was no association between the

knowledge of the samples with the other socio demographic variables such as age, religion,

38
 year of the study, type of the family, income, geographical data, dietary habit, family history

of cancer, source of information regarding risk factors of colon cancer and warning signs of

cancer.

The finding of the present study was supported by descriptive study was conducted in

Indore

(2009) to assess the knowledge regarding sign of cancer among 100 samples in several educational

institute selected purposively by using probability sampling method by using interview schedule. The

result showed that 55.1% had poor knowledge, 15.1% had moderate knowledge of warning signs

of cancer.

The findings of the present study was supported by a descriptive study was conducted

in Poland

(2014) to assess the knowledge regarding risk factors of colon cancer among 16000 young adults was

selected

purposively consecutive sampling techniques by using structured questionnaires . This study showed

that a strong evidence of poor knowledge of risk factors of colon cancer among young adults

attending District Hospital Wejherowo. The result showed that 45.3% had poor knowledge and

15.1% had good knowledge and 40.6% had fair knowledge of risk factors of colon cancer.

OBJECTIVE 3:

To prepare an information booklet on risk factors of Colon cancer and warning signs of

cancer. In the present study, a booklet on risk factors of colon cancer and warning signs of cancer

was developed by the researchers. It consists of introduction, warning signs of Cancer, risk factors of

39
colon cancer, warning signs of colon Cancer, signs and symptoms, diagnostic evaluation of colon

Cancer, treatment of colon cancer, prevention of colon Cancer and conclusion.

NURSING PRACTICE

The major implication of this study for nursing practice is nurse must be able to

apply knowledge of risk of colon cancer and warning signs of cancer to conduct health education

programmes in various settings of community.

NURSING EDUCATION

Nursing curriculum can be modified with increased emphasis on Medical and Surgical

nursing students can also be trained in Medical Surgical nursing care under guidance.

NURSING ADMINISTRATION

The nurse administrator has a role in planning the policies for impacting health information to

the target

population. Nurse administrator can suggests various interventions to improve the knowledge of risk

factors of

colon cancer and warning signs of cancer by providing an information booklet.

NURSING RESEARCH

This study provides awareness in the future studies among the students in the area.

LIMITATIONS

1. The generalization could not be done due to limited number of samples.

2. The study was limited to selected portion of the population.

40
RECOMMENDATIONS

1. A descriptive study can be conducted to assess the knowledge regarding risk

factors of colon cancer and warning signs of cancer.

2. A similar study can be replicated in large population for generalization of the result.

3. A similar study can be conducted in other setting.

4. Regular health education programmes should be conducted by health personnel regarding

risk factors of colon cancer and warning signs of cancer.

5. A self instructional module can be developed based on learning needs of young adults.

SUMMARY

The researchers found that there was a significant association between the knowledge score
and

socio demographic variables. There was no association with other demographic variables.

CONCLUSION
The study aimed to assess the knowledge regarding risk factors of colon cancer and
warning signs of

cancer among young adults. The study was found to be effective. These type of studies can be
conducted in other

settings.

41
 BIBLIOGRAPHY

1. Dr. Matel .C , Ferky J Francesehis, Etal, Global burden of cancer attributable to infection

in 2008: are view and synthetic analysis .The lancet oncology 2012-2013:page no:607-

616.

2. Jasdeep Kaur , Dr. Rajindeer Kaur mahae ,Assess the awareness of warning signs and

risk factors of cancer among general populations ,Volume 5 no:5[2015]

3. National centre for disease informatics and research National cancer registry programme

consolidated report of hospital based registries 2007-2011 Bangalore, India sep 2013.

4. I nternational journal of advance in nursing management 3(3) July-september 2015.

Awareness of cancer warning signs ,www.anj. publication.org.

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5. M. Krishnan Nair Cherian Varghese, R . Swaminathan current seenario intervention

strategies and projection for 2015, page no: 220-223.

6. K.Robb, S.Stubbings , A.Ramirez U. Maeleod, J.Waller S.Hiom and J.Wardle. public

awareness of cancer in Britain: A population based survey of adults British journal of

cancer (2009) 101 page no:18-23.

7. Sherin R, Lam K.P, Nair K.S, Tiwani V.K, Bacchu.S Assess the level of awareness and

knowledge about cancer prevention,2013 page no:4057-4062.

8. Awatfeizi, Anoshirvan Kazemnejad, Moshen Hosseina, Praayekta and Jamshid Jamali,

Assessing awareness level about warning signs of cancer and its determinants in an

Iranian general population. J. health population December 2011, 29(6): page no:656-659.

9. Samuals T (2009) Cancer introduction and incidence. Vol 55 ,Issue 1

10. Jema l A,Bray F , Center MM , Ferlay J, Ward E, Forman D(2011) Cancer statistics

;March April;61(2):69-90.

11. Mulcahy N (2008) Cancer incidence and mortality,World Cancer Report From The

International Agency For Research On Cancer Signs.

12. Puri S, Mangat. C, Bhatia .V, Kaur A.P , Kohil D.R.(2011) Knowledge of Cancer and

Its Risk factor in Chandigarh, India. The Internet Journal Of Epidemiology. ; 62 (6);659-

65.

13. S Stubbings , K .Robb , J Waller , A Ramirez , J Austoker, U Macleod , S Hiom and J

Wardle. British Journal Of Cancer (2009) 101,S13-S17

14. Brunner and Suddarth Text book of medical surgical nursing 10th edition Philadelphia,

Lippincott Williams and wilkims 2004.

15. Joyce and black and Jane Hokanson Hawks Text book of medical surgical nursing 8th

edition page no ; 145-176

16. Sharon l Lewis Text book of medical surgical nursing South Asian edition ,Page no :254-

287

17. Lippin cott Text book of manual nursing practice Indian edition distributed in India by

Jaypee brothers medical publishers PVT LTD Page no;257-289

43
18. Barbar K. Timby and Nancy is with Text book of Introductory Medical surgical nursing

9 th edition Page No ;175-254

19. Gayle Mckenzie and Taniya porterText book of clinical companion medcal surgical

nursing south Asian edition Page No ;654-719

20. Lois white and Jena Duncan Text book of medical surgical nursing an Integrated

Approach 2nd edition page no;234-543

21. http:\www.nsna.orge

22. http:\www.ispub.com\ostia\index.php

23. http:\www.pubmed.com

44
APPENDICES

45
46
47
48
49
50
51
TOOL

52
 SECTION-A
SOCIO-DEMOGRAPHICAL DATA

SECTION A : Socio demographic data

TECHNIQUE : Knowledge questionnaire

DATE : NO:

INSTRUCTION

1. Please read the following statement and instructions given

2. Put tick mark () for correct response in the box.
3. Please answer all the questions.
4. Your response will be kept confidentially and will be used only for
research study.

1) Age (in years)

a) 18-20yrs

b) 20-22 yrs

c) 22-24 yrs

d) 24-25 yrs

2) Gender

a)Male

b)Female

3) Religion

53
 a) Hindu

b) Christian

c) Muslim

4) Year of study

a) Ist year

b) IInd year

c) IIIrd year

d) IVrth year

5) Type of the family

a) Nuclear family

b) Joint family

c) Extended family

6) Income of the family

a) < Rs 5000\-

b) Rs 5000-10,000\-

c) Rs 10,000-15,000\-

d) Rs 15,000 and above

7) Geographical data

a) Urban

b) Rural

8) Dietary habits

54
 a) Vegetarian

b) Non vegetarian

9) Family history of cancer

a) Yes

b) No

10) Source of information regarding cancer

a) Peer group

b) Internet

, c) Television

c) Newspaper/magazine

d) Health personnels

55
 SECTION-B
STRUCTURED KNOWLEDGE QUESTIONNAIRE

TOOL 2 : knowledge assessing questions on warning signs of cancer and risk factors of
colon cancer.

1) The cancer means____

a) Abnormal proliferation and growth of cell

b) Dysfunction of organ

c) Invasion of microorganism

d) Inflammation of cells

2) World cancer day is on ____

a) May 8

b) Feb 4

c) Dec 1

d) May 12

3) Colon in the human body extends from____

a) Esophagus

b) Ileocaecal valve

c) Small intestine

d ) Jejunum

4) The most common site of malignancy in the alimentary tract is____

a) Esophagus

56
 b) Duodenum

c) Jejunum

d) Colon

5) The part where colon cancer is more affected is _____

a) Sigmoid colon

b) Transverse colon

c) Ascending and descending colon

d) Rectal areas

6) Cancer that can be prevented by removal of pre cancerous tissues of the area except____

a) Cervix

b) Colon

c) Bladder

d) Rectum

7) Most common cancer in male is____

a) Prostate cancer

b) Lungs cancer

c) Oral cancer

d) Blood cancer

8) Most common cancer in female in India is ____

a) Breast cancer

b) Cervical cancer

c) Ovarian cancer

57
 d) Skin cancer

9) The age group in which the colon cancer is most prevalent in ___

a) 30-40 yrs

b) 50-60 yrs

c) 60-70 yrs

d) 70 and above

10) Among the following which dietary pattern leads to colon cancer_____

a) High in fat, protein, beef, low in Fibre

b) Fresh vegetables

c) Milk products

d) None of the above

11) Risk of colon cancer can be reduced by___

a) Quit smoking

b) Maintain a healthy body weight

c) Inclusion of fruits and vegetables in the diet

d) Regular Exercise

12) Colon cancer is more prevalent among people with food habit of____

a) Green leafy vegetables

b) Red meat , saturated animal fat

c) Fruits

d) All of the above

58
13) The most common small growth on the lining of the colon or rectum that can lead to
cancer is_____

a) Cyst

b) Warts

c) Polyps

d) Moles

14) Most common predisposing disease which cause colon cancer is ___

a) Ulcerative colitis

b) Appendicitis

c) Peptic ulcer

d) Inflammatory bowel disease

15) The following is not a warning sign of cancer ____

a) Nagging cough

b) Increased level of blood sugar

c) A sore that does not heal

d) Unusual change in warts or moles

16) The acronym used for warning sign of cancer is ___

a) BEST

b) CAUTION UP

c) SHIELDED

d) ELEMENTS

17) Identify the initial warning signs of colon cancer ___

59
 a) Change in bowel and bladder habits

b) Nagging cough

c) Pernicious anemia

d) Unexplained weight loss

18) Cancer associated with familial history is ____

a) Colon cancer

b) Breast cancer

c) Blood cancer

d) Ovarian cancer

19) Average Estimation of number of people die from cancer in the world is ___

a) 1,500 a day

b) 1,500 a week

c) 1,500 a month

d) 1,500 a year

20) The spreading of cancer across the body is called ___

a) Homeostasis

b) Metastasis

c) Osmosis

d) None of the above

21) Survival rate for colon cancer can be increased by ___% if it detects early

60
 a) 15%

b) 38%

c) 50%

d) 90%

22) Testing of the colon cancer should begin at the age of __

a) 20-25 yrs

b) 25-30 yrs

c) 30-35 yrs

d) 35-40 yrs

23) The common diagnostic measure to rule out colon cancer____

a) Barium enema

b) Bronchoscopy

c) X-ray

d) ECG

24) The treatment modalities of cancer include is ____

a) Occupational therapy

b) Chemotherapy

c) Physiotherapy

d) Psychotherapy

25) Cancer causing carcinogens includes___

61
 a) Silicon

b) Insecticides

c) Tobacco

d) All of the above

26) Non invasive test for colon cancer is ___

a) X-ray

b) Autopsy

c) Hysterectomy

d) Fecal occult blood test

27) Surgical intervention for colon cancer___

a) Craniotomy

b) Mastectomy

c) Laparoscopic colostomy

d) Laminectomy

28) Major complication of colon cancer___

a) Bowel obstruction

b) Pleuritis

c) Herniation

d) Appendicitis

62
ANSWER KEY- SECTION B

1) a
2) b
3) b
4) d
5) c
6) b
7) c
8) a
9) a
10) a
11) c
12) b
13) c
14) a
15) b
16) b
17) a
18) a
19) c
20) b
21) d
22) a
23) a
24) a
25) d
26) a
27) c
28) a

63
 STATISTICAL FORMULA USED IN THIS STUDY

1. Mean;

x =

2. Standard deviation

)
(
SD=

3. Chi-Square

()
=

4. Degree of freedom

DF = (r 1) (c 1)

5. t test(t)

t- test =

64