BACKGROUND: In Australia over 50% of hepatocellular cancers (HCC) are diagnosed among migrants born in viral hepatitis endemic areas. Over 7% of Australians living with chronic hepatitis B (CHB) were born in Africa or the Middle East, yet little is known about their knowledge of liver cancer and viral hepatitis. Increasing community awareness of viral hepatitis and its links to liver cancer is critical in designing community-based cancer prevention programs. We conducted a community consultation process to ascertain disease knowledge and awareness among Arabic and Assyrian-speaking communities in Sydney.
MATERIAL AND METHODS: The consultation involved 12 semi-structured interviews with key opinion leaders in the Arabic and Assyrian communities, seven focus group discussions (FGD) with community members (56 participants). Additionally, 124 Arabic and Assyrian community members completed a hepatitis knowledge. The interviews and FGD transcripts were thematically analysed.
RESULTS: Participants believed that hepatitis was not part of the community discourse about illness, as it was not considered a serious disease. Participants were largely unaware of viral hepatitis, confused about the different forms and unaware of disease transmission patterns. Cancer is feared and only referred to as “that” disease. Some participants thought that alcohol drinking and smoking caused cancer of the liver; viral hepatitis was not causally linked to liver cancer. Cancer and hepatitis have moral implications, so they are best kept within the family. Variable levels of health literacy and trust in medical practitioners, language difficulties and fear of “bad news” makes people reluctant to see a doctor. Radio and community leaders’ endorsements are more effective for community health education, given that the target audience is older people.
CONCLUSION: As a result of this study, students from the Assyrian College produced an animated film about hepatitis and liver cancer in English and Arabic. The findings of the community consultation will inform future resources development and community-based hepatitis and liver cancer prevention services for these communities.