1990

Given the long induction time of many cancers and the fact that modifiable risk factors (e.g. initiation of cigarette smoking) including preventive factors (e.g. uptake of the HPV vaccine, healthy dietary and physical activity patterns) are influenced in adolescence, educating adolescents about cancer causation and risk reduction may have a large impact on reducing the cancer burden. We conducted a systematic review of literature evaluating the impact of cancer education interventions on adolescent knowledge of cancer risk-reduction. We searched for articles published from 2000-2019 and identified 33 studies meeting our criteria. Given the methodological heterogeneity across studies, we focused on examining the design of the intervention and study. The majority of studies took place outside of the U.S. (67%) and addressed skin or cervical cancer (70%). Only 12% of the interventions discussed multiple cancer types. Few studies (21%) discussed lifestyle and environmental risk factors such as diet and exposure to secondhand smoke. Only 9% of the studies designed culturally-appropriate interventions tailored to a vulnerable or understudied population. The majority of interventions were a single session (55%) and were evaluated using a pre-test and a single post-test (61%); some studies administered multiple post-tests. The majority of included studies (88%) reported improvement in student knowledge following an intervention. However, our review revealed wide methodological variation and a deficit of research evaluating interventions about multiple cancer types and both lifestyle and environmental risk factors. Our review highlighted a need to robustly test whether comprehensive cancer education for adolescents can reduce the cancer burden, particularly in communities with major cancer health disparities.