Awareness of Cancer Rehabilitation Services Among Cancer Patients in Uttar Pradesh: A Cross-Sectional Study

Abstract

Cancer rehabilitation with physiotherapy is critical for enhancing quality of life and functional 
outcomes in patients affected by cancer. Nonetheless, there are few data about patient awareness of 
such services in Uttar Pradesh, India. To evaluate cancer rehabilitation awareness of cancer patients 
in Uttar Pradesh, using a validated instrument, and to identify barriers to accessing these services. 
The adapted Cancer Awareness Measure (CAM) was applied to a cross-sectional survey that was 
conducted among 82 cancer patients attending oncology departments of hospitals in Uttar Pradesh, 
India in 2019 and 2020. The CAM is a well-validated, psychometrically strong, and highly reliable 
instrument (Cronbach alpha=0.77). Only 41.5% (n=34) of 82 participants (mean age 52.3±12.7 
years, 57.3% female) were aware of cancer rehabilitation services. Awareness was significantly 
higher among educated patients (p=0.023) and in urban areas (p=0.012). Education (adjusted 
OR=3.42, 95% CI: 1.31-8.93, p=0.012) and urban residence (adjusted OR=2.87, 95% CI: 1.09
7.54, p=0.032) independently predicted awareness. Most information was accessed through 
oncologists (52.9%) and family & friends (29.4%). Top barriers were lack of information (68.3%), 
cost barriers (43.9%), and distance (36.6%). Only 26.8% of patients who were aware had actually 
used physiotherapy services. Among these low-awareness patients, 89.0% indicated willingness to 
seek out services if available—indicating low awareness only. Despite the existence of cancer 
patients in Uttar Pradesh, there is a lack of awareness concerning cancer rehabilitation services. 
Education and residence in urban areas are important factors for awareness. Urgent system-level 
patient education programmes, better communication between health providers, and policy 
interventions that link rehabilitation with standard care pathways for cancer are urgently required.