Background: In Japan, the Cancer Control Act was enacted in 2006, and cancer education and the dissemination of cancer-related knowledge are among the issues addressed in the Basic Plan to Promote Cancer Control Programs (Phase 4). Cancer education was introduced to all middle schools in 2021, and high schools in 2022. To promote cancer education in schools further, the presence of teachers who are able to play a central role in the cancer education in the schools is the key requirement. School teachers' perceptions of cancer and cancer education may influence cancer education in schools. However, the perceptions regarding cancer and cancer education and related factors of school teachers in Japan have not been clarified.

Objective: This study aims to understand the perceptions of cancer education among school teachers in Japan and identify factors related to these perceptions.

Methods: A web-based anonymous questionnaire survey was conducted with 800 middle and high school teachers in Japan. The questionnaire is comprised of question items on the perceptions of cancer education (9 items; Questions 1 through 7 ask about positive perceptions of cancer education of middle and high school teachers, Questions 8 and 9 ask about its negative perceptions; Question 8: making students anxious or afraid of cancer”; Question 9: no change in the awareness of cancer), the Cancer Awareness Measures (CAM; Warning signs, Barriers to seeking help, Risk factors), personal factors, and environmental factors. The data were analyzed with Multiple logistic regression analysis.

Results: In total 779 responses were included in the analysis. Using the Mann-Whitney U test, age, years of teaching experience, and the scores of CAM positive and negative response groups were compared for the perceptions of cancer education. The relationship between the perceptions of cancer education and personal and environmental factors was analyzed using the chi-square test. Multiple logistic regression analysis was conducted using age and years of teaching experience, Warning signs, Barriers to seeking help, and Risk factors in the CAM, which were found to be significantly different in these univariate analyses, as independent variables, and the perceptions of cancer education as the dependent variable. Questions 1 through 7 showed statistically significant differences in Warning signs (OR = 1.077 to 1.164, p < .01 to .001) and Risk factors (OR = 1.041 to 1.053, p < .001). There were statistically significant differences in Questions 8 (OR = 1.100, p < .001) and 9 (OR = 1.159, p < .001) for Warning signs.

Conclusions: The findings show that the awareness of Warning signs and Risk factors affect the awareness that students benefit from cancer education, suggesting the necessity the efforts to improve the knowledge and understanding of cancer among teachers to promote cancer education in schools.