Survey: Americans Have High Concerns About Cancer, Low Awareness of Risk Factors

Results of the first annual National Cancer Opinion Survey, established by the American Society of Clinical Oncology (ASCO), show that the majority of Americans are unaware of several key risk factors for cancer, and that a minority are taking active steps to reduce their personal risk.

The nationally representative survey of 4016 US adults, conducted online by Harris Poll in 2017, demonstrated a limited awareness of key cancer risk factors. While most respondents (78%) correctly identified tobacco use as a potential cause of cancer, and a majority (66%) identified sun exposure as a risk factor, few Americans were aware that a lack of exercise (25%) and alcohol use (30%) also increase risk. Perhaps most concerningly, only 31% of respondents correctly identified obesity, the second leading preventable cause of cancer, as a risk. Obesity is, in fact, linked to at least 13 cancer types, including colorectal, pancreatic, and multiple myeloma.

While awareness of risk factors was low, misconceptions about about cancer persisted for some resondents. Some named caffeine use (8%) and cell phone use (14%) as potential cancer risks, while others (2%) believed that nothing increases an individual’s risk of developing cancer.

In addition to low awareness of risks, a minority said that they were taking steps to reduce their cancer risk:

• 48% use sunblock
• 48% limit their exposure to the sun when not using sunblock
• 48% engage in regular exercise
• 41% maintain a healthy weight
• 38% limit consumption of alcohol

Despite such a limitation in steps taken to curb cancer risks, 6 in 10 respondents said that they were worried about developing cancer in their lifetimes, and those who had a family member or a loved one with cancer reported the greatest levels of concern about experiencing suffering or pain (63%), being a “burden” to family or friends (60%), or dying from their disease (62%).

Most respondents also feared the cost of care: more than 90% of those surveyed believed that the cost of cancer therapies was too high, and among respondents who had the responsibility to pay for a loved one’s care, 68% said that they were worried about the cost of cancer treatment. Concerns about costs appear to be rooted in direct and indirect experience for many; among those who either had cancer themselves or had a loved one with cancer, 1 in 4 reported that they (or their loved one) had tried to reduce costs by taking measures that could negatively affect treatment outcome:

• 9% had skipped doctors’ appointments
• 8% had refused treatment
• 8% delayed filling or did not fill prescriptions
• 8% skipped doses of medications
• 7% cut pills in half

In order to help relieve the cost burden of cancer treatment, most respondents said, Medicare should be allowed to negotiate drug prices with manufacturers (92%), the FDA should speed its approvals process for generic anticancer therapies (89%), the federal government should regulate drug costs (86%), and US residents should be allowed to purchase cheaper drugs internationally (80%). Three out of 4 also called for greater federal funding—even if taxes would rise as a result—for research that could result in treatments and cures for cancer. Most Americans were optimistic that there will eventually be a cure for cancer: 79% believe that most cancer will be curable in the next 50 years.

ASCO’s president, Bruce Johnson, MD, said of the study, “This research helps us understand what our fellow Americans know and believe about cancer, and therefore where we need to focus as a nation in our efforts to conquer cancer.” He highlighted the need for ongoing work, saying, “It is clear there are many important gaps we need to address—from educating the public about cancer prevention, to confronting high treatment costs, to investing in cancer research that is vital to improving patients’ outcomes in the future.”