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Many Americans Confused About Cancer: Survey

1 in 4 think there's not much you can do to prevent it

THURSDAY, May 17, 2007 (HealthDay News) -- The first national survey in a generation to look at Americans' feelings on cancer prevention finds widespread confusion about the disease.

"We found that almost half of the American public believes that 'it seems that almost everything causes cancer,' about one in four feel there's not much one can do to lower the chances of getting cancer, and three out of four felt there were so many recommendations, it's hard to know which ones to follow," said study author Jeff Niederdeppe, a Robert Wood Johnson Foundation Health & Society Scholar at the University of Wisconsin, Madison.

"We took this as evidence that there is widespread confusion and helplessness in the American adult population in terms of cancer prevention -- even though we know quite a bit about prevention," he said.

And that sense of helplessness can leave people unable to take steps to reduce their cancer risk, experts say.

The findings are published in the May 17 issue of Cancer Epidemiology, Biomarkers and Prevention.

About half of all men and one-third of all women will develop some type of cancer during their lifetime, experts say.

It's also estimated that almost one-third of U.S. cancer deaths are attributable to smoking, while 14 percent to 20 percent are attributable to being overweight or obese.

Research shows that you can reduce your risk for the disease: by quitting smoking, eating more fruits and vegetables and maintaining a normal weight.

The last survey to examine beliefs around cancer prevention was conducted in 1986. It found about half of the U.S. population believing that "everything causes cancer" and that "there's not much a person can do to prevent cancer."

The current survey involved more than 6,000 adults interviewed by phone in 2003.

Nearly half of the respondents (47.1 percent) agreed that "It seems like almost everything causes cancer;" 27 percent agreed that "There's not much people can do to lower their chances of getting cancer;" and 71.5 percent agreed that "There are so many recommendations about preventing cancer, it's hard to know which ones to follow."

The beliefs were stronger in people who were less educated; they were weaker among both blacks and Hispanics compared to whites.

People who held at least one of these fatalistic beliefs were less likely to exercise weekly and to eat five or more servings of fruits and vegetables each day as recommended for cancer prevention.

Those who believed that "it's hard to know" what to do were more likely to smoke, the survey found.

And people with a family history of cancer were more likely to believe that "everything causes cancer" than people without such histories.

The study did not specifically address where the confusion comes from, but Niederdeppe had some theories.

"Cancer, as a word, evokes lots of fear among the American public," he said. Then you "combine this with cancer being a difficult thing to talk about, because it refers to 50 or more different diseases." For example, "things we know reduce the risk of breast cancer may not reduce the risk of lung cancer," Niederdeppe said.

There's also a tension between science and the media -- the former valuing the accumulation of solid evidence over time, and the latter trumpeting the results of perhaps only one particular study. "At times, what gets lost in translation is some of the nuance," Niederdeppe said.

The real question is whether these beliefs can be changed.

"There is some evidence that they are [changing]," Niederdeppe said. "How could we change them? One source would be to encourage doctors and nurses to do a better job in educating patients about lifestyle habits. If a doctor just asks whether or not a patient smokes and advises them to quit, that has a tremendous impact on subsequent attempts to quit."

"Patients can educate themselves by either talking with doctors, or the Internet can be very useful resource," he added. "Very trustworthy sites include the National Cancer Institute and the American Cancer Society. They aren't changing their recommendations based on every new study."

But the Internet has its own biases. Another study, this one in the May 2007 issue of the Journal of Oncology Practice, found that people with lower education levels and lower household incomes were less likely to seek Internet-based information about their health. The amount of information a patient gathers on his or her own can affect communication with their health care provider, the researchers said.

More information

There's more on cancer prevention at the American Cancer Society.

SOURCES: Jeff Niederdeppe, Ph.D., Robert Wood Johnson Foundation Health & Society Scholar, University of Wisconsin, Madison; May 17, 2007, Cancer Epidemiology, Biomarkers and Prevention; May 17, 2007, Journal of Oncology Practice
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