The majority of Americans are unaware of several major risk factors for cancer – most notably obesity, which will soon overtake smoking as the largest preventable cause of cancer in the United States.¹ High treatment costs are compromising care: one in four people who have had cancer or have an immediate family member who has had cancer are forgoing treatment or physician visits because of the expense. In addition, nearly three-quarters of Americans support greater federal investment in cancer research, even if it means higher taxes or adding to the deficit. These are a few of the many findings from the American Society of Clinical Oncology (ASCO)’s National Cancer Opinion Survey, a large, nationally representative survey conducted online by Harris Poll.
“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,” said ASCO President Bruce Johnson, MD, FASCO. “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.”
The national study on Americans’ attitudes about cancer, commissioned by ASCO, was scientifically conducted online by Harris Poll from July 10-18, 2017 among 4,016 U.S. adults ages 18 and older. It is believed to accurately represent the broader population of the U.S. These data show that more than a third of Americans report having firsthand experience with cancer: four percent have or had cancer themselves, and 32% have an immediate family member who has or had cancer.
Key Cancer Risk Factors Unrecognized
While a majority of Americans correctly identify tobacco use (78%) and sun exposure (66%) as risk factors for cancer, far fewer are aware of other lifestyle factors that increase their cancer risk. Notably, less than a third of Americans (31%) realize that obesity is a risk factor for cancer, even though it is currently the second leading preventable cause of the disease. In fact, a higher body mass index is associated with increased risk of a number of cancers, including colon, breast, high grade prostate, and uterine cancers. According to a recent analysis by the National Cancer Institute, if current the rates of obesity continue to trend upward, by 2030 there could be about 500,000 additional cases of cancer in the United States than would otherwise be expected.
The research also found that less than one in three Americans (30%) recognize alcohol as a risk factor for cancer, despite the fact that alcohol consumption can raise the risk of certain cancers, including cancers of the mouth, liver and breast.
At the same time, the majority of Americans are not taking some important preventive actions to reduce their cancer risk. Only 48%, each, say they use sunblock or limit their exposure to the sun; 41% say they maintain a healthy weight; and 38% say they limit alcohol consumption in order to prevent cancer.
In addition, some misperceptions about cancer risk persist: 14% of Americans incorrectly identify cell phones as increasing the risk of cancer, and 8% incorrectly identify caffeine as a risk factor for cancer.
“Our lifestyles have a big impact on our risk of developing many common cancers,” said ASCO Chief Medical Officer Richard Schilsky, MD, FACP, FASCO. “That so few Americans are aware that maintaining a healthy weight is associated with lower risk for many cancers should serve as a wake-up call. Unfortunately, obesity is a problem that cannot be solved overnight and will require broad societal engagement to address.”
Concerns About Cancer Greatest for Americans with a Loved One Who Has Had the Disease
Those who have an immediate family member who has or had cancer have the greatest concerns about being diagnosed with cancer. For example, among Americans whose family member has/had cancer, 63% say they are worried about experiencing pain and suffering if they personally are diagnosed with cancer; in contrast, among people with no experience with cancer, only 56% say they are concerned about pain and suffering if diagnosed. Similarly, among Americans who have a family member who has/had cancer,60% say they are worried about being a burden on family and friends if they personally are diagnosed, compared to 49% with no experience with cancer.
“As this survey shows, our perceptions of cancer are formed by our personal experiences with cancer,” said Dr. Schilsky. “Seeing the effects of this disease firsthand can certainly raise caregivers’ own fear and anxiety about what a diagnosis could mean for themselves.”
Due to High Costs, Americans Are Skimping on Treatment and Want the Government to Take Action
Of serious concern, more than a quarter of Americans (27%) who indicated that either they or an immediate family member has/had cancer say they/their family member have taken specific actions to reduce treatment costs – any of which could have a negative impact on their cancer treatment. Nine percent say they have skipped doctor appointments; 8% say they have refused treatment; 8% say they have postponed filling or not filled prescriptions; 8% say they have skipped doses of prescribed medications; and 7% say they have cut pills in half.
“We should all be alarmed that Americans are potentially risking not only their health but also their lives due to high treatment costs,” said Dr. Schilsky. “No patient or family member should have to face an impossible choice – between their cancer treatment and food, shelter, clothing, and other necessary expenses. Adjusting the prescribed dose of a cancer medication either by skipping doses or cutting pills is dangerous, and many healthcare providers may be unaware that their patients are putting themselves at risk this way.”
The study also reveals that a large majority of Americans believe the federal government should take action to lower prescription drug costs. For example, 92% of people say Medicare should be allowed to directly negotiate prescription drug prices with drug makers, 86% say the U.S. government should regulate the price of cancer drugs to lower their costs, and 80% say it should be legal for U.S. residents to buy cancer drugs from other countries.
Americans Overwhelmingly Support More Robust Federal Investment in Cancer Research
More than 9 in 10 Americans (91%) believe that the U.S. government should dedicate substantial funding to diagnose, prevent and treat cancer. Nearly three in four Americans (73%) say the government should spend more to develop cancer treatments and cures, even if it means higher taxes or adding to the deficit. That’s despite more varied views on other cancer-related priorities: just over half of Americans (54%) think the government should spend more to help Americans afford cancer screenings and care, and just under half (49%) believe more money should be spent on cancer prevention.
“Federal investment in cancer research plays a critical role in the search for new cures, and Americans clearly recognize this. This poll shows that people are not only expecting, but counting on Congress and the Administration to invest more in research that will deliver the next generation of cures to patients,” said Dr. Johnson. “More funding for cancer research would mean more innovation, more studies launched, more patients enrolled in clinical trials, more researchers entering the field, and faster progress toward new and improved treatments for patients.”
On the whole, Americans are optimistic about the future of cancer treatment and expect there to be a steady pace of progress over the coming decades. Nearly four in five (79%) are optimistic that the majority of cancers will be curable within the next 50 years, compared to 66% who think most cancers will be curable within the next 25 years, and 39% who believe most cancers will be curable within the next 10 years.
View the full set of National Cancer Opinion Survey findings.
About The National Cancer Opinion Survey
The National Cancer Opinion Survey was established by the American Society of Clinical Oncology (ASCO), in collaboration with the Harris Poll, to track the U.S. public’s views on cancer research and care. As the world’s leading organization of oncology care professionals, ASCO believes it is critical to understand what the public, including patients, think of, expect, and need from the nation’s cancer care system. The poll, supported by ASCO’s Conquer Cancer Foundation, is designed to be conducted annually to measure shifts in the public’s perceptions of a range of cancer-related issues over time.
The first annual poll was conducted online in the U.S. by Harris Poll on behalf of ASCO from July 10-18, 2017 among 4,016 U.S. adults aged 18+, among whom 1,508 have/had cancer or have an immediate family member who has/had cancer. The data is nationally representative: figures for age, sex, race/ethnicity, education, region, household income, household size, employment status and marital status were weighted where necessary to bring them into line with their actual proportions in the population. Propensity score weighting was also used to adjust for respondents’ propensity to be online.