06.06.2023 - A recent study published in the International Journal of Environmental Research and Public Health has provided valuable insights into the challenges and enabling factors for adopting and complying with cancer prevention recommendations among different population subgroups. The study by Lena Sharp and colleagues focused on cancer prevention literacy among people with intellectual disabilities, immigrants, young people, and young cancer survivors.
Cancer prevention can be significantly enhanced by increasing awareness and confronting modifiable risk factors for cancer, which include tobacco and alcohol use, sedentary lifestyle, obesity, unhealthy dietary habits, excessive sun exposure, and exposure to pollutants. Enhancing cancer prevention involves modifying these unhealthy behaviours and encouraging breastfeeding and participation in cancer screening and immunization programs.
The "European Code against Cancer. 12 ways to reduce your cancer risk" is a European Commission initiative that has been developed by the World Health Organization's (WHO) International Agency for Research on Cancer (IARC). The European Code against Cancer (ECAC) aims to educate the public about actions they can take personally or on behalf of their families to decrease their risk of developing cancer. This code comprises 12 evidence-based recommendations, such as encouraging weight reduction measures, and is accessible in all 23 official EU languages. Despite the comprehensive nature of the ECAC as a tool for communicating cancer prevention, its recognition among the general public has been limited.
Some study participants were oblivious that alcohol is a risk factor for cancer (as detailed in ECAC recommendation 6). Although this recommendation was considered among the most explicit and understandable in the ECAC, some participants questioned the term "limit" and sought more specific instructions.
Misunderstandings relating to alcohol were also discovered. Some participants believed alcohol has other health benefits, leading to noncompliance with this recommendation. This issue was primarily raised among participants with immigrant backgrounds. A conversation between two participants illustrates this misunderstanding:
Participant 7: "I have read about red wine. It supposedly benefits your heart and blood."
Participant 3: "I have noticed that a glass of wine helps his [her husband's] diabetes, but not beer."
Participant 7: "So, you mean it assists in reducing blood sugar levels?"
Participant 3: "Yes, it does help."
Participant 7: "I was not aware of that before."
Several vulnerability aspects linked to cultural and language issues were highlighted. A few younger participants with no personal cancer experiences reported that cultural expectations concerning unhealthy food and alcohol in certain countries contribute to vulnerability.
A significant finding of the current study was the misunderstandings surrounding cancer risk factors, especially regarding ECAC recommendations 7–12. Misconceptions associated with alcohol were particularly problematic as these participants function as peer advisors for cancer prevention in their communities. This emphasizes the importance of providing adequate education to peer advisors. Previous studies have noted similar misconceptions about cancer risk factors. One survey found that such misconceptions were more prevalent among participants with lower health literacy. While the authors of this study did not deem health literacy to be a significant determinant of cancer prevention behaviour, they acknowledged that improved information could likely reduce a number of these misconceptions.
In addition to these findings, the study identified several general and subgroup-specific vulnerabilities that impact cancer prevention literacy. For instance, participants with intellectual disabilities described difficulties complying with some recommendations due to inadequate support from staff at their homes and workplaces. This highlights the importance of supportive societal structures in addition to individual actions.
The study provides valuable insights into the challenges and enabling factors for improving cancer prevention literacy among different population subgroups. By addressing these issues and providing clear and accurate information about cancer risk factors, including alcohol consumption, it may be possible to improve cancer prevention efforts and reduce the incidence of cancer in Europe.