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November 05, 2019
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ASCO survey: 24% of Americans incorporate cancer prevention into daily lives

Photo of Howard Burris 
Howard A. Burris III
Richard L. Schilsky, MD, FACP, FASCO 
Richard L. Schilsky

Most Americans lack knowledge of best cancer prevention practices, the dangers of e-cigarettes and available end-of-life care despite an abundance of published data, according to results of ASCO’s third annual Cancer Opinions Survey.

Additionally, fewer than one-quarter of survey respondents indicated they incorporate cancer prevention practices into their daily lives.

“Our survey helps us better understand Americans’ views on a range of cancer-related issues and exposes areas that are important to address,” Howard A. Burris III, MD, FACP, FASCO, president of ASCO, said in a press release. “This year’s findings raise concerns about the current state of cancer prevention in America, and strongly support the need for more education on the topic, beginning at a young age.”

The survey — conducted online between July 9 and Aug. 10 — included 4,001 adults (53% women, 63% white) plus an oversample of 814 adults with cancer, for a total of 1,009 respondents (54% women, 83% white) who have or previously had cancer.

Cancer risk

More than half (57%) of those surveyed expressed concern about developing cancer in their lifetime. However, only 24% indicated they care deeply and incorporate cancer prevention practices into their daily lives.

Most adults (81%) agreed that a wealth of information is available on the causes of cancer, but 66% did not know which sources to trust when looking for this information. Another 64% agreed that it is hard to know the most important things to do to prevent cancer.

Twenty-two percent of adults had talked with a physician about their cancer risk, and 18% talked specifically with a physician about how to reduce their risk, whereas 24% searched online for this information.

Although most of those surveyed agreed that smoking cigarettes (81%), family history (69%) and sun exposure (63%) increase risk for cancer, fewer knew about other lifestyle factors that increase risk, including obesity (36%) and alcohol (31%).

Misconceptions regarding causes of cancer also persist, survey results show. Despite the lack of evidence, 28% percent of adults believed artificial sweeteners cause cancer, 16% thought cell phones cause cancer and 9% believed caffeine causes cancer.

“Tobacco use, diet, sun exposure, alcohol consumption and other lifestyle choices can have a major impact on people’s risk [for] developing many common cancers, or of cancer recurring,” Richard L. Schilsky, MD, FACP, FASCO, ASCO chief medical officer, said in a press release. “[Although] it’s never too late to make healthy choices, it’s most critical for young people to take action to reduce their cancer risk [because] it can take decades for the disease to develop.”

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E-cigarettes

Nearly three-quarters (73%) of respondents indicated they have not tried e-cigarettes, and 13% reported using them regularly.

About one in five parents (17%) of children aged 9 to 17 years reported that they know their children have tried e-cigarettes; 7% indicated their children are regular users.

The majority of current or former cigarette smokers who used e-cigarettes reported doing so to decrease their use of traditional cigarettes (44%) or to quit smoking traditional cigarettes (41%). Most who used e-cigarettes for these reasons (85%) reported they were very or somewhat helpful.

Although most adults (71%) agreed that e-cigarettes cause cancer, 20% believed they are not addictive and 16% viewed them as harmless.

Financial concerns

Fifty-three percent of adults who have or had cancer — as well as 74% of caregivers for patients with cancer (n = 496) — expressed concern about the affordability of treatment.

To address this issue, a large proportion of all respondents favored allowing Medicare to negotiate prescription drug prices directly with drug makers (89%).

Most also believed that the FDA should speed up approvals of generic versions of drugs (87%) and that the U.S. government should regulate the price of cancer drugs, as long as it does not affect the pharmaceutical industry’s investment in development of new therapies (75%).

Access to care

Most respondents who have or had cancer (88%) agreed that they are receiving the best possible cancer care, regardless of where they reside.

However, 34% of those living in rural areas and 22% of those in nonrural areas indicated they have or had to travel too far for treatment. Patients in rural areas reported a longer one-way drive to see their physician (45 minutes vs. 30 minutes).

Thirty-nine percent of respondents who have or had cancer and live in rural areas indicated there aren’t or weren’t enough cancer specialists nearby, and 41% would not know or have known where to go if their cancer care provider closed. ‘

Medical marijuana

Medical marijuana had broad support among those surveyed, with 84% supporting its use by patients with cancer and 76% supporting it for any medical reason.

However, only 13% of those who have or had cancer talked to a physician about acquiring it for symptom management.

Among the cancer population, more than half (56%) who used medical marijuana had difficulty accessing it, whereas 37% had difficulty accessing prescription opioids. Fifty-one percent of medical marijuana users reported that it managed symptoms very well, whereas 47% indicated it worked somewhat well.

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Although the percentage of adults who believed that alternative therapies alone can cure cancer decreased from 39% in 2018 to 34% in 2019, nearly three-quarters (73%) of respondents believed that alternative therapies are a useful supplement to standard cancer treatment.

End-of -life care

Fifty-three percent of adults surveyed reported that they have thought about end-of-life care. Respondents who have or had cancer (66%), family members and loved ones of patients with cancer (56%), and caregivers (72%) were more likely to have thought about this than those unaffected by cancer (48%).

The vast majority of respondents (91%) agreed it is important to discuss end-of-life care with a physician, and 88% believed it is important to share end-of-life care wishes with a physician.

Only about one in three adults touched by cancer ever discussed end-of-life care with their physician. Additionally, one in five caregivers did not feel prepared to make decisions about end-of-life care for their loved one. Most of these caregivers (70%) wished for more information to help prepare them and their loved one for end-of-life care. – by John DeRosier

Reference:

ASCO 2019 Cancer Opinions Survey. Available at: www.asco.org/sites/new-www.asco.org/files/content-files/blog-release/pdf/2019-ASCO-Cancer-Opinion-Survey-Final-Report.pdf. Accessed Nov. 4, 2019.