What Does the Public Know?

Many people do not know alcohol causes cancer, although the link has been well documented in medical literature since 1988.¹  Information from the United States Health Information National Trends Survey shows of the 5,586 participants, only 11.33% were aware that reducing or eliminating alcohol from their diet could significantly reduce their cancer risk.²  There are many reasons why the public knows so little about the carcinogenic effects of alcohol.  Influence from the media and the alcohol industry, as well as a general belief alcohol consumption is healthy, has a large impact on public perceptions about alcohol.³⁻⁵ 

We reviewed three databases to determine if the public knew alcohol caused cancer and if so, what types.  Most of the studies were completed in Australia and the fewest completed in Denmark, Ireland, Italy, South Korea, Sweden, and Poland.³,⁶–¹⁸ Awareness of the carcinogenic effects of alcohol varied from 3% to 98% depending on the country, with the lowest percentage in the United States (U.S.) and the highest percentage in Saudi Arabia.⁹⁻²¹

Many participants identified liver cancer as a risk factor of alcohol use, but unable to identify other alcohol-attributed cancers.⁷,⁸,¹⁵,²⁰  Our results show the percentage of participants who correctly identified the following cancers: liver (80% to 86%), gastric (65.3%), colorectal (60% to 87%), bowel (24.4%), pharyngeal (22.2%), esophageal (21.1%), larynx (21%), oral (21% to 60%), and breast (3%-52%).⁷–¹⁰,¹⁴,¹⁵,¹⁷,²⁰–²⁷ A few studies grouped head and neck cancers as opposed to asking about a particular organ, with results ranging from 23% to 43.4%.¹⁰,¹⁴,²⁰  In some cases, participants incorrectly identified bladder and brain cancer as risk factors of alcohol use.²⁸

Misconceptions About Cancer

The belief cancer is preventable, survivable, and can be discovered early with routine screenings may deter individuals from changing their drinking habits.  In one study, 72.1% of the participants believed routine screening would prevent stomach cancer, although only 54% were routinely screened.¹⁵  In another study, women viewed breast cancer as survivable and participants did not see a need to limit their consumption of alcohol.¹³  Another misconception was the belief everything cause cancer. This fatalistic idea gives individuals little reason to curtail their alcohol use or abstain altogether.¹²,¹³,²¹

Demographics

A few demographic populations were consistent in several studies.  More women than men were aware alcohol causes cancer and socially disadvantaged individuals or those from rural or regional locations were found to be less aware.⁷,⁸,²¹,²⁹,³⁰  Other populations in the review were inconclusive.  Some studies found a college degree increased awareness, while others found educational level had no influence.⁷,⁸,²¹,²⁸,²⁹  There was also a discrepancy when determining if participants who had the highest alcohol consumption knew more or less about their cancer risk.⁷,¹⁶

There was also inconsistency with how study participants were surveyed for their answers.  For example, asking open-ended questions versus closed-ended questions may significantly affect the results.  In one study, only 12.5% of survey participants identified cancer as a potential risk factor when asked with an open-ended question, yet 46.9% identified cancer when it was an option to choose among a list of negative health outcomes.²⁸ One study had potentially skewed results because researchers asked participants multiple-choice questions, increasing the odds of choosing the correct answer by chance alone.⁴

We could not decisively answer the question “what does the public know” for the following reasons: a lack of research (especially in particular countries), an inability to generalize results due to population sampling techniques, and the variety of ways researchers assessed public knowledge.  It was also difficult to determine exactly what the public knew about the risk because of the tendency to give socially desirable responses.¹¹,²²  Many participants without a history of cancer denied a possibility alcohol could increase the risk and even those who developed cancer failed to attribute their diagnosis to alcohol use.¹³,²¹  Despite our inability to answer our question, we’ve identified a knowledge gap. There is a general lack of knowledge alcohol increases the risk of cancer.  Our goal is to inform the public of the risk so they can make an informed decision when deciding to drink or change their drinking habits.

References

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