Members of the general public lack awareness about factors that cause cancer, and awareness is especially poor among people who reject vaccines, prefer alternative medicine, or believe conspiracy theories, according to a study published in The BMJ.
An online survey revealed that many respondents were confused about causes of cancer, but confusion was especially high among people who have refused to be vaccinated against COVID-19, prefer alternative medicine to conventional medicine, or endorse flat Earth or reptilian conspiracy theories.
Researchers distributed this survey across Reddit, 4Chan, HispaChan, and ForoCoches. Respondents’ awareness of cancer causes was assessed using the Cancer Awareness Measure (CAM) and Cancer Awareness Measure Mythical Causes Scale (CAM-MYCS).
A total of 1494 people responded to the survey. This group included 209 respondents who had not received a COVID-19 vaccination, 112 who preferred alternative medicine to conventional medicine, and 62 who reported believing the Earth is flat or that shape-shifting lizards exist.
Among all respondents, awareness of the actual causes of cancer was greater than awareness of mythical causes of cancer. The median CAM score was 63.6%, and the median CAM-MYCS score was 41.7%.
Most respondents knew that actual causes of cancer included active smoking (97.4%), passive smoking (85.1%), family history of cancer (77.6%), and being overweight (71.4%). However, less than 25% of respondents knew that low intake of fruits and vegetables is a cause of cancer.
Many respondents incorrectly identified some lifestyle factors as causes of cancer, including eating food containing additives (63.9%) or sweeteners (50.7%), feeling stressed (59.7%), and eating genetically modified foods (38.4%).
Awareness of actual and mythical causes of cancer was lower among respondents who preferred alternative medicine, were unvaccinated against COVID-19, or believed in flat Earth or reptilian conspiracy theories.
The unvaccinated group and the group of conspiracy believers each correctly identified a median of 54.5% of the actual causes of cancer. In contrast, the vaccinated group and conspiracy non-believers each accurately identified a median of 63.6% of the actual causes of cancer (P =.13 and P =.003, respectively).
The unvaccinated group correctly identified a median of 25.0% of the mythical causes of cancer, and the conspiracy believers correctly identified a median of 16.7%. The vaccinated group and conspiracy non-believers each accurately identified a median of 41.7% of the mythical causes of cancer (P <.001 for both comparisons).
Respondents who preferred alternative medicine accurately identified a median of 54.5% of the actual causes of cancer, and respondents who preferred conventional medicine accurately identified a median of 63.6% (P =.04). For mythical causes of cancer, those percentages were 16.7% and 41.7%, respectively (P <.001).
Among all respondents, 45.0% agreed or strongly agreed that, “It seems like everything causes cancer.” A similar proportion of respondents agreed with this statement regardless of views about alternative medicine, vaccination status, or conspiracy beliefs.
According to the researchers, this finding highlights, “the difficulty that society encounters in differentiating actual causes of cancer from mythical causes owing to mass (veridical or not) information.”
“This suggests a direct connection between digital misinformation and consequent potential erroneous health decisions, which may represent a further preventable fraction of cancer,” the researchers wrote.
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Paytubi S, Benavente Y, Montoliu A, et al. Everything causes cancer? Beliefs and attitudes towards cancer prevention among anti-vaxxers, flat earthers, and reptilianconspiracists: Online cross sectional survey. BMJ. Published online December 21, 2022. doi:10.1136/bmj-2022-072561
This article originally appeared on Cancer Therapy Advisor