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Knowledge of cancer risk factors promotes healthy lifestyle

No. 40 | 19/07/2023 | by Koh

Why is it that many people do not make an effort to reduce their own cancer risk through a healthy lifestyle? Is it because they are not sufficiently informed about cancer risk factors? Or do they ignore cancer prevention recommendations despite knowing the risk factors? This was investigated by scientists from the National Center for Cancer Prevention and the German Cancer Research Center (DKFZ)
The National Cancer Prevention Center (NCPC) ist currently beeing established in a strategic partnership between the DKFZ and the German Cancer Aid.

Do people ignore cancer prevention recommendations despite knowledge of risk factors?
© Adobe Stock

Worldwide, at least one in three cancer cases is due to known cancer risk factors, WHO reports. These include alcohol, physical inactivity, unhealthy diet, obesity, red and processed meat, sugary drinks, tobacco exposure and use, and UV radiation.

National and international recommendations on cancer prevention therefore focus on providing information about these risk factors and tips on how to avoid them. Experts refer to this as "behavioral prevention".

But what is the connection between knowledge of these risk factors and personal commitment to protect oneself from cancer? "It is important to understand whether people do nothing to reduce their personal cancer risk because they do not know about the risk factors, or whether they do not act despite knowing about the risk factors," says Pricivel Carrera of the National Center for Cancer Prevention in Heidelberg. "We wanted to shed light on this connection with our current study."

Based on a UICC international survey on cancer*, Carrera and her DKFZ colleague Silvia Calderazzo explored this question. They focused on ten high-income industrialized countries (Australia, Canada, France, Germany, Japan, Israel, Spain, Sweden, United Kingdom, United States). In these countries, on average, one in three people say they do not follow cancer prevention recommendations.

The researchers' conclusion: The more people in a country know about cancer risk factors, the higher the proportion of people who make an effort to reduce their personal cancer risk. This effect can be expressed in numbers: For every percentage point increase in people who are well informed about cancer risk factors, the number of people who take action to reduce their risk increases by an average of 0.169 percentage points.

This relationship is observed to significantly vary across countries. Carrera and Cardozzo observed, in particular, that an increase in percentage of people aware about risk factors is associated with a significantly smaller increase (and indeed an overall average decrease) in proportion on people taking action for France, as compared to the overall countries average

The researchers found the highest proportion of people who showed gaps in knowledge about cancer risk factors in Japan. Accordingly, the proportion of people there who report making no effort to reduce their cancer risk is also high. Compared to the other high-income countries, Germans had comparatively poor knowledge about most cancer risk factors.

In Germany, close to 40 percent of all cancer cases are considered preventable - through a healthy lifestyle and the use of vaccinations. But the best recommendations for cancer prevention are of no use if people do not act on them. "With our research, we want to find out what conditions must be in place so that more people actually implement the recommendations for cancer prevention," says Pricivel Carrera

The known cancer risk factors are also largely involved in the development of other serious chronic diseases. If the population could be made more aware of these risk factors, the effect of behavioral prevention could go far beyond reducing the number of new cancer cases, the authors emphasize.

Carrera, P.M., Calderazzo, S.: Knowledge of cancer risk factors and risk-reduction in high-income countries.
Preventive Medicine 2023, DOI:

* Public Opinion Survey on Cancer 2020 der Union for International Cancer Control (UICC)
World Cancer Day 2020 International Public Opinion Survey on Cancer 2020 | UICC

With more than 3,000 employees, the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) is Germany’s largest biomedical research institute. DKFZ scientists identify cancer risk factors, investigate how cancer progresses and develop new cancer prevention strategies. They are also developing new methods to diagnose tumors more precisely and treat cancer patients more successfully. The DKFZ's Cancer Information Service (KID) provides patients, interested citizens and experts with individual answers to questions relating to cancer.

To transfer promising approaches from cancer research to the clinic and thus improve the prognosis of cancer patients, the DKFZ cooperates with excellent research institutions and university hospitals throughout Germany:

  • National Center for Tumor Diseases (NCT, 6 sites)
  • German Cancer Consortium (DKTK, 8 sites)
  • Hopp Children's Cancer Center (KiTZ) Heidelberg
  • Helmholtz Institute for Translational Oncology (HI-TRON Mainz) - A Helmholtz Institute of the DKFZ
  • DKFZ-Hector Cancer Institute at the University Medical Center Mannheim
  • National Cancer Prevention Center (jointly with German Cancer Aid)
The DKFZ is 90 percent financed by the Federal Ministry of Education and Research and 10 percent by the state of Baden-Württemberg. The DKFZ is a member of the Helmholtz Association of German Research Centers.


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