The American Society of Clinical Oncology (ASCO) initiated a survey by The Harris Poll of adults in the United States between July 9, 2019, to August 10, 2019, which included a total of 4815 individuals: 1009 with cancer or who have had a diagnosis of cancer in the past, 496 caregivers of a family member or loved one with cancer, 668 who have a family member or loved one with cancer, and 2642 individuals who have never had cancer themselves and who do not have an immediate family member with cancer.1
Also conducted in 2017 and 2019, the opinion poll asked adults 18 years and older about their perspectives about cancer, including potential causes of cancer and how to reduce their risk, the use of e-cigarettes, cancer management, end-of-life care discussions with their doctors or family members, and access and affordability of cancer care.
Among the sample of individuals from the general population (4001 individuals), the majority of respondents had at least a high school degree (91%), and 32% had a household income of at least $100,000. The sample was collected from across the US, with 29% living in an urban area, 48% in a suburban area, and 23% in a rural area. The general population was 63% white, 16% Hispanic, 12% African American, 6% Asian or Pacific Islander (2% of respondents identified as “mixed race” or preferred not to answer; percentages in this case did not add up to 100% due to weighting and/or computer rounding and the acceptance of multiple responses, according to the authors of the report). Regarding respondent gender, 53% identified as female and 47% identified as male. Most of the general population was employed full-time (40%) or retired (20%).
Among the people in the survey that have cancer or had a cancer diagnosis in the past (1009), most were 65 years or older (53%) or aged between 50 and 64 years (30%), and primarily reported that they were white (83%). The proportions living in urban, suburban, and rural areas were similar to that of the general population sample. Among the population of people who have cancer or have had a malignancy in the past, approximately 91% had at least a high school diploma, and 29% had a household income of at least $100,000. The most common types of cancer were those of the breast (23%), prostate (16%), and lung (7%).
General Views About Cancer
Among the general population, 57% reported that they were concerned about developing cancer during their lifetime, and 87% are engaging in some behaviors that they perceive will reduce their risk of cancer. The most common risk-reduction strategies that were practiced were not smoking or using tobacco products (63%), eating lots of fruits and vegetables (51%), limiting sun exposure or using sunblock (both 49%), maintaining a healthy weight (45%), and taking vitamins or supplements (44%). However, just 24% reported that they incorporate cancer prevention into their daily lives.
The results suggest that many adults are unsure how to reduce their cancer risk and do not know what sources of information to trust. Among the general population, 81% agreed that there is a lot of information about what causes cancer, but 66% felt unsure about which sources to trust or believe and 64% felt it was hard to know what factors were most important to reduce their risk of developing cancer.
Perceptions and Use of E-Cigarettes
Although 73% of adults among the general population report they have never used e-cigarettes, 15% have tried them and 13% are regular users. The highest proportion of use is among those who are current smokers, with 37% reporting that they are regular users of e-cigarettes. The participants who have ever been traditional cigarette smokers and who regularly use e-cigarettes do so to decrease their use of traditional cigarettes (44%) or to quit using traditional cigarettes (41%).
According to the ASCO poll, children and adolescents appear to use e-cigarettes more frequently than nonsmoking adults. Among adults who have never smoked traditional cigarettes, 7% have tried e-cigarettes a few times and 4% were regular users. However, parents of children aged 9 to 17 years reported that 17% had tried e-cigarettes — with 4% using them recreationally and 3% using them regularly.
Although many adults agree that the long-term health effects of e-cigarettes are unknown and believe cigarettes cause cancer, there is still a proportion of individuals who believe e-cigarettes are harmless. In the general population, 16% felt that e-cigarettes are harmless and 19% thought that you cannot become addicted to e-cigarettes. In addition, more individuals in the age groups of 18 to 22 years (20%) and 23 to 38 years (24%) felt that e-cigarettes are harmless and/or nonaddictive (22% and 24%, respectively). These false beliefs are higher among regular e-cigarette users — 40% reported they believe that they cannot become addicted to these vaped products and 43% believe that they are harmless.