Improving cancer prevention literacy in a Spanish cancer screening population (JA PreventNCD study)

Introduction

A percentage (between 30-50%) of cancers could be prevented by adopting healthy lifestyle habits; therefore, it is essential that the population knows and follows the recommendations of the European Code Against Cancer (ECAC). This study evaluates the effectiveness of an intervention aimed at increasing the Cancer Prevention Literacy (CPL).

Methods

A longitudinal pre–post study evaluated an intervention consisting of including a leaflet with ECAC recommendations with the invitation letter to the population-based colorectal cancer screening programme (Valencian Community, Spain). Participants (n = 383) completed a questionnaire on ECAC recommendations including 26 categorical items (two per ECAC topic), before and after the intervention. Topics included tobacco, passive smoking, overweight, physical activity, diet, alcohol, UV radiation, pollutants, radiation, breastfeeding, Hormone Replacement Therapy (HRT), vaccination and screening. Changes in responses were analysed using McNemar’s test.

Results

The lowest percentages of correct answers were observed for breastfeeding (29.9%) and HRT (24.3%). After the intervention, significant increases were found in pollutants item (i) 1 (83.0% to 89.3%, p = 0.008), radiation i1 (35.4% to 44.4%, p = 0.004), radiation i2 (61.9% to 69.7%, p < 0.001), breastfeeding i1 (48.8% to 59.5%, p < 0.001), HRT i2 (25.3% to 35.5%, p < 0.001), vaccination i1 (59.0% to 66.6%, p = 0.006), and vaccination i2 (12.3% to 18.3%, p = 0.01). Overall, 8 of 26 questions (30.8%) showed significant improvement, while 16 (61.5%) showed no change and 2 (7.7%) decreased slightly.

Conclusions

The intervention was associated with significant improvements in cancer prevention knowledge. These findings support the effectiveness of simple, low-cost interventions that can be integrated into existing frameworks such as population-based screening programmes to improve CPL. Further research is needed to assess the long-term sustainability of these effects.

Key messages

• Sending the European Code Against Cancer leaflet with the cancer screening invitation letter increases cancer prevention literacy.

• Population-based colorectal cancer screening programmes can be used to raise public awareness about cancer prevention.