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Cancer prevention literacy in Europe: a cross-sectional study
Paula Romeo-Cervera1, Mercedes Vanaclocha-Espí1, Mireia Gandía-Prat1
1Cancer and Public Health Research Unit, Foundation for the Promotion of Health and Biomedical Research (FISABIO), Valencia, Spain.
European Journal of Public Health
|July 25, 2026
Summary
While most adults have sufficient cancer prevention literacy, awareness of the European Code Against Cancer (ECAC) is low. Digital health literacy significantly boosts cancer prevention literacy, yet social and gender inequalities persist.
Area of Science:
- Public Health
- Health Literacy
- Cancer Prevention
Background:
- Cancer prevention literacy (CPL) and awareness of guidelines like the European Code Against Cancer (ECAC) are crucial for public health.
- Understanding social determinants influencing CPL is essential for targeted interventions.
Purpose of the Study:
- To assess CPL and ECAC awareness in the EU adult population.
- To identify social and digital factors associated with CPL.
Main Methods:
- Cross-sectional online survey across 23 EU countries (n=2312).
- Multivariate logistic regression analyzed associations between demographics, digital health literacy (DHL), cancer history, and CPL outcomes.
Main Results:
- 81.4% had sufficient CPL, but 61.1% were unaware of ECAC.
- Lower CPL was linked to male gender, lower educational attainment, and older age.
- Digital health literacy was the strongest predictor of CPL (OR=3.11); cancer history also increased CPL odds (OR=1.47).
Conclusions:
- Overall CPL is adequate, but ECAC awareness is critically low.
- Significant social and gender disparities in CPL require addressing.
- Digital health literacy is a key factor for improving CPL and cancer prevention efforts.
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