http://hints.cancer.gov 

briefs

NUMBER 13 

Americans Often Misunderstand 

the Extent to Which Colon, 

Skin, and Lung Cancers are 

Treatable and Beatable 

“State-of-the-science” evidence in cancer refers to consensus among 

researchers and specialists regarding the most effective ways to 

prevent, screen for, and treat the disease, as well as rates of survival 

among those diagnosed. Because a person’s understanding of cancer 

prevention, screening, and survival may influence their health behaviors 

and health outcomes, it is important for cancer researchers and health 

communication practitioners to promote state-of-the-science evidence 

in cancer control, in order to reduce confusion, increase knowledge, 

and promote evidence-based preventive action. 

Data from HINTS 2005 show that Americans possess differing levels of 

accurate knowledge about the extent to which colon, skin, and lung 

cancers are preventable, treatable, and beatable.While most Americans 

have gotten the message that these cancers can be prevented, 

knowledge is not always consistent with state-of-the-science evidence 

when it comes to screening and survival. 

Approximately 90% of HINTS respondents believe “getting checked 

regularly” for lung and skin cancers increases the chance of finding 

those cancers at an early, treatable stage.This is not consistent with 

current evidence, as public health authorities have inadequate evidence 

to recommend for or against common lung cancer detection 

modalities and total-body skin exams as a way to screen for lung and 

skin cancers, respectively. 

Approximately 80% of HINTS respondents overestimate the survival 

rate for lung cancer, inaccurately assuming that most people diagnosed 

with lung cancer will survive at least 5 years, when the odds are 

actually much lower, with a 15% combined relative survival rate. 

In this HINTS Brief, we compare public perceptions of cancer 

prevention, screening, and survival with state-of-the-science evidence 

for colon, skin, and lung cancers. 

0

20

40

60

80

100

88% 87% 

Colon Skin Lung 

Public Knowledge of 

Preventing, Detecting, 

and Surviving Cancer 

Consistency of public knowledge with state-of-the-science 

evidence in cancer prevention, detection, and survival varies by 

type of cancer, levels of evidence for screening techniques, and 

sociodemographic characteristics. 

A recent study using HINTS 2005 data found that overall, public 

understanding of cancer prevention, detection, and survival is 

greater for cancers and screening techniques for which there is 

ample evidence and information upon which to make judgments 

and decisions. But when messages from the scientific community 

are inconsistent, or when evidence is unavailable for the best 

ways to screen for certain cancers, people may overextend 

their knowledge about more common cancers (such as breast 

cancer) to those cancers with which they are less familiar. 

87% 

Consistency with State-of-the-Science Screening 

Recommendations for Colon, Skin, and Lung Cancers 

10% 12% 13%

Agree 

Disagree 

Response is 

consistent with 

evidence 

“Getting checked 

regularly for cancer 

increases the chance 

of finding cancer when 

it is easy to treat.” 

3

3

3

3

Quick Facts 

• The risk of developing colon cancer can be reduced with 

physical activity, diet, and removal of adenomatous polyps. 

Experts strongly recommend colorectal cancer screening 

for men and women 50 and older with a fecal occult 

blood test (FOBT), or with sigmoidoscopy alone or in 

combination with FOBT. Colon cancer is highly treatable 

and often curable. 

• The risk of developing skin cancer can be reduced by 

wearing sunscreen and reducing exposure to UV rays. 

Experts do not recommend total-body skin exams to 

screen for cutaneous melanoma, basal cell skin cancer, or 

squamous cell skin cancer, as there is inadequate evidence 

to suggest that population-wide screening would be 

effective. Basal and squamous cell skin cancers are very 

common and highly curable, and the combined survival 

rate for melanoma is 82%. 

• The risk of developing lung cancer can be reduced by not 

smoking and by avoiding secondhand smoke. Experts do 

not recommend lung cancer screening by low-dose 

computerized tomography, chest x-ray, or sputum cytology, 

as there is inadequate evidence to suggest that these 

screening modalities save lives. Survival rates for lung 

cancer are very low. 

U.S. Population Precentages, HINTS 2005 

In this HINTS Brief, we compare public perceptions of cancer prevention, screening, and survival with state-of-the-science evidence. 
 

The National Cancer Institute (NCI) fielded the first Health Information National Trends Survey (HINTS) in 2002 and 2003, surveying 

6,369 Americans. Subsequent surveys followed in 2005 (5,586 Americans surveyed) and 2008 (7,674 Americans surveyed). HINTS was 

created to monitor changes in the rapidly evolving field of health communication.The survey data can be used to understand how 

adults 18 years and older use different communication channels to obtain health information for themselves and their loved ones, and 

to create more effective health communication strategies across populations. 

HINTS Briefs provide a snapshot of noteworthy, data-driven research findings.They introduce population-level estimates for specific 

questions in the survey and summarize significant research findings that are a result of analyzing how certain demographic 

characteristics influence specific outcomes. Many Briefs summarize research findings from recent peer-reviewed journal articles using 

HINTS data. 

How Can This Inform Your Work? 

State-of-the-science evidence is complex and often difficult to 

understand.When messages from the scientific community appear 

to be conflicting, or when evidence is missing or inadequate to 

make recommendations for appropriate screening modalities, 

people may extend or substitute their knowledge of more familiar 

cancer types (such as breast cancer) onto cancers with which they 

are less familiar. 

Most Americans have gotten the message that colon, skin, and lung 

cancers are preventable. However, the cancer control community 

could do a better job of educating the public about which 

screening modalities have been proven effective for specific 

cancers, and about the varying rates of survival for common 

cancers. Increasing accurate knowledge could provide people with 

higher levels of perceived control over their health and influence 

positive health behaviors and health outcomes.The following are 

examples of objectives for educating the public about cancer: 

• Promote prevention for those cancers associated with 

behavioral risk factors (e.g., smoking, unprotected sun exposure, 

unhealthy diet). 

• Promote screening for colon cancer for women and men aged 

50 and older. 

• Enhance perceived control by emphasizing high survival rates 

for most colon and skin cancers. 

• Decrease confusion about screening and effective treatment 

for lung cancer, in order to shift the emphasis to prevention 

until there are evidence-based detection strategies and 

effective treatments. 

About HINTS 

http://hints.cancer.gov 

Colon Cancer 

Most Americans (66%) know that 50% to 75% of people who develop 

colon cancer will survive at least 5 years. (The combined relative 

survival rate for colorectal cancer is 64%.) Education and 

race/ethnicity are associated with having knowledge that is consistent 

with the state-of-the-science evidence. Compared to those with less 

than a high school education, those with some college or a college 

degree are more than twice as likely to hold accurate perceptions of 

colon cancer survival. Compared with non-Hispanic Whites, Hispanics 

and non-Hispanic Blacks are less likely to be familiar with colon 

cancer’s high survival rate. 

Skin Cancer 

Most Americans (64%) know that the majority of people diagnosed 

with skin cancer will survive at least 5 years. (The combined relative 

survival rate for skin cancer is 82%.) Age, education, and race are 

associated with knowledge of state-of-the-science evidence for skin 

cancer survival. People in their 40s, 50s, and 60s are significantly more 

likely than those aged 18–29 to be familiar with skin cancer survival 

estimates. Moreover, college graduates are more than twice as likely to 

respond consistently with survival rates for skin cancer. Hispanics and 

non-Hispanic Blacks are less likely than non-Hispanic Whites to be 

familiar with survival rates for skin cancer. 

Lung Cancer 

Few (17%) Americans are aware that only a small minority of 

individuals diagnosed with lung cancer will survive 5 years beyond 

diagnosis. (The 5-year combined relative survival rate for lung cancer 

is 15%.) This lack of knowledge does not vary by sociodemographic 

characteristics, indicating that the lack of knowledge about successful 

treatment for lung cancer is widespread. 

Public Understanding of Colon, 

Skin, and Lung Cancer Survival 

Responses Consistent with State-of-the-Science 

Evidence Vary by Age, Education, and Race/Ethnicity 

For More Information on Cancer 

• Call the NCI Cancer Information Service at 1-800-4-CANCER 

(1-800-422-6237) 

• Visit http://cancer.gov 

• Order NCI publications at https://cissecure.nci.nih.gov/ncipubs/ 

References Used in This HINTS Brief 

Finney Rutten LJ, Hesse BW, Moser RP, McCaul KD, Rothman AJ. 

Public perceptions of cancer prevention, screening, and survival: 

comparison with state-of-the-science evidence for colon, skin, and 

lung cancer. J Cancer Ed. 2009; 24(1):40–8. 

National Cancer Institute Physician Data Query.Available from: 

http://www.cancer.gov/cancertopics/pdq/cancerdatabase. 

August 2009