Associations between indoor and outdoor air pollution worry and awareness and acceptability of multi-cancer early detection testing: Evidence from a nationally representative US survey.

Abstract

e22521 Background: Public concern regarding the carcinogenic effects of air pollution has intensified, shaping perceptions of cancer risk and prevention. Multi-Cancer Early Detection (MCED) blood tests, which aim to detect multiple malignancies from a single blood draw, represent a promising frontier in early detection. However, it remains unclear whether environmental worry particularly perceived health threat from indoor and outdoor air pollution translates into greater awareness of MCED testing or greater perceived value of these emerging technologies. Methods: We analyzed nationally representative data from U.S. adults aged ≥18 years using the 2024 Health Information National Trends Survey (HINTS 7; N = 6,597), restricted to respondents with complete data on air pollution worry and MCED outcomes. The primary exposures were self-reported worry that indoor and outdoor air pollution would harm health, categorized as little/none versus some/a lot. Outcomes included awareness of MCED tests and perceived value/acceptability of MCED testing. Weighted multivariable logistic regression models were fitted for each outcome, adjusting for demographic and socioeconomic characteristics and behavioral covariates. Results: The weighted sample was 48.9% female; 48.2% were aged ≥50 years; 60.8% were Non-Hispanic White, 17.0% Hispanic, and 11.0% Non-Hispanic Black. Overall, 37.0% reported that indoor air pollution was some/a lot harmful to their health, and 50.0% reported similar worry about outdoor air pollution. MCED awareness was low (16.8%), while perceived value was high (73.5%). Greater indoor air pollution worry (OR 0.89; 95% CI 0.69–1.16; p=0.38) and outdoor air pollution worry (OR 0.95; 95% CI 0.75–1.19; p=0.62) were not associated with MCED awareness. In contrast, both indoor (OR 1.50; 95% CI 1.13–2.00; p=0.006) and outdoor air pollution worry (OR 1.48; 95% CI 1.19–1.85; p=0.001) were associated with higher perceived value of MCED testing. Conclusions: In a nationally representative U.S. sample, air pollution worry was associated with greater perceived value of MCED testing but not greater awareness, suggesting that environmental risk concern may increase receptivity to novel screening technologies even when knowledge remains limited.