Correlates of alcohol-related cancer risk awareness in U.S. adults.

Abstract

e22675 Background: Alcohol consumption is a modifiable risk factor for multiple malignancies, yet public understanding of this association remains limited in the United States. Identifying sociodemographic, behavioral, and perceptual correlates of awareness is essential to inform targeted cancer prevention communication strategies. Methods: We analyzed data from 15,826 U.S. adults who participated in the Health Information National Trends Survey (HINTS) 4, Cycle 3, through HINTS 7 (2013–2024). Participants were categorized by awareness of alcohol as a cancer risk factor (“Yes,” “No,” or “Don’t know”). Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for demographic, behavioral, and cancer-related belief variables associated with awareness. Results: The study population had a mean age of ~55 years. Overall, 42.2% of participants reported awareness that alcohol increases cancer risk. Awareness was significantly associated with higher educational attainment (OR = 1.20, 95% CI 1.14–1.26), with awareness reaching 55.5% among individuals with a bachelor’s degree or higher, compared with 17.9% among those with a high school education or less. Greater annual household income (OR = 1.11, 95% CI 1.07–1.15) and having ever sought information about cancer (OR = 1.78, 95% CI 1.59–1.99) were also significant predictors of awareness. Perceptually, awareness was associated with lower cancer fatalism; 38.0% of aware respondents strongly disagreed that little can be done to reduce cancer risk. Behaviorally, non-smokers were more likely to report awareness (OR = 1.22, 95% CI 1.09–1.37). Notably, a knowledge–behavior paradox was observed, as heavy alcohol consumption (≥9 drinks/week) was most prevalent among those who were aware (11.8%) compared with those responding “No” (10.1%) or “Don’t know” (7.2%). Conclusions: Awareness of alcohol as a cancer risk factor among U.S. adults remains suboptimal and is strongly patterned by socioeconomic status, health information-seeking, and cancer-related beliefs. These findings highlight persistent disparities in cancer risk knowledge and underscore the need for targeted public health messaging, to bridge gaps between awareness and behavioral risk reduction.