Cancer prevention literacy in Europe: a cross-sectional study

Romeo-Cervera, Paula;Vanaclocha-Espí, Mercedes;Gandía-Prat, Mireia;García-Sauret, Óscar;Molina-Barceló, Ana;et.al.
(2026) European Journal of Public Health — Vol. 36, n° 4, p. ckag132 (2026)

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  • Romeo-Cervera, PaulaCancer and Public Health Research Unit, Foundation for the Promotion of Health and Biomedical Research (FISABIO) , Valencia,
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  • Vanaclocha-Espí, MercedesCancer and Public Health Research Unit, Foundation for the Promotion of Health and Biomedical Research (FISABIO) , Valencia,
    Author
  • Gandía-Prat, MireiaCancer and Public Health Research Unit, Foundation for the Promotion of Health and Biomedical Research (FISABIO) , Valencia,
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  • García-Sauret, ÓscarCancer and Public Health Research Unit, Foundation for the Promotion of Health and Biomedical Research (FISABIO) , Valencia,
    Author
  • Molina-Barceló, AnaCancer and Public Health Research Unit, Foundation for the Promotion of Health and Biomedical Research (FISABIO) , Valencia,
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Abstract
This study aimed to assess cancer prevention literacy (CPL) levels and awareness of the European Code Against Cancer (ECAC) among the adult population in the European Union (EU), as well as identify social determinants associated with CPL. A cross-sectional study was conducted (February-March 2024) via an online survey across 23 EU-countries (n ¼ 2312). Multivariate logistic regression models examined associations between explanatory variables (age, gender, educational level, history of cancer, region, and digital health literacy [DHL] quartiles) and knowledge outcomes (CPL, ECAC awareness, and cancer prevention specific knowledge topics). Although 81.4% of participants demonstrated sufficient CPL, 61.1% were unaware of the ECAC. Men were less likely to have sufficient CPL than women (OR ¼ 0.66, [0.49-0.89]), and participants with an education below the university level had lower odds of CPL than those with higher education (OR ¼ 0.50, [0.39-0.64]). DHL was the strongest predictor of CPL, with, participants in the highest DHL quartile being more than three times more likely to have sufficient CPL than those in the lowest quartile (
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Romeo-Cervera, P., Vanaclocha-Espí, M., Gandía-Prat, M., García-Sauret, Ó., Pinto-Carbó, M., De Pablo-Pardo, T., Ahmed, F., Seum, T., Fonseca, C., Van Den Broucke, S., Ros Comesana, H., Yared, W., Lopez-Espinosa, M.-J., & Molina-Barceló, A. (2026). Cancer prevention literacy in Europe: a cross-sectional study. European Journal of Public Health, 36(4), ckag132. https://doi.org/10.1093/eurpub/ckag132 (Original work published 2026)