European Code Against Cancer: what does the Spanish population know and think about its recommendations?

The aim of this study was to evaluate the Spanish population's knowledge of and beliefs regarding the European Code Against Cancer (ECAC) recommendations. This was a cross-sectional, observational, multicentric study that used self-administered surveys. Ten individuals, between the ages of 15 and 69 years old, were enrolled by each participating primary care professional in their respective surgery consultations. This study used 2058 individuals who were recruited by 205 professionals from 106 health centres. Their average age was 41.5 years (52.2% women). The majority believe that smoking [94.1%; 95% confidence interval (CI): 93.1-95.2], sun exposure (91%; 95% CI: 89.7-92.3) and alcoholism (72.1%; 95% CI: 70.1-74.1) are factors related to cancer. The least relevant are infection by the hepatitis B virus (25.7%; 95% CI: 23.8-27.7) and having multiple sexual partners (25%; 95% CI: 23.1-26.9). In all, 86.7% (95% CI: 85.2-88.2) had never heard about the ECAC. Patients adequately identify the carcinogenic effect of tobacco, alcohol or sun exposure. Moreover, they inadequately identify having hepatitis B and multiple sexual partners as being related to cancer. A large majority of individuals have not heard of the ECAC, which raises the need to conduct outreach campaigns at an institutional level and/or through scientific associations and activities promoting health education among primary care professionals.