Aims
To assess changes in NSW adults’ awareness of cancer risk factors and preventive behaviours from 2020 to 2026 and identify population groups where knowledge gaps persist. This evidence informs the design of equitable cancer prevention, screening and behaviour-change strategies.
Methods
Repeated cross-sectional surveys were conducted in 2020 (n=935) and 2026 (n=2033) using The Social Research Centre’s probability-based Life in Australia™ panel. Respondents reported unprompted and prompted awareness of cancer risk factors and identified protective factors. They reported their smoking and vaping status. Statistical tests were conducted using α=0.05.
Results
Awareness of cancer risk factors improved from 2020 to 2026. The three most identified unprompted risk factors remained smoking/tobacco, diet and alcohol with recall increasing for each: smoking/tobacco 79% from 70% , diet 65% from 55%, and alcohol 52% from 45%. People who currently smoke were less likely than others to identify smoking/tobacco (69% vs 80%) and alcohol (40% vs 53%) as cancer risks.
Prompted awareness was high for smoking/tobacco (98%), vaping (96%), sun exposure (87%), alcohol consumption (86%), overweight/obesity (85%), and processed meat consumption (79%). Recognition of alcohol and processed meat as cancer risks increased significantly over time. However, only 40% identified HPV Vaccination as reducing cancer risk, with higher recognition among women than men (44% vs 34%).
Despite overall gains, lower recognition was generally observed among older adults, people with lower educational attainment, those living in lower socioeconomic areas, and people born outside Australia.
Conclusions
NSW adults’ awareness of cancer risk factors has increased substantially, but important inequities remain. Further, the finding that only 40% of respondents recognised HPV vaccination as reducing cancer risk highlights a gap in understanding of one of the most effective cancer prevention interventions available. These findings support equity-focused, systems-based prevention strategies that combine public communication with action on broader conditions shaping health behaviours.