title: Awareness of risk factors for cancer: a comparative study of Sweden and Denmark.
abstract: BACKGROUND
  Sweden and Denmark are neighbouring countries with similarities in culture, healthcare, and economics, yet notable differences in cancer statistics. A crucial component of primary prevention is high awareness of risk factors in the general public. We aimed to determine and compare awareness of risk factors for cancer between a Danish and a Swedish population sample, and to examine whether there are differences in awareness across age groups.
  
  
  METHODS
  Data derive from Module 2 of the International Cancer Benchmarking Partnership. Telephone interviews were conducted with 3000 adults in Denmark and 3070 in Sweden using the Awareness and Beliefs about Cancer measure. Data reported here relate to awareness of 13 prompted risk factors for cancer. Prevalence ratios with 95 % confidence intervals were calculated to examine associations between country, age, and awareness of risk factors.
  
  
  RESULTS
  Over 90 % of respondents in both countries recognized smoking, use of sunbeds and ionizing radiation as risk factors for cancer. Lowest awareness (<50 %) was found for HPV-infection, low fruit and vegetable intake and alcohol intake. Swedish respondents reported higher awareness than Danish respondents for ten of the 13 risk factors studied. Respondents from Denmark reported higher awareness only regarding low fruit and vegetable intake and use of sunbeds. Low physical activity was the only risk factor for which there was no difference in awareness between the countries. A decline in awareness was generally seen with increasing age in both countries, but deviating patterns were seen for alcohol intake, red/processed meat, obesity and age 70+.
  
  
  CONCLUSIONS
  This study supports findings from other European studies that generally demonstrate modest public awareness of many established cancer risk factors. Efforts should be made to improve awareness of the cancer risk factors HPV-infection, low fruit and vegetable intake and alcohol intake, which showed particularly low awareness in both countries. Previous studies indicate that repeated, broad campaigns are successful, and suggest that a multimedia approach is used.
authors.affiliation: Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, SE 171 77, Sweden. mlagerlu@gmail.com.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Lagerlund
authors.affiliation: Research Centre for Cancer Diagnosis in Primary Care (CaP), Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark. line.hvidberg@ph.au.dk.|Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark. line.hvidberg@ph.au.dk.
authors.forename: Line
authors.initials: L
authors.lastname: Hvidberg
authors.affiliation: Department of Nursing, Umeå University, Umeå, Sweden. senada.hajdarevic@umu.se.
authors.forename: Senada
authors.initials: S
authors.lastname: Hajdarevic
authors.affiliation: Research Centre for Cancer Diagnosis in Primary Care (CaP), Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark. afp@ph.au.dk.
authors.forename: Anette
authors.initials: A
authors.lastname: Fischer Pedersen
authors.affiliation: Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, SE 171 77, Sweden. sara.runesdotter@ki.se.
authors.forename: Sara
authors.initials: S
authors.lastname: Runesdotter
authors.affiliation: Research Centre for Cancer Diagnosis in Primary Care (CaP), Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark. p.vedsted@alm.au.dk.
authors.forename: Peter
authors.initials: P
authors.lastname: Vedsted
authors.affiliation: Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, SE 171 77, Sweden. carol.tishelman@ki.se.|Innovation Centre, Karolinska University Hospital, Stockholm, Sweden. carol.tishelman@ki.se.
authors.forename: Carol
authors.initials: C
authors.lastname: Tishelman
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D003718:Denmark / Q000453:epidemiology; D004032:Diet / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000706:statistics & numerical data*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology