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ASCO in Action Podcast

Nov 12, 2019

ASCO CEO Dr. Clifford A. Hudis discusses findings from the ASCO 2019 National Cancer Opinion Survey, which found that only one in four Americans are taking concrete steps to prevent cancer, even though evidence exists that as many as half of all cancer cases are preventable. Further, the survey found that while 6 in 10 adults report being concerned about developing cancer, 25% believe that there is nothing they can do to prevent cancer. The survey also revealed troubling behaviors and attitudes around e-cigarette usage and end-of-life care.


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The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

Welcome to the ASCO in Action podcast brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content that offer enriching insights into the world of cancer care. You can find all of ASCO's podcasts, including this one, at

The ASCO in Action podcast is ASCO's podcast series that explores policy and practice issues that impact oncologists, the entire cancer care delivery team, and the individuals we care for, people with cancer. I’m Clifford Hudis, CEO of ASCO and the host of the ASCO in Action podcast series. Today, I want to share some very interesting findings from ASCO’s 2019 National Cancer Opinion Survey. 

ASCO started doing this annual survey three years ago in collaboration with the Harris Poll so we could track the public’s views on cancer research and care. The poll, supported by the Mission Endowment of ASCO’s Conquer Cancer Foundation, is conducted annually to measure shifts in the public’s perceptions of a range of cancer-related issues over time. 

The findings come from a large, nationally representative sample of U.S. adults ages 18 and older that included individuals with cancer. 

As the world’s leading organization of oncology professionals who care for people with cancer, ASCO believes it is critical to understand what the public, including patients, think of, expect, and need from the nation’s cancer care system.  

So, what did this year’s survey tell us? Well, this year’s findings raise serious concerns about an area of cancer care that—as anyone who treats cancer patients would say—should be uppermost in all our minds, and that is cancer prevention in America. I’ll get into the details in just a moment, but the results tell us that much more education on cancer prevention is needed, beginning at a young age—when it can have the greatest impact. 

This year’s survey also tells us that far too many young people regularly use e-cigarettes and believe they are harmless and not addictive. And, a third area the National Cancer Opinion Survey examined is end-of-life care and, here, we found gaps in awareness about the importance of patients discussing end-of-life wishes with their doctors and family members. 

So, turning to the area of cancer prevention, the ASCO survey found that only one in four Americans incorporate cancer prevention into their daily lives. When you think about it, this low rate is remarkable since research shows that as many as half of all cancer cases are preventable. 

Interestingly, our survey also reported six in 10 adults (57%) are concerned about getting cancer. You might think more than 25% of us would care deeply about cancer prevention and take risk reduction steps every day. So, we’re seeing a disconnect between attitudes and behaviors on this point. 

We also found low levels of public awareness of known cancer risk factors such as alcohol and obesity, and misconceptions that artificial sweeteners and cell phones cause cancer in humans. Clearly, this is a larger public health issue and more work needs to be done.  For starters, we urge every American to have regular conversations with their physician about reducing their risk of cancer and other chronic diseases. 

As I’m sure most of you know, stories about the use of e-cigarettes—or vaping—have been in the headlines with reported deaths from severe respiratory illness with e-cigarette use. As an organization of cancer doctors, we’re very concerned about the potential for e-cigarettes to become a gateway for youth to use cancer-causing tobacco products and the serious side effects that are beginning to emerge. 

So, we wanted to examine this issue more deeply in this year’s National Cancer Opinion Survey and what we found is troubling:  Roughly one in five young adults uses e-cigarettes daily or recreationally, and nearly one in four believes the products are harmless and not addictive. These findings reflect survey responses from Generation Z respondents, who are ages 18 to 22, and Millennials, who are ages 23 to 38.  

But, I also want to note that there is also evidence that e-cigarette use among pre-teens and teens is on the rise. Make no mistake, this is very worrisome news. The U.S. Surgeon General has warned that e-cigarettes contain addictive and harmful or potentially harmful ingredients, including nicotine; lead and other heavy metals; and flavorants such as diacetyl, a chemical linked to serious lung disease. 

For ASCO’s part, we issued a policy statement with the American Association for Cancer Research which called for putting safety labels with a warning about nicotine addiction on all e-cigarette packaging; prohibiting youth-oriented advertising; and banning the sale of e-cigarettes containing candy or youth-oriented flavors unless there is evidence demonstrating these products do not encourage use of e-cigarettes by youth. 

We will continue to monitor this issue closely and keep ASCO members informed of developments. 

Finally, I want to touch on a notable survey finding related to end-of-life care. Our survey found that most people affected by cancer aren’t discussing end-of-life care with their doctors, even though they believe it’s important. 

As cancer doctors, we understand that it’s critical to plan ahead for end-of-life care in the advanced stages of cancer or any disease. Physicians and patients should discuss all available care options and develop a plan that reflects patients’ wishes and goals. This can ease the emotional and may even reduce the financial burden for patients and their loved ones. 

I want our listeners to know that resources for planning for end-of-life care, including a patient booklet, are available at Cancer.Net. I encourage you to take advantage of this free resource. 

If you’re interested in learning more about the ASCO National Cancer Opinion Survey, please visit and search for National Cancer Opinion Survey. 

We would like our listeners to know that resources for planning end of life care, including a patient educational booklet, are available at And I would encourage everyone to take a look at this and take advantage of this free resource.

I want to close by thanking our audience for taking the time to listen to this overview of our survey findings. At ASCO, the results of this survey will inform our activities as we work to conquer cancer through research, education, and the promotion of the highest quality patient care. If you're interested in learning more about the ASCO National Cancer Opinion Survey, please visit and search for National Cancer Opinion Survey.

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So, until next time, thanks again for listening to this ASCO in Action podcast.