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More than 85% of Americans consider themselves at least somewhat knowledgeable about cancer, yet a substantial number of people still believe common myths about the disease and its treatment. That's the finding from a new American Cancer Society study published online Monday in the journal Cancer.

The finding is disappointing, said lead researcher Ted Gansler, MD, MBA, because it suggests many people may be basing their health care decisions on wrong information.

Gansler and his colleagues analyzed responses from a telephone survey of 957 US adults who said they'd never had cancer. Participants were asked how informed they thought they were about cancer, and about personal characteristics like age, race/ethnicity (white, African-American, Hispanic, other), gender, income, education, and where they lived. Then they were asked whether they agreed with 5 common cancer myths:

• "Pain medications are not effective in reducing the amount of pain people have from cancer."
• "All you need to beat cancer is a positive attitude, not treatment."
• "Treating cancer with surgery can cause it to spread throughout the body."
• "There is currently a cure for cancer but the medical industry won't tell the public about it because they make too much money treating cancer patients."
• "Cancer is something that cannot be effectively treated."

About 75% of the people who took the survey either believed or were uncertain about at least one of these incorrect statements.

"Many people don’t spend a lot of time learning about specific health problems until those conditions affect them or someone close to them," said Gansler, who is director of medical content at ACS. "Consequently, people recently diagnosed with cancer who want to actively participate in their healthcare decisions often face the challenge of learning a lot of new information very quickly."

The most commonly-believed myth was that surgery could make cancer spread. Nearly 41% of participants said this was true, and another 13% said they weren't sure whether it was true or not. Men and people who said they weren't very informed about cancer were most likely to believe this misstatement. People with at least some college education were least likely to believe this claim.

In reality, though, surgery is a very effective treatment for cancer, Gansler said, and often the first treatment a patient will get.

This myth may stem from earlier decades, when cancer detection and treatment were less refined than they are now. In those days, cancer often wasn't found until it was very advanced, when surgery would have been less likely to help. People may have assumed the surgery caused the problem, giving rise to this rumor.

"Before modern cancer screening tests, CT scans, and MRIs, exploratory surgery was used much more often and, unfortunately, often found cancer that was too advanced to be removed by surgery," Gansler explained. "Without modern chemotherapy and radiation therapy, the outlook for such patients was generally bleak. However, it is incorrect to assume that the initial surgery was responsible this poor prognosis."

The second most-commonly held misconception was that the medical industry is withholding a cure for cancer. More than 27% of participants agreed with that statement, and another 14% weren't sure. People with lower education levels were most likely to believe this conspiracy theory.

Those figures point to a certain level of distrust toward the medical community that could be problematic, Gansler noted. If patients don't trust their doctors, they're less likely to follow advice about cancer prevention, screening, and treatment -- and may even put their health in danger.

But that finding may not be as dire as it seems, Gansler said.

"Although many people indicated they do not trust the 'medical industry,' previous studies show that they have more confidence in their own doctors. So, the number of people completely rejecting appropriate medical advice is probably much lower than 27%."

Two of the myths in the survey were recognized as false by nearly everyone who participated. More than 87% of people knew that cancer can be treated effectively, and 89% knew a positive attitude isn't enough to beat the disease.

However, 19% of people thought pain medications weren't effective for cancer pain, and just over 13% weren't sure. Older people and poorer people were especially likely to believe this statement, and college graduates were least likely.

One reason for that gap may be that poorer people simply don't have as much access to effective pain medication, either because they can't afford it or because pharmacies in their area don't carry the strongest medicines, fearing break-ins by criminals and drug addicts.

"It's particularly troubling that many people may be suffering needlessly, when studies show that cancer pain can be relieved in most cases," Gansler said.

Ideally, Gansler said, the people should be more informed about health issues. The most important cancer information for the general public is about prevention and early detection, since this knowledge influences decisions they make quite often. And once someone is diagnosed with cancer, they need access to accurate and easy-to-understand information about the disease, he added.

"It's important for clinicians to assess how well their patients understand the key issues about their disease and to address any misconceptions themselves or by referring the patient to organizations that can help, such as ACS," Gansler said. "Although the need is especially great in areas that serve low-income populations with less education, almost everyone needs at least some help."

Citation: "Sociodemographic Determinants of Cancer Treatment Health Literacy." Published online June 27 in Cancer (August 1, 2005 print edition). First author: Ted Gansler, MD, MBA, of the American Cancer Society.