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

Pérula-de-Torres, Luis Ángela,b,c; Marzo-Castillejo, Mercèd,e; Ranchal-Sánchez, Antoniob; Bartolomé-Moreno, Cruze,f,g; Parras-Rejano, Juan Manuelb,h; Bellas-Beceiro, Begoñae,i; Vela-Vallespin, Carmene,j; Nuin-Villanueva, Maria Angelese,k; Melús-Palazón, Elenae,f,l; Vilarrubí-Estrella, Mercèe,j; Martin-Rabadán Muro, Maríac,m; Martin-Carrillo Domingez, Pilarc,n; Magallón-Botaya, Rosaf,ocollaborative Group CECC-AP study

European Journal of Cancer Prevention: March 2015 - Volume 24 - Issue 2 - p 69–75
doi: 10.1097/CEJ.0000000000000102
Research Papers: Prevention Strategy

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.

aTeaching Unit of Family and Community Medicine in Cordoba

bInstitute Biomedical Research Maimonides Córdoba (IMIBIC)/Hospital Universitario Reina Sofia/University of Cordoba

cImprovement Group PAPPS (semFYC)

dUnit for Research Support of Costa de Ponent - IDIAP Jordi Gol, Address of Costa de Ponent primary care, Institut Català de la Salut, Barcelona, and PAPPS Cancer Group (semFYC)

ePAPPS Cancer Group (semFYC)

fTeaching Unit Family and Community Medicine Sector I, Zaragoza, Aragon Health Service

gGoya Park Health Center, Zaragoza

hPeñarroya Health Center Cordoba

iHospital Universitario de Canarias, Santa Cruz de Tenerife

jABS Riu i Riu Nord Sud, Santa Coloma de Gramenet, Barcelona, Catalan Institute of Health

kService Clinical Management and Information Systems Directorate Primary Care Navarra Health Service

lActur Health Center West, Zaragoza

mHealth Center Can Misses, Ibiza

nYébenes Health Center, Madrid and Center Health Arrabal, Zaragoza, Spain

oHealth Center Arrabal, Zaragoza, Spain

All supplementary digital content is available directly from the corresponding author.

Correspondence to Luis Ángel Pérula-de-Torres, PhD, Unidad Docente de Medicina Familiar y Comunitaria de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba, Avda. Menéndez Pidal, s/n, Córdoba 14004, Spain Tel: +34 957 354250; fax: +34 957354233; e-mail:

Received March 24, 2013

Accepted October 13, 2014

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