OBJECTIVES: In addition to age, a series of risk factors are associated with increased incidence of cancer. Understanding the prevalence and characteristics of US adults with these risk factors is important for the purpose of screening and management. This paper quantifies the number of individuals in the US at elevated risk for cancer for the overall population and by selected patient characteristics.

METHODS: Using a cross-sectional observational approach with the National Health Interview Survey cancer supplement data from 2015, nationally representative estimates of the prevalence and correlates of cancer risk factors in the United States are estimated. The eight cancer risk factors assessed are history of smoking, current smoking status, heavy alcohol consumption, excess body weight, diabetes, excessive ultraviolet exposure, personal cancer history, and family cancer history. Individual characteristics such as race, ethnicity, education, age, gender, cancer screening history, and medical comorbidities were summarized.

RESULTS: An estimated 203.5 million (84%) US adults have at least one of the eight risk factors for cancer, while 70.3 million (29%) have three or more. Individuals with more risk factors for cancer were more likely to be white, less educated, lower income, male, and older. Non-white or Hispanic adults were more likely to have high body mass index, diabetes, and heavy alcohol consumption. The eight risk factors for cancer were found to be concentrated within individuals, i.e., having one risk factor is in general correlated with having other risk factors. Individuals with 3+ cancer risk factors are more likely to have other comorbidities such as hypertension, arthritis, and high cholesterol than those with <3 risk factors.

CONCLUSIONS: Many US adults have multiple risk factors for cancer other than age, with large disparities by education and income levels. These results highlight the need for an increased role for early cancer surveillance and testing.