Assessing Knowledge of Primary Liver Cancer Risk Factors and Health Communication Campaign Preferences Among Adults Attending the Minnesota State Fair

Abstract

Globally, hepatocellular carcinoma (HCC), the most common primary liver cancer, is rising in incidence, with limited data on public awareness. This study evaluated understanding of liver cancer risk factors and communication preferences among Minnesota State Fair attendees to inform tailored campaigns. We conducted a cross-sectional survey among 481 attendees in 2023. Participants completed questionnaires assessing knowledge of four established liver cancer risk factors and preferences for health communication approaches. We used chi-square or Fisher’s exact tests to examine group differences. Less than half correctly identified at least three of four major risk factors, with higher knowledge among older adults. No significant differences in knowledge were detected by gender, race, metropolitan status, or country of birth. Among participants with campaign style preferences, older adults significantly preferred fact-based approaches over emotionally evocative ones, whereas younger adults favored emotionally evocative campaigns. Younger adults also preferred memorable or humorous messages and cartoons or illustrations. Health care providers were the most trusted information source across all age groups. People with higher liver cancer risk knowledge had more trust in health care providers and the U.S. Centers for Disease Control and Prevention (CDC). Knowledge gaps about liver cancer risk factors exist among the general public, with notable variations by age, and effective prevention campaigns should incorporate age-tailored communication strategies.