Population awareness of HBV, HCV, and their association with cancer in the US

Introduction: It is estimated that there will be 42,240 new cases and 30,090 deaths of liver cancer in the US in 2025. Chronic hepatitis B and C infections are the leading risk factors of liver cancer, yet public awareness of their oncogenic potential remains limited. Understanding population-level awareness of this link is essential for improving prevention, screening, and vaccination efforts. We examined the prevalence and association between sociodemographic characteristics and awareness of the link between hepatitis B or C and cancer among U.S. adults. Methods: We analyzed data from the Health Information National Trends Survey (HINTS 7), a nationally representative survey of U.S. adults conducted in 2024. The outcome was awareness about the link between hepatitis B or C and cancer (yes/no). The outcome was accessed with the question “Do you think the Hepatitis B virus (also known as Hep B or HBV), or Hepatitis C virus (also known as Hep C or HCV) can cause cancer?” Weighted prevalence of awareness of hepatitis B or C as a cause of cancer was estimated among respondents. A weighted multivariable logistic regression model was used to estimate the association between sociodemographic characteristics (age, gender, race/ethnicity, marital status, education level, household income, rural-urban status, # of healthcare visits, and health status) and awareness of the link between hepatitis B or C and cancer. Results: A total of 7,278 participants were included in the analysis, including 51% of individuals aged 18-48 years, 52% of female, 61% of non-Hispanic White, 56% of married, 33% of college graduates, and 27% with household annual income of <$35,000. Of these, 26.9% were aware that hepatitis B or C can cause cancer. Compared with respondents aged 18-49 years, those aged ≥65 years were less likely to know that hepatitis B or C can cause cancer (aOR=0.57; 95% CI: 0.44-0.76). Similarly, compared to respondents who were married, those who were divorced/separated/widowed were less likely to know that hepatitis B or C can cause cancer (aOR=0.73; 95% CI: 0.53-0.98). However, respondents who were college graduates were more likely to know hepatitis B or C can cause cancer (aOR=2.03; 95% CI: 1.39-2.95) compared with those with high school diploma or less. Conclusion: Despite the growing burden of liver cancer in the US, population awareness that hepatitis B or C viruses can cause cancer remains low and varies substantially across sociodemographic groups. These findings suggest critical information/knowledge gaps persist across the U.S. population and call for targeted, health-literacy-appropriate educational interventions to enhance public awareness of preventable cancer risks.