A new national survey released by the American Society of Clinical Oncology (ASCO) has revealed that most Americans are dangerously unaware of several key risk factors for cancer — most notably obesity, which is soon expected to overtake smoking as the largest preventable cause of cancer in the United States, Healio reports.

More than 4,000 U.S. adults ages 18 and older were interviewed via an online nationally representative survey for the report, known as ASCO’s first annual “National Cancer Opinion Survey.” Findings from the study span a wide array of topics—from the percentage of Americans who have had personal experience with cancer to concerns about cancer care and research. However, researchers decided to emphasize key cancer risk factors upfront due to the high degree of misinformation they say is circulating in the cancer community today.

For instance, the survey showed that while a majority of Americans (78 percent) correctly identified tobacco use as a key risk factor for cancer, less than a third of respondents (31 percent) realized that obesity could lead to colon, breast, prostate and uterine cancers, among others. Researchers also found that only 30 percent of Americans recognize alcohol as a preventable cancer risk, despite the fact that it can increase the likelihood of cancers of the mouth, liver and breast. Meanwhile, less than half (48 percent) of respondents said they used sunblock to limit their exposure to the sun, despite the fact that 66 percent identified it as a risk factor for skin cancer.

In addition, the survey revealed the persistence of several misperceptions about cancer. For instance, 14 percent of Americans incorrectly identified cell phones as a cancer risk factor, while 8 percent incorrectly stated caffeine could increase cancer risk.

ASCO’s report also uncovered some troubling realities about the state of cancer care in the United States. According to the survey, one in four people who have had cancer or who had an immediate family member with a cancer-related illness said they had forgone treatment or doctor visits in an effort to save money. What’s more, nearly three-quarters of Americans support greater federal investment in cancer research, even if it means higher taxes or adding to the national deficit in order to drive down the prices and improve the efficacy of current cancer treatments.

“It is clear that there are many important gaps we need to address—from educating the public about cancer prevention to confronting high treatment costs to investing in cancer research that is vital to improving patients’ outcomes in the future,” said ASCO president Bruce Johnson, MD, in a press release about the report. Study authors say they hope the survey helps inform national decisions around our current efforts to conquer the disease.

Click here to view the full set of National Cancer Opinion Survey findings.