Background: Cancer prevention guidelines have been developed to improve knowledge and adherence to modi-
fiable cancer risk factors. The implementation of these guidelines has largely been studied in North American and
European populations. The aim of this study was to examine the association between health care access and
adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention
guidelines in South Africa, where the cancer incidence is rising.
Methods: Data from the 2003 South Africa World Health Survey was used to assess adherence to WCRF/AICR
cancer prevention guidelines on alcohol, body mass index, nutrition, physical activity and smoking. Health care
affordability, availability, accessibility, accommodation and acceptability in the past 12 months were assessed
via self-report.
Results: Residing in a high socio-economic status household (affordability), visiting a non-governmental health
care facility (availability), perception of health care provider skills as adequate (accommodation) and lack of perception
of worse treatment based on social class (acceptability) were each associated with higher levels of
adherence to the WCRF/AICR guidelines.
Conclusions: In South Africa, better access to health care is associated with better patient adherence to cancer
prevention guidelines. Future studies and efforts can focus on improving access to quality health care in this
population.