Objective To analyze and compare the differences in cancer early diagnosis and treatment literacy levels between urban and rural residents in Liaoning province, China, and to provide a basis for improving residents’ cancer awareness and literacy.

Methods In 2021, a convenient online sampling method was used to conduct a questionnaire survey on the significance of early diagnosis and treatment of cancer, recognition of cancer warning signs, early detection of cancer, and timely medical treatment among 17 474 residents aged 15 – 69 years old in 14 cities of Liaoning province. The χ² test and multivariate logistic regression analysis were used to compare the differences and influencing factors of early diagnosis and treatment literacy levels among different groups.

Results In 2021, the overall level of cancer early diagnosis and treatment literacy among residents in Liaoning province was 35.61% (95%CI: 33.87% – 37.36%), with 41.36% (95%CI: 39.39% – 43.32%) in urban areas, higher than 23.67% (95%CI: 20.37% – 26.99%) in rural areas. Among different dimensions, residents' literacy levels on the significance of early diagnosis and treatment (67.19%, 95%CI: 65.09% – 69.28%) and timely medical treatment (64.56%, 95%CI: 62.43% – 66.69%) were relatively high, while the literacy levels on recognition of cancer warning signs (25.98%, 95%CI: 24.24% – 27.73%) and early detection of cancer (31.18%, 95%CI: 29.52% – 32.84%) were relatively low. The results of multivariate logistic regression analysis showed that among urban residents, females, those aged 35 – 54 years old, those with a college education or above, those with an annual per capita household income of ≥ 16 666.6 yuan, and those with a family history of cancer or cancer screening history were more likely to have cancer early diagnosis and treatment literacy (all P < 0.05), while those engaged in the primary industry and current or former smokers were less likely to have early diagnosis and treatment literacy (all P < 0.05). Among rural residents, females, those aged 35 – 54 years old, those with a middle school education or above, and those with an annual per capita household income of ≥ 10 000 yuan were more likely to have cancer early diagnosis and treatment literacy (all P < 0.01), while those who were unemployed or retired and current or former smokers were less likely to have early diagnosis and treatment literacy (all P < 0.05).

Conclusion There are significant differences in cancer early diagnosis and treatment literacy levels between urban and rural residents in Liaoning province, China. In the future, cancer screening programs can be used to carry out targeted interventions and health education for key populations in key areas.