Objective To understand the awareness, attitude and behavior of cancer prevention related knowledge among adults in Huaihe areas of Anhui province. Methods Using multi-stage cluster random sampling method, residents aged 18 years old and above were recruited from 5 counties. Data on demographic information and health-related knowledge, attitude and behavior were collected by face to face interview. Results A total of 3 995 subjects aged ≥18 years were included in the study. The ratio of awareness of smoking and excessive drinking to increase the risk of cancer were 90.1% and 71.6%, respectively. However, the awareness of the effects of environmental pollution, such as virus infection, irrational diet, obesity, occupational factors and water soil on cancer, were 35.1%, 33.6%, 19.5%, 23.2% and 41.6%, respectively. Only 2.7% of the survey population knew that reproductive factors were risk factors for cancer. In addition to viral bacterial infection, occupational factors and reproductive factors, the awareness rate of other risk factors were higher in males than in females (all P< 0.05). Except smoking, the awareness rate of other risk factors decreased with age increasing (all P<0.05).The awareness rates of effective prevention, early detection and treatment to reduce cancer were 63.1% and 60.2% respectively. The awareness rates of eating more fresh fruit and vegetables, changing bad behavior and eating habits to prevent cancer were 58.5% and 66.1%. 76.9% of the respondents believed that eating moldy food could cause cancer. The proportion of people willing to be vaccinated against hepatitis B was 80.6%, but the rate of hepatitis B vaccination was only 42.8%. The percentages of knowledge and attitude awareness in males were higher than those in females (all P< 0.05), and decreased with age (all P< 0.05). 20.0% subjects were salt diet, 9.7% liked to eat partial hot food, and 28.3% families didn't connect clean tap water. The smoking rate of the survey population was 29.5%, the rate of subjects drinking alcohol frequently was 15.8%, which was higher in men than in women (all P<0.05). Conclusion The awareness rate of cancer related risk factors among adult residents in Huaihe areas of Anhui was low (except for smoking and excessive drinking), and the rate of hepatitis B vaccination was not high, especially in the high age group. Smoking and high-frequency drinking were still common, although the proportion of people surveyed who knew that smoking and excessive drinking were risk factors for cancer was high.