An American Cancer Society (ACS) review of cancer prevention and early detection measures for 2018 and 2019 in the United States shows mixed progress. Smoking prevalence during this time was at an historic low, partly because most people who ever smoked have quit. However, obesity rates remained high, and cancer screening and human papillomavirus (HPV) vaccination levels were inadequate to make the desired progress toward a world without cancer. Plus, racial/ethnic and socioeconomic disparities persisted across most major modifiable cancer risk factors and preventive measures. These findings were published by Bandi et al in Cancer Epidemiology, Biomarkers & Prevention as well as in the ACS report Cancer Prevention and Early Detection Facts & Figures, 2021–2022.
Every 2 years, researchers from the ACS analyze data from multiple national surveys to understand how many adults in the United States report behaviors that can affect their cancer risk or help find it early—because these efforts are central to reducing the cancer burden. The review is one of the only sources that looks at the major modifiable cancer risk factors, in addition to HPV vaccination and cancer screening test use. All data were compiled before the COVID-19 pandemic.
Of the estimated 608,570 deaths from cancer expected to occur in the United States in 2021, about 45% are from potentially preventable causes such as cigarette smoking, excess body weight, alcohol intake, physical inactivity, and unhealthy diet.
“Our snapshot of the status of cancer prevention and early detection measures was mixed,” said ACS researcher Priti Bandi, PhD, who led the study. “Overall cigarette smoking is down, but obesity remains high, and the use of cancer screening and HPV vaccination continues to be underused.”
Tobacco Use and Disparities in Smoking Cessation
Cigarette smoking increases the risk for lung cancer, as well as about a dozen other types of cancer. Quitting smoking reduces the risk of developing all cancers caused by smoking.
Here are some of the study’s key statistics from the 2018 to 2019 data for U.S. adults.
“These data highlight the critical importance of expanding tobacco cessation coverage in state Medicaid programs,” said Dr. Bandi. The geographic disparities in the South, the authors said, were also potentially related to inequitable distribution of cessation coverage policies, as well as health-care access and evidence-based tobacco control policies.
Promoting state-level population tobacco control policies was one of the key recommendations in the study to reduce the use of tobacco and lessen disparities in smoking cessation. These policies include:
Excess Body Weight, Physical Activity, Diet, and Alcohol Consumption
About 18% of cancer cases in the U.S. can be attributed to a combination of excess body weight, lack of physical activity, unhealthy diet, and consumption of alcohol.
Here are some of review’s key statistics from the 2017 to 2019 data for adults in the US.
“It will require collaboration between communities and governments at the national, state, and local levels to take culturally appropriate efforts to reducing the cancer burden in the future,” said Dr. Bandi. The study authors recommend these actions:
HPV Vaccinations and Cancer Screenings
The HPV vaccine currently used in the U.S. has the potential to prevent about 90% of HPV-caused cancers.
Early detection of cancer through screening reduces death from breast, cervical, colorectal, and lung cancers. Screenings for colorectal and cervical cancer can also prevent these cancers by identifying precancerous areas that can be removed.
Here are some of study’s key statistics from the 2018 to 2019 data.
To increase the number of people who receive the HPV vaccine in adolescence, the study authors recommend:
The report notes that recent health-care reforms, including the ACA Medicaid expansions and elimination of cost-sharing for screenings, have shown promise in helping to reduce screening disparities.
“We can still make substantial progress by promoting smoking cessation among socially vulnerable populations, focusing efforts to stem the rising prevalence of obesity, and improving cancer screening and HPV vaccination levels,” concluded Dr. Bandi.
Disclosure: For full disclosures of the study authors, visit cebp.aacrjournals.org.The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.