Investigators discovered both favorable and unfavorable changes in major cancer risk factors, preventive behaviors and services, and screenings in the United States during the COVID-19 pandemic, according to a new study published by Star et al in Cancer Epidemiology, Biomarkers & Prevention. The new findings revealed that between 2019 and 2021, smoking rates, heavy alcohol consumption, and physical inactivity declined; whereas, human papillomavirus (HPV) vaccination and stool testing for colorectal cancer increased. In contrast, obesity prevalence increased, disparities by racial/ethnic and socioeconomic status persisted, and cervical cancer screening rates declined during the same time frame.
Background
The investigators noted that about 45% of the 609,820 cancer deaths expected to occur in the United States in 2023 may be attributable to modifiable cancer risk factors such as smoking, alcohol consumption, excess body weight, physical inactivity, unhealthy diets, and obesity. They detailed that these risk factors may all be potentially avoidable through lifestyle changes. Cancer screenings can further prevent thousands of additional cancer incidences and deaths.
“These latest findings give us a mixed bag concerning progress in the fight to help reduce the cancer burden in [U.S.] adults,” explained co–study author Priti Bandi, PhD, Scientific Director of Cancer Risk Factors & Screening Surveillance Research in the Department of Surveillance & Health Equity Science at the American Cancer Society. “As more years of data are collected, it will be clearer whether these contrasting changes are transient or not,” she added.
Study Methods and Results
In the new study, the investigators analyzed data from the National Health Interview Survey, the Behavioral Risk Factors Surveillance System, and the National Immunization Survey to identify changes in major modifiable cancer risk factors, preventive behaviors, and screenings during the COVID-19 pandemic.
They uncovered improvements in select cancer risk factors and screenings:
However, the investigators also reported unfavorable trends from 2019 to 2021:
Additionally, disparities by racial/ethnic and socioeconomic status persisted:
Conclusions
“Ongoing efforts to reduce modifiable risk factors and improve receipt of screenings are warranted,” emphasized senior study author Ahmedin Jemal, DVM, PhD, Senior Vice President of Surveillance & Health Equity Science at the American Cancer Society. “We also must target our interventions among individuals of racially/ethnically diverse groups and socioeconomic positions who continue to be greatly affected by cancer,” he suggested.
“The pandemic put a spotlight on [how] the criticality of maintaining health and access to free preventive services—including cancer screening, HPV vaccination, and tobacco cessation—is more important than ever,” underscored Lisa Lacasse, MBA, President of the American Cancer Society Cancer Action Network. “We urge lawmakers at all levels of government to protect and advance policies that prioritize cancer prevention,” she concluded.
Disclosure: For full disclosures of the study authors, visit 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®.