Americans take one step forward, one step back for cancer prevention
First, the good news: The overall cancer death rate has been on a steady decline—as have smoking rates, with only 11% of Americans now smoking cigarettes. As a result, cancers associated with tobacco smoking have fallen. Also, breast and colorectal cancer screening rates rebounded after decreasing or stalling during the pandemic.
But there's bad news, too: Up-to-date screenings for cervical cancer are low, remaining below pre-pandemic levels and continuing what's been a decline since the early 2000s. Meanwhile, rates of HPV vaccinations—highly effective against most cases of cervical cancer—have flattened.
Such was this week's mixed cancer and cancer-prevention report from both the American Cancer Society and the National Institutes of Health (NIH) annual report on the status of cancer.
'Cancer prevention and early detection are central to the American Cancer Society's goal to ensure everyone has an opportunity to prevent, detect, treat, and survive cancer,' Dr. Priti Bandi, a scientific director at the American Cancer Society and lead author of its new study, published in the the journal Cancer Epidemiology, Biomarkers & Prevention. 'These latest findings are encouraging, mainly the reduction in smoking rates and screening for certain cancers, but it's clear urgent efforts are needed to address lagging cervical cancer prevention.'
The ACS news came right after that of the NIH, which reported on Monday in the journal Cancer that overall death rates from cancer declined steadily among both men and women from 2001 through 2022, even during the first two years of the COVID-19 pandemic. Among men, it found, overall cancer incidence (rate of new cancer diagnosis) decreased from 2001 through 2013 and then stabilized through 2021. Among women, overall cancer incidence increased slightly every year from 2003 through 2021, except for 2020.
An estimated 40% of cancer cases in the U.S. can be attributed to modifiable risk factors, the ACS noted, including cigarette smoking, excess body weight, dietary factors, physical inactivity, ultraviolet radiation exposure, and cancer-causing infections, including HPV. Cancer screening tests can also prevent thousands of additional cancer cases and deaths, the study highlighted.
Highlights of the ACS report regarding cancer risks and screenings include:
Cigarette smoking declined from 14% in 2022 to 11% in 2023—but high smoking prevalence remains in American Indian/Alaska Native individuals, Black males, people with lower education, and bisexual females.
Up-to-date cervical cancer screening in 2021 was at 73%, remaining below pre-pandemic levels. Meanwhile, up-to-date breast cancer screening and colorectal screening rebounded and exceeded pre-pandemic levels in 2023 after declining and stalling, respectively, during the pandemic.
After a trend of increasing, up-to-date HPV vaccination prevalence in adolescents 13-17 years of age remained flat between 2021 and 2023 (61%), largely due to pandemic-related disruptions. Persistent, high-risk HPV infection causes almost all cervical and anal cancers and 64% to 75% of vaginal cancers.
Less than half of adults (48%) met recommended physical activity levels, and an estimated one-third (27%) reported no leisure-time physical activity in 2022—remaining unchanged from 2020.
'Our report underscores the need to strengthen efforts to improve access and receipt of preventive services, including cancer screening, HPV vaccination, and counseling and treatment for tobacco dependence,' said Dr. Ahmedin Jemal, a senior vice president at the American Cancer Society and senior author of the report. 'We must also work to identify individuals of racially/ethnically diverse groups and socioeconomic positions who continue to be greatly affected by cancer to accelerate progress against the disease.'
Added Lisa Lacasse, president of the American Cancer Society Cancer Action Network (ACS CAN), the advocacy affiliate of the American Cancer Society, 'These findings only further prove how investments in tobacco control have helped reduce the number of people falling prey to Big Tobacco's deadly products and practices.' That control was largely thanks to federal agencies, she stressed, which is why recent government cuts to such agencies has the ACS 'deeply concerned' that they will 'jeopardize continued progress to reduce tobacco utilization nationwide.'
More on cancer:
Childhood exposure to this bacteria could be driving rates of colorectal cancer in millennials and Gen Xers, new study warns
The truth about CT scans: The common health check could drive 103,000 cancer cases, research warns
Cancer deaths are down, but rates in women under 50 are rising
This story was originally featured on Fortune.com
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