Cancer Prevention: Progress and Problems

Cancer prevention efforts in US have led to both progress and areas of concern

(RxWiki News) Controlling cancer requires multiple prevention strategies. The United States has made some notable progress in recent years, but there's still room for improvement.

A new American Cancer Society (ACS) report found that smoking rates overall had decreased. However, in some populations, smoking was still a problem. Obesity continued to be a problem. Colorectal screening was underutilized — most noticeably by the uninsured.

This new ACS report highlights areas of concern and can help strengthen cancer prevention efforts.

The ACS team, led by epidemiologist Stacey E. Fedewa, MPH, noted in the report, “Much of the suffering and death from cancer could be prevented by more systematic efforts to reduce tobacco use, improve diet, increase physical activity, reduce obesity, and expand the use of established screening tests. Monitoring the prevalence of cancer risk factors and screening is important to measure progress and strengthen cancer prevention and early detection efforts.”

In addition to smoking, risk factors for cancer include obesity, lack of exercise and not eating a healthy diet. Screening can identify cancer at an early stage, when treatment is most likely to be successful.

Tobacco use is — as it has been for some time — the largest and most important factor in preventable disease and premature death in the US. Around 18 percent of all Americans still smoke, according to the ACS.

David Winter, MD, president, chief clinical officer and chairman of the board of HealthTexas Provider Network (HTPN), a division of Baylor Health Care System, told dailyRx News, “The percentage of the population that smokes cigarettes has fallen significantly since its peak in the 1940’s. Unfortunately, there is still a minority of folks, many of them young, who take up and continue this habit. Education has been helpful though is often countered by advertising from the tobacco companies. There is no question that smoking is the leading cause of preventable death and disability in the world today."

Education appeared to be a factor in US smoking rates. Twenty-two percent of those with only a high school education smoked, compared to 5.6 percent of those with a graduate degree.

Smoking cessation programs are often available, but the ACS found that use of these programs was low. Other options for those who want to quit include nicotine replacements — like patches, gum and oral medications — and counseling.

Around two-thirds of US adults were overweight or obese, according to the ACS. The combination of obesity, physical inactivity and poor nutrition increases the risk of some cancers.

Fedewa and colleagues found that close to one-third of Americans did not engage in any leisure-time physical activity during the week. Aerobic exercise improves overall health and helps decrease the risk of obesity.

Americans need to eat more fruits and vegetables, the ACS researchers said. Eating non-starchy vegetables — that means potatoes don't count — can decrease the risk of mouth, stomach and breast cancers.

Ultraviolet (UV) radiation from the sun or tanning beds can cause skin cancer. Around 20 percent of young women report using tanning beds.

Most adults and adolescents in the US did not protect themselves from exposure to sunlight, these researchers found. Simple strategies like wearing a hat and sunglasses or using sunscreen on exposed skin can help protect from UV rays.

Breast and cervical cancer screening increased, but colorectal cancer screening seemed to have leveled off. For those who were uninsured, the colonoscopy screening rate was only 21.9 percent.

The human papillomavirus (HPV) is the most commonly transmitted sexual infection in the US. It can cause cancer. Vaccinations can help prevent young people from acquiring the disease.

"Immunizations and cancer screening are being addressed by organized groups of physicians and other health care workers." Dr. Winter said. "Using population health techniques, patients are being contacted in these groups to encourage appropriate vaccines, colon screenings, Pap smears and mammograms. These efforts are starting to pay off. Colon cancer is becoming infrequent in those who have regular colon examinations.”

Fedewa and team noted that their cancer “report card” may help governments and doctors target the specific populations most in need of cancer prevention efforts.

This report was published April 1 in Cancer Epidemiology, Biomarkers & Prevention.

The ACS Intramural Research Department funded this research. The authors disclosed no conflicts of interest.

Review Date: 
April 2, 2015