Progress made in cancer prevention in U.S., but challenges remain

Issue 21, Summer/Fall 2013

Report from American Cancer Society finds social, legislative trends are key

There's good news and bad news from a sweeping report on trends for behaviors that affect Americans' risk for cancer.

While there's been significant headway in issues, such as youth smoking and uptake of the human papillomavirus (HPV) vaccine, rates of obesity remain high and cancer screening rates have stalled, according to the report from the American Cancer Society.

The report, released in April, "finds continuing challenges in changing behaviors and risk factors in order to reduce suffering and death from cancer," the ACS said in a statement.

First, however, the good news: Rates of smoking continue to fall, especially among the young.

Between 2005 and 2011, smoking rates among adults edged downwards again from 20.9 percent to 19 percent, the report found. That was mirrored by a concurrent decline in rates of heavy smoking, so that even those who smoke today may do so less frequently than in years past.

But it was among the young that smoking rates fell most steeply: In 1997, more than a third (36.4 percent) of U.S. high school students smoked, compared to just over 18 percent by 2011.

It's too bad the same trends weren't seen for obesity, which continues to plague millions of Americans. According to the ACS report, nearly 38 percent of adults are now obese, as are 18.4 percent of adolescents. By 2011, no state in the nation had an obesity rate below 20 percent.

Still, there's a glimmer of hope: the rate of increase of obesity seems to be slowing, especially among women and girls, the American Cancer Society said.

When it comes to cancer screening, much more needs to be done, the report's authors said. For example, in 2010 two-thirds of women age 40 or older said they had gotten a mammogram within the past two years -- a number that hasn't changed much since 2000. For uninsured females, the rate fell to under 32 percent.

In 2010, 83 percent of women said they had gotten a Pap test within the past 3 years, and about 59 percent of adults over age 50 said they had undergone either a fecal occult blood test or an endoscopy to screen for colon cancer. However, uptake rates for each of these tests were much lower among the uninsured, the report found.

One of the biggest advances in cancer prevention in recent years has been the HPV vaccine, crucial to warding off cervical cancers. The new report found a big jump in uptake of the vaccine -- from 25 percent of girls aged 13 to 17 in 2007 to 53 percent in 2011, with 70 percent of these girls getting all three required doses.

One other statistic was heartening: The report notes that 33 states have now enacted legislation restricting minors' access to the UV rays of indoor tanning beds, a major source of skin cancer.

According to the ACS, sweeping public initiatives like those may "profoundly influence" Americans to engage in healthy behaviors and shun activities that promote cancer risk.

"Our report is a striking reminder that we need to do a better job of reducing behavioral risk factors that increase cancer risk," report lead author Dr. Vilma Cokkinides, strategic director of risk factors and screening for the ACS, said in a news release.

"We could eliminate much of the suffering and death from cancer with better, more systematic efforts to reduce tobacco use, improve nutrition and opportunities for physical activity, and expand the use of those screening tests that are proven effective," she said.