More needs to be done in cancer prevention and detection suggests report

While there have been improvements in some areas of cancer prevention and early detection, the use of potentially lifesaving measures is suboptimal and strongly influenced by individual behaviours, as well as social, economic, and public policy factors, according to a new report from the American Cancer Society.

Since 1992, the American Cancer Society has published Cancer Prevention & Early Detection Facts & Figures (CPED) as a resource to strengthen cancer prevention and early detection efforts at the local, state, and national levels. The report, published every two years, assesses current prevalence of cancer risk factors and prevention measures, an important component of monitoring progress and strengthening cancer prevention and early detection efforts.

Highlights from the 2017-2018 report:

Tobacco Use

• In 2015, 15% of adults were current cigarette smokers. Smoking prevalence varied widely by state, ranging from 9% in Utah to 26% in Kentucky.
• Current cigarette smoking among high school students declined from 29% in 1999 to 9% in 2015. By state, smoking prevalence among high school students in 2015 ranged from 5% in Rhode Island to 19% in West Virginia.
• Since 2002, there have been more former smokers than current smokers in the US. In 2015, there were approximately 52.8 million former and 36.5 million current cigarette smokers.

Overweight and Obesity, Physical Activity, and Nutrition

• About seven out of 10 adults are overweight or obese; 38% are obese (men: 35%, women: 40%). The prevalence of obesity among women continues to rise, while it appears to have stabilised among men in recent years.
• The prevalence of obesity tripled between 1976 and 2002, among adolescents (ages 12-19 years) and is currently about 21%, unchanged in recent years.
• In 2015, about 50% of adults reported meeting recommended levels of aerobic physical activity. An estimated 27% of high school students met recommended levels of physical activity.
• In 2015, only 29% of adults reported eating two or more servings of fruit and 16% reported eating three or more servings of vegetables per day. About one in three (32%) high school students consumed fruit two or more times per day and 15% consumed vegetables three or more times per day.
• About 28% of adults reported excessive alcohol consumption, according to 2011-2014 data.

Ultraviolet Radiation and Skin Cancer

• Only 13% of adults reported wearing a long-sleeved shirt and only 15% reported wearing a wide-brimmed hat always or most of the time when outside on a warm, sunny day for more than an hour.
• Among US high school students, 56% (girls: 60%, boys: 52%) reported having had a sunburn in the past year.
• In 2015, approximately 4% of adults reported using an indoor tanning device in the past year; use was higher among women (6%) than men (2%) and those living in the Midwest (6%) compared to other regions.
• The use of indoor tanning devices among female high school students appears to have declined in recent years from 25% in 2009 to 11% in 2015. However, only 13 states and the District of Columbia have a law prohibiting indoor tanning for minors without exemptions as of January 1, 2017.

Infectious Agents

• Though HPV vaccination rates have increased in recent years, uptake lags behind other vaccines. In 2015, about 52% of girls and 39% of boys completed two or more doses.

Cancer Screening

• In 2015, 50% of women 40 years of age and older reported having a mammogram within the past year, and 64% reported having one within the past two years. The lowest prevalence of mammography use in the past two years occurred among uninsured women (31%).
• In 2015, 81% of women 21-65 years of age had received a Pap test in the past three years, with lowest use among women who are uninsured (61%) and recent immigrants (68%).
• In 2015, 63% of adults 50 years of age and older reported having either an FOBT/FIT within the past year or sigmoidoscopy within the past five years or colonoscopy within the past 10 years. Prevalence was lowest among uninsured individuals (25%) and recent immigrants (34%).

"While some measures of cancer prevention and early detection have improved over time, others have either stabilised or worsened," said Ann Goding Sauer MSPH, lead author of the report. "For example, cigarette smoking among U.S. adults has dropped to 15% but remains at the level of the 1970s in some geographic areas and population groups. The prevalence of obesity among both adults and youth remains high, particularly among black women.

"The bottom line is that despite improvements in some areas of cancer prevention and early detection, systematic efforts to further reduce the suffering and death from cancer are needed," said Ms. Sauer.