According to the American Cancer Society (ACS) estimates, 608,570 deaths will occur from cancer in the United States in 2021. About 45% are attributed to potentially preventable, pre-pandemic causes such as tobacco smoking, obesity, alcohol intake, physical inactivity, and an unhealthy diet.

In the ACS report Cancer Prevention and Early Detection Facts & Figures, 2021-2022, Priti Bandi, PhD noted the ACS “…snapshot of the status of cancer prevention and early detection measures was mixed…Overall cigarette smoking is down, but obesity remains high, and the use of cancer screening and HPV vaccination continues to be underused.” The report also indicates that substantial racial/ethnic and socioeconomic disparities persist.

Tobacco Use and Smoking Cessation

While tobacco use dropped to a historic low in 2019, 14% of the US population (thirty-four million people) continue to smoke and still accounts for 30% of all cancer-related deaths and are as follows:

• Sixty-two percent of Hispanic and Latino smokers counseled by their physician to quit smoking, as compared to 72% of African Americans and 73% of Asian and White individuals.
• Twenty-four percent of Asians and 25% of Hispanic Latinos used the recommending smoking cessation treatments, as compared to 30% of African American and 36% of White individuals.
• About 40% of individuals insured by Medicaid successfully stopped smoking.
• Only 14 US states provided comprehensive smoking cessation treatments for Medicare enrollees in 2020.

These statistics point to the importance of expanding tobacco cessation coverage in the United States and the need to reduce tobacco use by lessening the disparities related to smoking cessation in our states and local communities. Cessation programs should target the lower socioeconomic groups identified above.

Obesity, Exercise, Diet and Alcohol

Approximately 18% of all cancer-related deaths in the US are related to obesity, physical inactivity, unhealthy diet, or alcohol use. Research has shown that adults who follow the ACS nutrition and physical activity guidelines are less likely to be diagnosed or die from cancer then those who do not follow them.

Here are some key statistics from the report:

• Obesity rates increased (42%) in adults ages twenty and above. Rates were highest among African American women (57%) and lowest in Asian men and women (approximately 17%).
• Only 26% of adults eat the recommended amount of fresh or whole fruit each day and 13% the recommended number of vegetables.
• Half the adults surveyed reported the recommended levels of physical activity each day. However, one out of three adults reported no physical activity at all during their leisure time.
• White and Asian individuals are more likely to follow a healthy diet as compared to Hispanic Latino’s and African Americans.
• Approximately 5% of US adults are classified as heavy drinkers. Alcohol consumption increased in women with higher levels of education and income, however the reverse is true for men.

Reducing the lifestyle and behavioral habits for these individuals will require consistent collaboration between the communities, government, and national, state, and local agencies to target culturally appropriate prevention events and activities to reduce the cancer burden associated with these causes.

Cancer Screening

Early detection through cancer screening is effective and reduces cancer-related deaths from breast, cervical, colorectal and lung cancers. Screening for colorectal and cervical cancer is known to prevent these cancers through early detection of pre-cancerous (non-malignant) conditions. Some key statistics are:

• Cervical cancer screening rates are the highest in the US with almost 84% of women ages 21-65 years having their recommended screening.
• About 63% of women ages 45 and above follow the breast cancer screening guidelines
• Sixty-six percent of adults aged 50 and above follow colorectal cancer screening guidelines.
• Screening rates are lowest among the uninsured, with less than 50% following the national guidelines for most types of cancer.

HPV Vaccination

Human papillomavirus (HPV) vaccines currently used in the United States have the potential to prevent about 90% of the HPV-related cancers.

Yet, HPV vaccination rates in adolescents, ages 13-17 years shows over 40% of the eligible population are not vaccinated.

COVID-19 and Cancer Screening

There are unanswered questions about how the COVID-9 pandemic will impact cancer screening and early detection. We do know that in March-April 2020 the breast, cervical and colorectal screening rates plummeted. There does appear to be a rebound and screening rates are slowly starting to increase in late 2021. But the economic impact of the pandemic and historic unemployment rates that resulted in a loss in health insurance for millions of Americans will continue to impact early detection rates. For more information on the COVID-19 pandemic and cancer, click here.

What Can Be Done?

To address the barriers, disparities, healthcare policies and cancer screening rates multicomponent interventions are needed. Access to screening and timely healthcare may be improved by reducing the administrative barriers and costs, offering alternative and flexible screening programs (i.e., location and hours) and by providing childcare, transportation, and language translation services. Healthcare system-wide reminders, feedback and incentives could improve providers’ recommendations, particularly when combined with multimedia and educational campaigns targeted to the appropriate ethnic and cultural populations.

Government and healthcare policy standards need further revision to reduce the out-of-pocket expenses for the under- or uninsured populations.

Providers and healthcare organizations need to analyze their screening and prevention programs to ensure they target to the populations at risk and in need of screening services. Proper planning of these community-based events combined with a collaborative approach and partnership with the local agencies will ensure those in greatest need are served.

You can read the entire ACS Cancer Prevention & Early Detection Facts & Figures 2021-2022 report by clicking here.