Pre-COVID-19 data show ‘suboptimal’ rates of cancer prevention, early detection in US
Click Here to Manage Email Alerts
Despite historic lows in smoking prevalence, rates of cancer prevention and early detection remained suboptimal in the U.S. between 2018 and 2019, according to a study by researchers at American Cancer Society.
The findings — published in Cancer Epidemiology, Biomarkers & Prevention and compiled before the COVID-19 pandemic — showed racial/ethnic and socioeconomic disparities persisted across the majority of modifiable cancer risk factors and preventive outcomes, according to a press release.
Bandi P, et al. Cancer Epidemiol Biomarkers Prev. 2021;doi:10.1158/1055-9965.EPI-20-1754.
“In the U.S., cancer death rates have steadily declined since the early 1990s. Yet, in 2021, about 608,570 cancer deaths are expected to occur, approximately 45% of which are attributable to modifiable risk factors such as cigarette smoking, excess body weight, alcohol intake, physical inactivity and unhealthy diet,” Priti Bandi, PhD, researcher at American Cancer Society, and colleagues wrote.
‘Historical gains’ in smoking cessation
According to results of the study, which used data from several population-based surveys, the rate of cigarette smoking reached a historic low of 14.2% in 2019 alone, with a quit ratio of 61.7%. Quit ratios remained lowest among Black, American Indian/Alaska Native, poor, lower educated, lesbian, gay or bisexual individuals, as well as residents of Southern states. Researchers also reported lower levels of recent successful cessation among smokers in these subgroups, despite high quit attempt levels.
The greatest disparity occurred among lower-income and Medicaid-insured or uninsured individuals, for whom the successful cessation rate was nearly 40% lower compared with higher-income and privately insured individuals, according to the release.
Moreover, 71.7% of smokers reported being advised by a physician to quit smoking, and nearly one in three used evidence-based treatments for tobacco dependence.
“[Although] historical gains in smoking cessation have led to steep declines in lung cancer mortality in the past decade, substantial progress can still be made by improving cessation outcomes among socially vulnerable groups. Much can be achieved by expanding tobacco cessation coverage in state Medicaid programs and equitably implementing effective tobacco control policies within and across U.S. states,” Bandi said in the release.
Screening and vaccination
In 2018, 65.6% of individuals aged 50 years or older underwent colorectal cancer screening, 63.2% of those aged 45 years or older underwent breast cancer screening and 83.7% of women aged 21 to 65 years underwent cervical cancer screening.
“Cancer screening prevalence was suboptimal ... especially among uninsured adults,” researchers wrote, citing rates of 29.8% for colorectal cancer screening and 31.1% for breast cancer screening among this group.
HPV vaccination, which has been shown to potentially avert as many as 90% of HPV-associated cancers, remained underutilized in 2019 among those aged 13 to 17 years, more than 40% of whom were not up to date. Among those aged 19 to 26 years, only 52% of women and 31.7% of men reported ever receiving one or more HPV vaccine dose.
Obesity, diet and physical activity
Obesity rates remained high, according to researchers, specifically among those aged older than 20 years, with 42.4% of these adults considered obese and 30.7% considered overweight between 2017 and 2018. Obesity prevalence appeared highest among Black (56.9%) and Hispanic (43.7%) women and lowest among Asian men (17.5%) and women (17.2%).
Approximately one-quarter (25.6%) of adults reported having no leisure time physical activity.
Regarding diet, only 12.3% of adults reported consumption of three or more servings of vegetables per day and approximately 26% reported consumption of two or more servings of fruit per day. Asian and white women had the highest rates of vegetable consumption.
Approximately 5% of adults were considered heavy alcohol drinkers. Rates of heavy consumption increased with education levels among women — 2.4% of those with less than a high school diploma were considered heavy drinkers vs. 6.4% of those with a college degree. Conversely, the prevalence of heavy drinking among men appeared highest for those with less than a high school diploma and lowest for those who were college educated (7.1% vs. 4.2%).
“This snapshot reported a mixed picture, with historic lows in smoking prevalence but suboptimal obesity, cancer screening and HPV vaccination levels,” the researchers wrote. “Additionally, racial/ethnic and socioeconomic status disparities persisted across most outcomes. Substantial progress can still be achieved by promoting smoking cessation among health-disparate populations. Additionally, focused efforts to stem rising obesity levels and improve screening and HPV vaccination levels are also necessary to accelerate progress and avoid reversing gains achieved thus far in reducing overall cancer burden.”
Collapse
Read more about
Click Here to Manage Email Alerts