The Report to the Nation on the Status of Cancer: Good News Tempered by a Worrisome Trend

This year’s Report to the Nation on the Status of Cancer provides an update of cancer incidence (new cases) and mortality (death) rates and trends in the United States, and this year, the status is once again improving.  But as the Special Feature of the report points out, there’s a worrisome trend on the horizon. Obesity and lack of physical activity are poised to become the top cause of preventable cancer deaths in this country.

The report is put together by researchers at the Centers for Disease Control and Prevention, the American Cancer Society, the National Cancer Institute, and the North American Association of Central Cancer Registries. This year’s report finds for all cancers combined, incidence rates among men dropped  0.6 percent per year from 2004 through 2008. Among women, cancer incidence rates declined 0.5 percent per year from 1998 to 2006, with rates leveling off from 2006 to 2008.

For men, incidence rates for five of the 17 most common cancers – prostate, lung and bronchus, colorectal, stomach, and larynx – decreased between 1999 through 2008. In contrast, rates among men increased from 1999 through 2008 for seven cancers: kidney and renal pelvis, pancreas, liver, thyroid, melanoma, leukemia, and myeloma.

Among women, incidence rates decreased from 1999 through 2008 for six of the 18 most common cancers: lung, colorectal, bladder, cervix, oral cavity and pharynx, and stomach. Incidence rates among women increased from 1999 through 2008 for six cancers: thyroid, melanoma, kidney and renal pelvis, pancreas, leukemia, and liver.

Mortality rates, as published in our Cancer Statistics report earlier this year, continue to drop, as they have since the early 1990s. These rates declined an average of 1.6 percent per year in the latest time period (between 2004 and 2008). Death rates are the best indicator of progress against cancer.

The Report to the Nation was first issued in 1998. In addition to drops in overall cancer mortality and incidence, this year’s report also documents the second consecutive year of decreasing lung cancer mortality rates among women. Lung cancer death rates in men have been decreasing since the early 1990s.

The special feature section of this year’s report highlights the effects of excess weight and lack of physical activity on cancer risk. And the news is not good.

For more than 30 years, excess weight, insufficient physical activity, and an unhealthy diet have been second only to tobacco as preventable causes of disease and death in the United States. But while tobacco use has declined significantly since the 1960s, obesity rates have doubled. That is having a major impact on the relative contributions of these risk factors to cancer deaths. John R. Seffrin, Ph.D., chief executive officer of the American Cancer Society commented:

“In the United States, 2 in 3 adults are overweight or obese and fewer than half get enough physical activity. Between children and youth, 1 in 3 is overweight or obese, and fewer than 1 in 4 high school students get recommended levels of physical activity. Obesity and physical inactivity are critical problems facing all states. For people who do not smoke, excess weight and lack of sufficient physical activity may be among the most important risk factors for cancer.”

Esophageal adenocarcinoma, cancers of the colon and rectum, kidney cancer, pancreatic cancer, endometrial cancer, and breast cancer among postmenopausal women are associated with being overweight or obese. Several of these cancers also are associated with not being sufficiently physically active.

The authors conclude:

“Although trends in the prevalence of excess weight and physical inactivity in the United States seem to be stabilizing or improving, current levels, particularly the unprecedented high levels of obesity among young individuals, are concerning and can impact future disease rates…. Continued progress in reducing cancer incidence and mortality will be difficult without success in promoting healthy weight and physical activity, particularly among youth.”

And how do we get there? Well, in June 2011, the U.S. Department of Health and Human Services and other departments released the first-ever National Prevention and Health Promotion Strategy, formed under the Affordable Care Act. It focuses on coordinating prevention, wellness, and health promotion efforts within the federal government and in communities around the nation. Dr Seffrin is a presidentially-appointed member of the Advisory Group that played a key role in the development of the strategy.

To improve healthy eating, the National Prevention Strategy recommends:

  • Increasing access to healthy and affordable foods in communities
  • Implementing organizational and programmatic nutrition standards and policies
  • Improving nutritional quality of the food supply
  • Helping individuals recognize and make healthy food and beverage choices
  • Supporting policies and programs to promote breastfeeding
  • Enhancing food safety.

To encourage physical activity, the National Prevention Strategy recommends:

  • Encouraging community design and development that supports physical activity
  • Promoting and strengthening school and early learning policies and programs that increase physical activity
  • Facilitating access to safe, accessible, and affordable places for physical activity
  • Supporting workplace policies and programs that increase physical activity
  • Assessing physical activity levels and providing education, counseling, and referrals.

They are bold proposals in a time of decreasing resources, but the report indicates the time is now for bold action.

About David Sampson

I am the director of medical and scientific communications for the American Cancer Society national home office.
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