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One-third of the world now overweight

​About 30% of the world's population is affected by weight problems, with 10% obese, according to a new study published June 12 in the New England Journal of Medicine. (People were classified as overweight if their body mass index was in the 25 to 29 range, while obesity is defined as anyone with a BMI of 30 or more.)

The study, compiled by the Institute for Health Metrics and Evaluation at the University of Washington in Seattle and funded by the Gates Foundation, looked at 195 countries, finding that rates of obesity at least doubled in 73 countries — including Turkey, Venezuela, and Bhutan — from 1980 to 2015, and “continuously increased in most other countries.”

The findings represent "a growing and disturbing global public health crisis," said the authors. An accompanying editorial said: "The Global Burden of Disease (GBD) study. . . . offers a discouraging reminder that the global obesity epidemic is worsening in most parts of the world and that its implications regarding both physical health and economic health remain ominous."

Among the 20 most-populous countries, the highest level of obesity among children and young adults was in the U.S., at nearly 13%. Egypt topped the list for adult obesity at about 35%, while the lowest rates were in Bangladesh and Vietnam, respectively, at 1%.

“Excess body weight is one of the most challenging public health problems of our time, affecting nearly one in every three people,” said Dr. Ashkan Afshin, the paper’s lead author. Obesity and inactivity could someday account for more cancer deaths than smoking if current trends continue. 

Researchers found that excess weight played a role in four million deaths in 2015, from heart disease, diabetes, kidney disease and other factors. The per capita death rate was up 28 percent since 1990 and 40 percent of the deaths were among people who were overweight but not heavy enough to be classified as obese.

Combining children and adults, the U.S. had the largest increase in percentile points of any country, a jump of 16 percentage points to 26.5 percent of the overall population. But other countries had obesity rates that rose much faster, even though they remained lower as an overall percent of the population. Broadly, the fastest rises were found in Latin America, Africa, and China.

In China, for example, less than 1 percent of the population was obese in 1980, but now more than 5 percent is, a fivefold increase. The rise in childhood obesity in China roughly paralleled that overall change.

Three countries in Africa — Burkina Faso, Mali and Guinea-Bissau — had the fastest growth. Burkina Faso, the country with the fastest growth in the world in obesity, began in 1980 with around one-third of a percent of its population as obese. Its rate rose to nearly 7 percent of the population.

The study did not go deeply into the causes of obesity, but the authors said the growing accessibility of inexpensive, nutrient-poor packaged foods was probably a major factor and the general slowdown in physical activity was probably not.

“The change in physical activity preceded the global increase in obesity,” Dr. Afshin said. “We have more processed food, more energy-dense food, more intense marketing of food products, and these products are more available and more accessible,” he added. “The food environment seems to be the main driver of obesity.”


  • New report on liver cancer: The fastest growing cause of cancer death in U.S.

    A new report provides an overview of incidence, mortality, and survival rates and trends for liver cancer, a cancer for which death rates have doubled in the U.S. since the mid-1980s, the fastest rise of any cancer in the U.S.

    The report appears in CA: A Cancer Journal for Clinicians, and says differences in major risk factors as well as inequalities in access to care have led to significant racial disparities in liver cancer mortality.

    The American Cancer Society estimates that liver cancer will account for about 41,000 new cancer cases and 29,000 cancer deaths in the U.S. in 2017. It is the fifth leading cause of cancer death in men and the eighth leading cause of cancer death in women. About 1.0 percent of men and women will be diagnosed with liver cancer in their lifetimes.

    The report notes that liver cancer incidence has been rising in the U.S. since at least the mid-1970s, a trend that is expected to continue through at least 2030.

    Reasons

    • One major factor contributing to the increase is a higher rate of hepatitis C virus (HCV) infection among baby boomers (born between 1945 through 1965). Among this age group, HCV prevalence is approximately 2.6%, a rate 6-fold greater than that of other adults.
    • A rise in obesity and type II diabetes over the past several decades has also likely contributed to the trend.
    • Other risk factors include alcohol, which increases liver cancer risk by about 10% per drink per day, and tobacco use, which increases liver cancer risk by approximately 50%.

    Despite improvements in liver cancer survival in recent decades, only 1 in 5 patients survives five years after diagnosis.

    The report identifies substantial disparity in liver cancer death rates by race/ethnicity, ranging from 5.5 per 100,000 in non-Hispanic whites to 11.9 per 100,000 in American Indians/Alaska Natives. There are also wide disparities by state, with the lowest death rates in North Dakota (3.8 per 100,000), and the highest in the District of Columbia (9.6 per 100,000).

    The report says the wide racial and state disparities in liver cancer mortality reflect differences in the prevalence of major risk factors and, to some extent, inequalities in access to high-quality care. "However, most liver cancers are potentially preventable," write the authors. "Interventions to curb the rising burden of liver cancer and reduce racial/ethnic and geographic disparities should include the targeted application of existing knowledge in prevention, early detection, and treatment, including improvements in [hepatitis B virus] vaccination, screening and treatment of HCV, maintaining a healthy body weight, access to high-quality diabetes care, prevention of excessive alcohol drinking, and tobacco control.

  • Annual meeting of cancer specialists wraps up today

    ​More than 30,000 cancer specialists from around the world have been meeting in Chicago since Friday at the 53rd annual meeting of the American Society of Clinical Oncology (ASCO). The event, which closes today, highlights the latest advances in clinical cancer research, including the latest findings from clinical trials.

    The theme of this year’s meeting is "Making a Difference in Cancer Care With You," emphasizing ASCO's role in improving the care of people who are at risk for cancer, who have cancer, or who have survived cancer.

    News out of this year's meeting include positive findings about breast cancer and pregnancy, the benefits of an online program to report symptoms, how one dose of radiation may help spine pain in cancer patients, and how therapy can tackle an overlooked and undertreated side effect of cancer: fear. Another study that has gotten a lot of media coverage involves Johnson & Johnson's cancer treatment Zytiga. Data released at the meeting shows it significantly cut the death risk for newly diagnosed, advanced prostate cancer patients. Read more about that here

    Get the latest consumer news from ASCO at CURE and WebMD. You can also find more news on Twitter using the hashtag #ASCO17.

  • World No Tobacco Day underscores dangers of smoking. What is ACS doing to fight the tobacco epidemic?

    May 31 was World No Tobacco Day, a day set aside since 1987 by the World Health Organization (WHO) to highlight the health risks associated with tobacco use and encourage governments to adopt effective policies to reduce smoking and other tobacco use.

    This year, WHO is highlighting how tobacco threatens the development of nations worldwide, and it is calling on governments to implement strong tobacco control measures, including:

    • Banning marketing and advertising of tobacco
    • Promoting plain packaging of tobacco products
    • Raising excise taxes
    • Making indoor public places and workplaces smoke-free

    According to the WHO, tobacco threatens all people, and national and regional development, in many ways, including:

    • Poverty: Around 860 million adult smokers live in low- and middle-income countries. Many studies have shown that in the poorest households, spending on tobacco products often represents more than 10% of total household expenditure – meaning less money for food, education and healthcare.
    • Children and education: Tobacco farming stops children attending school. 10%–14% of children from tobacco-growing families miss class because of working in tobacco fields.
    • Women: 60%–70% of tobacco farm workers are women, putting them in close contact with often hazardous chemicals. For more alarming statistics about tobacco and women, read this blog post on Medium by Sally Cowal, senior VP, global cancer control.
    • Health: Tobacco contributes to 16% of all noncommunicable diseases (NCDs) deaths.

    What is the American Cancer Society doing to end this public health threat? The short answer is "a lot"

    • In the past year, ACS helped form a global coalition called Prevent20 that will work toward increasing tobacco taxes in member countries. Its name is in recognition of the 20 percent of global cancer deaths caused by tobacco use, all of them avoidable. Prevent20 now counts nearly 30 members from every continent committed to building this tobacco tax movement – and it is still growing. Read an op-ed piece on this subject by our CEO Gary Reedy.
    • Our Center for Tobacco Control is playing a leadership role, domestically and globally, in accelerating the reduction of tobacco use and elimination of tobacco-caused cancers and death.
    • Researchers in our Economic and Health Policy Research program (EHPR) continue their innovative research on the economic and policy aspects of tobacco control. In particular, the team has developed world-leading expertise on the illicit trade of tobacco products; the effects of international trade and investment agreements on tobacco control; tobacco taxation; tobacco’s impacts on poverty and development, which includes the economics of tobacco farming; and the dynamics around the affordability of tobacco products. The team also participates actively in global capacity-building efforts in these and related area. Specifically:
    • EHPR’s research on international trade and investment policies closely examines not only how opponents of tobacco control are utilizing key institutional features of international economic agreements (e.g. the World Trade Organization) to undermine tobacco control, but also how these same agreements might serve to engender public health efforts. EHPR Vice President Jeffrey Drope, PhD., is leading the Society’s research in this area through a multi-year collaborative project funded by the National Institutes of Health and the Johns Hopkins Bloomberg School of Public Health.
    • EHPR researchers have produced pioneering research about the affordability of tobacco products, helping to re-shape the public health community’s conceptualization of the nexus of price, tax, and consumption. This work is now integrated into the WHO's formal recommendations on tobacco excise taxation. Through the years, our researchers have generated many articles about how to implement effective tobacco excise tax reforms.
    • The research agenda of EHPR emphasizes poverty and development issues of tobacco use and control. Nigar Nargis, PhD, has studied the poverty and development impact of tobacco use as a global phenomenon. Currently, she is devoting her research to the impact of tobacco control, particularly tobacco taxation on the poor and other socially disadvantaged populations. Jeffrey Drope, PhD., is leading a project in major tobacco-growing countries that examines the impacts of tobacco farming on poverty and development.
    • At home in the U.S., ACS CAN advocates have worked hard to ensure passage of laws raising tobacco excise taxes. Nationwide, a 10% increase in price reduces overall cigarette consumption by 3% to 5% and youth prevalence by 6% to 7%. Tax increases are particularly effective for low-socioeconomic status and/or young smokers who are more price sensitive than other smokers. In addition, such increases can also form an important revenue source for government-funded health care or tobacco control programs.
    • We help people quit smoking through Quit For Life, a collaboration between ACS and Optum. This phone-based coaching and web-based learning support service is offered by 26 states and more than 700 employers and health plans throughout the U.S. This program has helped more that 1 million tobacco users make a plan to quit for good. 
    • Through the American Cancer Society's Center for Tobacco Control, the Tobacco-Free Generation Campus Initiative (TFGCI) is providing grants to accelerate and expand the adoption and implementation of 100% smoke- and tobacco-free policies on college and university campuses across the nation.
    • ACS CAN also is supporting graphic warning labels, however tobacco companies are challenging this requirement in court. The Society, ACS CAN, and other tobacco control collaborators have filed a lawsuit against the FDA to force the implementation of this provision.
    • Thanks to the work of ACS CAN and other tobacco control advocacy groups, almost 60% of the U.S. population is covered by a comprehensive law that prohibits smoking in all non-hospitality workplaces (such as offices, factories, and warehouses), restaurants, and bars. 
    • And, let's not forget that early Society epidemiologic studies provided some of the strongest evidence linking smoking with lung cancer and higher overall death rates. This evidence led to the Surgeon General’s landmark 1964 conclusion that smoking causes lung cancer, helping drive a decline in adult smoking rates from over 40% in 1964 to less than 20% today. American Cancer Society epidemiologic studies continue to document the ongoing health impact of smoking. 


  • Study says evidence links ventilation holes in cigarette filters to a rise in adenocarcinoma

    An analysis appearing in the Journal of the National Cancer Institute finds strong evidence that adding ventilation holes to cigarette filters has contributed to a rise in a type of lung cancer called adenocarcinoma among smokers. The authors say the FDA should consider regulating the use of filter ventilation, up to and including a ban.

    Eric Jacobs, PhD. (pictured here in the smaller image), our strategic director of pharmacoepidemiology, says the new analysis should lead to further research to find out whether regulation is warranted. Below is his reaction to the study:

    “Rates of lung cancer in cigarette smokers were already high in the 1950s and 1960s, but have increased over time, driven by increases in adenocarcinoma, now the most common type of lung cancer. The new review in the Journal of the National Cancer Institute is therefore important because it systematically lays out and evaluates the scientific evidence that a specific change in cigarette design, the introduction of filter ventilation holes, may be responsible for the increased risk of adenocarcinoma of the lung in smokers.

    “Ventilation holes, engineered into cigarette filters by the tobacco industry starting in the 1960s, are present in nearly all modern cigarettes and are tied to a long history of deception. These holes allow air to be drawn in, resulting in cigarettes that have lower tar levels when measured by smoke-testing machines and that have been misleadingly marketed as “light” or “low-tar.” In fact, it has long been known that real-life smokers inhale similar amounts of tar when smoking cigarettes with ventilation holes. This occurs because smokers, often unconsciously, compensate for the ventilation holes by changing their smoking behavior, for example by taking by taking bigger puffs, in order to obtain the level of nicotine to which they are addicted.

    “Among other evidence, the review describes studies showing that ventilation holes cause smokers to take bigger puffs, potentially inhaling carcinogen-containing smoke deeper into the parts of the lungs where adenocarcinoma typically arises.

    “Thorough evidence reviews, like this one, help establish the scientific basis the Food and Drug Administration (FDA) needs to make sound decisions about the regulation of ventilation holes and other design features of tobacco products.”

    NOTE: This first appeared on the ACS Pressroom Blog, written by staffer David Sampson, our director of medical and scientific communications.


  • 1 in 5 cancers diagnosed in the U.S. qualifies as a rare cancer

    About 1 in 5 cancer diagnoses in the U.S. is a rare cancer, according to a new American Cancer Society report. The report, appearing in CA: A Cancer Journal for Clinicians, a peer-reviewed journal of the Society, finds rare cancers account for more than 2 in 3 cancers occurring in children and adolescents.

    “Cancer is always difficult, but being diagnosed with a rare cancer presents additional challenges,” said Carol E. DeSantis, MPH, lead investigator of the report and American Cancer Society Director of Breast and Gynecological Cancer Surveillance, Intramural Research. “It’s challenging for patients and their families to find information and support when the doctor is uncertain what kind of cancer you have.”

    As a group, rare cancers are more difficult to diagnose than common cancers and often involve numerous physician visits and misdiagnoses while the more common causes for symptoms are ruled out. As a consequence, they are more likely to be diagnosed at later stages, which can make them even harder to treat. In addition, treatment options for rare cancers are often more limited and less effective than for common cancers. This is partly because there is less clinical research and fewer clinical trials for rare cancers, as it is harder to enroll enough people for a study.

    There are limited published data on the burden of rare cancers in the U.S., but the report notes that "the proportion of rare cancers is likely to grow because of the increasing use of molecular markers in the classification of cancers.”

    Investigators led by DeSantis MPH (pictured here in the smaller photo), used data from the North American Association of Central Cancer Registries and the Surveillance, Epidemiology, and End Results (SEER) program to comprehensively examine contemporary incidence rates, stage at diagnosis, and survival for more than 100 rare cancers (defined as an incidence of fewer than 6 cases per 100,000 individuals per year) in the U.S.

    They found overall:

    • Approximately 20% of patients with cancer in the U.S. are diagnosed with a rare cancer.
    • Rare cancers make up a larger proportion of cancers diagnosed in Hispanic (24%) and Asian/Pacific Islander (22%) patients compared with non-Hispanic blacks (20%) and non-Hispanic whites (19%). 

    Rare cancers in young people

    • The proportion of rare cancers is greater among children, adolescents, and young adults. Rare cancers account for most of the diagnoses (71%) in those aged younger than 20, and 39% of the diagnoses in those ages 20 to 39. Rare cancers accounted for about 17% to 20% of cancers diagnosed in adults ages 40 and older.
    • Five-year relative survival is significantly higher among children, adolescents, and young adults with rare cancers (about 80%) than among adults ages 40 and older with rare cancers (60% or less). However, patients with a rare cancer diagnosis have poorer survival than those with a common cancer diagnosis across all age groups.

    Reducing the burden

    "Continued efforts are needed to develop interventions for prevention, early detection, and treatment to reduce the burden of rare cancers, write the authors. “Such discoveries can often advance knowledge for all cancers.”

    Strategies to enroll more people in clinical trials include international collaboration and changes in study designs that would maximize findings with smaller numbers of patients. In 2011, the International Rare Cancers Institute was established as a joint initiative among research institutes in the US, Europe, and Canada. In 2014, the National Clinical Trials Network was launched in the US with a focus on the study of rare cancers. 

  • ACS study: Frequent, customized emails rival medication in helping people quit smoking

    ​Smokers who received frequent, tailored emails with quitting tips, motivational messages, and social support had cessation rates rivaling that of the most effective medication available for cessation, according to a new American Cancer Society study. The study appears in Tobacco Control.

    New communication technologies have the potential to provide, more cheaply, the same kinds of social and other support that have previously proven effective in tobacco cessation. Telephone counselling has been shown to be effective for treating tobacco dependence, but its reach is low. Other modalities using internet and smartphone technologies to deliver evidence-based cessation treatment have begun to expand and have shown promise.

    For the new research, authors studied the use of email, which has the advantage of being read daily or near-daily by most individuals. Email can also provide substantial content, eliminating the need to access a specific website, and with the popularity of mobile phones and tablets, can be read on the go. Emails can also be tailored to address unique characteristics of the recipient.

    To explore whether emails could be effective in cessation, researchers led by J. Lee Westmaas, PhD, strategic director of tobacco control research at the Society, recruited 1,070 smokers who were planning to quit. They were randomly assigned to receive one of three email protocols: 27 tailored cessation emails; 3 to 4 tailored emails with links to downloadable booklets; or a single non-tailored email. All emails included links to quitting resources. To measure success, abstinence was assessed one, three, and six months post-enrollment by asking whether participants had smoked in the previous seven days.

    Across all three follow-up times, the mean abstinence rate was highest for smokers getting the custom emails (34%), followed by receiving three or four emails (30.8%), and a single email (25.8%). Results were independent of baseline cigarettes per day, interest in quitting, whether there was a fellow smoker in household, and the use of nicotine replacement therapy (NRT) or varenicline, a drug also approved for smoking cessation.

    "The overall quit rate for the main intervention group is about equivalent to the abstinence rates achieved by the most effective medication for cessation," said Dr. Westmaas. "It appears that the personalization in the emails and their frequency — initially every day then tapering off — gave people the assurance that someone cared about them, and wanted them to succeed. They were receiving daily or nearly daily guidance about how to deal with issues that come up in their quit attempt, made possible by a relatively simple computer tailoring algorithm."

    Dr. Westmaas believes the program can be adapted to target particular groups that show disparities in smoking and the health effects of smoking, and he plans to conduct a pilot study to help guide an intervention aimed at low socioeconomic status smokers, a group with higher smoking rates.




  • Society awards new research and training grants

    ​The American Cancer Society is pleased to announce the funding of 109 research and training grants totaling $45,624,250 in the first of two grant cycles for 2017. 

    The grants will fund investigators at 75 institutions across the U.S. One hundred and two are new grants, while seven are renewals of previous grants. Twenty-four of the grants will support the training of oncology nurses and social workers, an area that is currently underfunded. All the grants go into effect July 1, 2017.

    The Council for Extramural Research also approved 88 grant applications for funding, totaling $47,908,000, that could not be funded due to budgetary constraints. These "pay-if" applications can be, and often are, subsidized by donors. In 2016, more than $9 million in additional funding helped finance 35 "pay-if" applications.

    Since 1946, the Society has funded research and training of health professionals to investigate the causes, prevention, and early detection of cancer, as well as new treatments, cancer survivorship, and end of life support for patients and their families. In those 70 years, our research program has devoted more than $4.5 billion to cancer research, and has funded 47 scientists who went on to win the Nobel Prize. ​

    Highlights of New Grants

    • Pasi A. Janne, MD, PhD, of the Dana-Farber Cancer Institute in Boston has been awarded a five-year renewable Research Professorship.  Dr. Janne has made seminal contributions in understanding and translating the therapeutic implications of genetic alterations in lung cancer, particularly within the context of drug resistance. By integrating laboratory-and clinical-based studies, Dr. Janne and his team now aim to develop and evaluate combination therapies for effectively treating genetically distinct subtypes of lung cancer.
    • Hani Goodarzi, PhD from the University of California, San Francisco has received a major multi-year Research Scholar Grant to study metastatic breast cancer. The grant will start a detailed research program that combines state-of-the art computational and analytical tools with modern biochemical, cell biological, and animal studies to study a novel pathway, previously identified by his lab, that may be associated with cancer spread. Their work will expand the understanding of gene expression regulation in health and disease and provide novel targets for new therapies to reign in tumor progression and metastasis.​
    • Michelle Mendoza, PhD, of the University of Utah will investigate ERK/RSK signals, associated with mutations in KRas and BRaf, and their role in cancer cell invasion, in hopes of leading to new therapeutic approaches.
    • Eric Bartee, PhD, of the Medical University of South Carolina will investigate a novel therapeutic virus developed by his lab to potentially improve attacking cancer. The innovative strategy first selectively infects cancer cells and then bolsters anti-tumor immunity within and around the tumor.
    • Claudio Scafoglio, MD, PhD, of the University of California, Los Angeles proposes to use a newly identified 3D imaging technique that could allow not only for early diagnosis of lung cancer, but also to determine which patients are most likely to benefit from a novel metabolic treatment currently used in diabetes.
    • Gabrielle Rocque, MD, of the University of Alabama at Birmingham will look to develop an electronic treatment decision plan specifically for women with metastatic breast cancer (MBC). The treatment plans would integrate outcomes, patient preferences, and information about treatment options, and serve as a decision-aid for patients and their physicians to enhance shared decision-making and communicate decisions to others.
    • Lydia Pace, MD, at Brigham and Women's Hospital in Boston will investigate issues surrounding the implementation of BRCA1/2 mutation testing into primary care to address the need for access to cancer screening, particularly for high risk individuals, with the goal of developing an intervention to systematically educate and engage primary care physicians in BRCA1/2 testing.​ 
    Types of Grants

    Through the Extramural grant funding program, the Society awards two types of grants for independent investigators. Research Scholar Grants are awarded within six years of first academic appointment and are generally for four years. Institutional Research Grants are awarded to an institution as block grants to provide seed money for newly independent investigators to initiate research projects.

    Additionally, we have several career development and mentored training grants:
    • Postdoctoral Fellowships for researchers who have received a doctoral degree provide training leading to an independent career in cancer research. ​
    • Mentored Research Scholar Grants provide support for mentored research and training to full-time junior faculty, typically within the initial four years of their first independent appointment. The goal is for these beginning investigators to become independent researchers as either clinician scientists or cancer control and prevention researchers. ​​
    • Cancer Control Career Development Awards for Primary Care Physicians support primary care physicians in supervised programs. They are intended to develop clinical and teaching expertise, and the capacity to perform independent research or educational innovation in cancer control. ​​
    • Physician Training Awards in Cancer Prevention are awarded to institutions to support physician training in accredited preventive medicine residency programs that provide cancer prevention and control research and practice opportunities.​
    Grants for predoctoral training for oncology and social work

    As part of our mission, we provide patient support throughout the cancer experience. Our research program does the same through these types of grants: 
    • Doctoral Training Grants in Oncology Social Work are given to doctoral students to conduct research related to the psychosocial needs of cancer patients and their families.
    • ​Master's Training Grants in Clinical Oncology Social Work are awarded to institutions to support the training of second-year master's degree students to provide psychosocial services to people with cancer and their families. ​
    • Doctoral Degree Scholarships in Cancer Nursing provide support for study in a doctoral degree program in nursing or a related area, and prepare the graduate for a career as a cancer nurse scientist. ​
    • Graduate Scholarships in Cancer Nursing Practice support graduate students pursuing a master's degree in cancer nursing or doctorate of nursing practice.​​​​​
    The highest honor given by the Society is the Research Professor Awards, given to outstanding mid-career investigators who have made seminal contributions that have changed the direction of cancer research. In general, applicants recently have attained the rank of full professor. Clinical Research Professor Awards carry the same importance and are focused on clinical, psychosocial, behavioral, health policy, or epidemiologic cancer research.​​


  • ​Annual Report to the Nation: Cancer death rates continue to decline

    ​Overall cancer death rates continue to decrease in men, women, and children for all major racial and ethnic groups, according to the Annual Report to the Nation on the Status of Cancer, 1975-2014, released today. Credited for the decline are reduced tobacco use (a well-established cause of 16 cancer types), improved early detection, and more effective treatments. 

    The report finds that death rates during the period 2010-2014 decreased for 11 of the 16 most common types of cancer in men, and for 13 of the 18 most common types of cancer in women, including lung, colorectal, female breast, and prostate cancers. Meanwhile, death rates increased for cancers of the liver, pancreas, and brain in men, and for liver and uterine cancer in women. 
    The report finds overall cancer incidence rates, or rates of new cancers, decreased in men, but stabilized in women during the period 1999-2013.
    The American Cancer Society, Centers for Disease Control and Prevention (CDC), National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) have collaborated annually since 1998 to provide updates on cancer incidence and mortality patterns in the U.S. This most recent report appears early online in the Journal of the National Cancer Institute​. 
    This year’s special topic: survival
    Each Annual Report to the Nation features an in-depth analysis of a selected topic. This year’s focus is on survival by stage, race/ethnicity, and state of residence for common cancers. It finds that several but not all cancer types showed a significant improvement over time for both early- and late-stage disease, and varied significantly by race/ethnicity and state.
    “While trends in death rates are the most commonly used measure to assess progress against cancer, survival trends are also an important measure to evaluate progress in improvement of cancer outcomes,” said the Society’s Ahmedin Jemal, DVM, PhD., lead author of the study. “We last included a special section on cancer survival in 2004, and as we found then, survival improved over time for almost all cancers at every stage of diagnosis. But survival remains very low for some types of cancer and for most types of cancers diagnosed at an advanced stage.”
    • Compared to cases diagnosed in 1975-1977, five-year survival for cancers diagnosed in 2006-2012 increased significantly for all but two types of cancer: cervix and uterus. 
    • The greatest absolute increases in survival (25 percent or greater) were seen in prostate and kidney cancers as well as non-Hodgkin lymphoma, myeloma, and leukemia.
    • Cancers wit​h the lowest five-year relative survival for cases diagnosed in 2006-2012 were pancreas (8.5 percent), liver (18.1 percent), lung (18.7 percent), esophagus (20.5 percent), stomach (31.1 percent) and brain (35 percent).
    • Cancers with the highest five-year relative survival for cases diagnosed in 2006-2012 were prostate (99.3 percent), thyroid (98.3 percent), melanoma (93.2 percent) and female breast (90.8 percent).
    Racial Disparities
    “While this report found that five-year survival for most types of cancer improved among both blacks and whites over the past several decades, racial disparities for many common cancers have persisted, and they may have increased for prostate cancer and female breast cancer,” said Lynne T. Penberthy, MD, MPH, associate director of NCI’s Surveillance Research Program. “We still have a lot of work to do to understand the causes of these differences, but certainly differences in the kinds and timing of recommended treatments are likely to play a role.”
    Tobacco 
    “This report found that tobacco-related cancers have low survival rates, which underscores the importance of continuing to do what we know works to significantly reduce tobacco use,” said Lisa C. Richardson, MD, MPH, director of CDC’s Division of Cancer Prevention and Control.  
    The authors say devoting increased resources and enacting laws and regulations to strengthen tobacco control policies at both state and federal levels — such as tobacco product pricing strategies, plain packaging, statewide comprehensive smoke-free laws, and reducing nicotine content in tobacco products to nonaddictive — could greatly reduce morbidity and mortality from smoking-related cancers and other smoking-related diseases.
    Obesity
    “In addition, every state in the nation has an adult obesity prevalence of 20 percent or more. With obesity as a risk factor for cancer, we need to continue to support communities and families in prevention approaches that can help reverse the nation’s obesity epidemic. We need to come together to create interventions aimed at increasing the uptake of recommended, effective cancer screening tests, and access to timely cancer care,” said Dr. Richardson. 
    The authors say additional resources are required to create neighborhoods that encourage physical activity and healthy eating habits, and to identify new approaches to prevent and reverse the obesity epidemic.
    Study of risk factors needed
    The authors say more attention and resources are needed to identify major risk factors for common cancers, such as colorectal, breast, and prostate. Also needed, they say, are concerted efforts to understand the increasing incidence trends in uterine, female breast, and pancreatic cancer.
    “The continued drops in overall cancer death rates in the United States are welcome news, reflecting improvements in prevention, early detection, and treatment,” said Betsy A. Kohler, MPH, CTR, executive director of NAACCR. “But this report also shows us that progress has been limited for several cancers, which should compel us to renew our commitment to efforts to discover new strategies for prevention, early detection, and treatment, and to apply proven interventions broadly and equitably.”​​
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