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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.

Rare cancers present unique challenges for clinicians and their patients. For most rare cancers, research to identify causes or to develop strategies for prevention or early detection is limited or nonexistent. In addition, rare cancers can be challenging to diagnose, often resulting in numerous physician visits, misdiagnoses, and substantial delays in diagnosis.

Treatment options for rare cancers are often more limited and less effective than for more common cancers, partly because there is less preclinical research and fewer clinical trials for rare cancers, which are often limited to select high-volume cancer centers. Consequently, rare cancers have become an area of priority for some researchers and public health advocates.

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 Carol E. DeSantis MPH (pictured here), 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%). 
  • More than two-thirds (71%) of cancers occurring in children and adolescents are rare cancers compared with less than 20% of cancers diagnosed in patients aged 65 years and older.

Among solid tumors:

  • 59% of rare cancers are diagnosed at regional or distant stages compared with 45% of common cancers. In part because of this stage distribution, 5-year relative survival is poorer for patients with a rare cancer compared with those diagnosed with a common cancer among both males (55% vs 75%) and females (60% vs 74%). 
  • However, 5-year relative survival is substantially higher for children and adolescents diagnosed with a rare cancer (82%) than for adults (46% for ages 65-79 years).

"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."


  • 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.”​​

  • ACS News Minute: colorectal cancer rates rising among young and middle-aged adults

    ​A major American Cancer Society study, published in the Journal of the National Cancer Institute, shows an alarming increase in rates of colorectal cancer among young and middle-aged adults in the United States. 

    Though colorectal cancer rates in the U.S. have declined since the 1980s, Generation X and millennials have double the risk of colon cancer and quadruple the rate of rectal cancer compared to those born around 1950.

    Watch the latest edition of ACS News Minute to learn more.

    If you want even more information, read this story on Society Source.


  • An update on CPS-3

    On a recent Society Talk program, a staffer submitted a question about the status o​f CPS-3, and whether it is on track. We are happy to answer that question here, for the benefit of all volunteers and staff.

    The answer is 'yes,' our Cancer Prevention Study 3 is on track, with large percentages of enrollees filling out follow-up surveys as they promised they would.
    If you recall, we recruited more than 300,000 participants by the end of 2013 for CPS-3. In 2016, we completed the first full follow-up survey of those enrollees, which for the first time included a comprehensive dietary assessment.
    "The response rate to the 20-page survey was excellent, at nearly 75%," said Susan Gapstur, MPH, PHD, vice president, Epidemiology. "We also began the consent and collection of medical records and tissue samples from CPS-3 participants who reported a diagnosis of cancers of the breast, ovary, colorectum, prostate, and the hematopoietic system," she said. "We will complete the collection of this information from our first round of follow-up in 2017," she said, adding that, to date, ​participant response to these requests also has been excellent.
    Also last year, we successfully completed a diet validation sub-study, and a physical activity and sleep sub-study, with about 750 participants in each. The participants completed daily physical activity diaries, wore activity monitoring devices, responded to diet phone interviews, and provided biospecimens and/or additional details via surveys.
    "Nearly 88% of participants completed the dietary assessment validation study, and over 90% completed the physical activity and sleep validation study," Susan said. In 2017, we will begin the laboratory analyses of nutrients in the blood and urine samples collected in the CPS-3 diet validation study, and the statistical analysis of information collected from the  diaries and surveys in both sub-studies. "These analyses will allow us to report the reliability and quality of diet and physical activity information collected from the total cohort," Susan explained.
    In addition, the first three papers using data from CPS-3 were accepted for publication in 2016. These papers included a baseline descriptive paper of the methods of recruitment and description of the cohort; a second paper described the validity of our approach for ascertaining cancer incidence information; and a third paper described results of a pilot study of gene variation in relation to the ease​ of quitting smoking. Susan said numerous other papers are being prepared to assess the reliability of other information collected at enrollments such as height, weight, and smoking behaviors.
    More about our Cancer Prevention Studies​
    The Society’s cancer prevention studies help researchers identify cancer risk factors by allowing them to study large groups of people over long periods of time.
    The Hammond-Horn cohort study, conducted from 1952-55, was the first cancer prevention study that the Society conducted. It provided the first U.S prospective evidence confirming the association between cigarette smoking and lung cancer, cardiovascular disease and other conditions in men. This cohort included 188,000 men recruited by 22,000 volunteers.
    The success of this early cohort led the Society to invest in a series of large prospective cohort studies to identify the causes of cancer: Cancer Prevention Study I (CPS-I, 1959-72), CPS-II (1982-present), sub-cohorts of CPS-II, and the newest cohort CPS-3 (2006-present).
    CONTRIBUTIONS of the Cancer Prevention Studies
    Society epidemiologists have published more than 750 scientific articles from these studies, the findings of which have significantly contributed to tobacco-related research and to the understanding of obesity, diet, physical activity, hormone use, air pollution, and various other exposures in relation to cancer and other diseases. Here are some key findings:​
    • The link between smoking and lung cancer: 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. 
    • The risks of obesity: CPS-I provided the first epidemiologic evidence that obesity increases risk of premature death, and subsequent studies from CPS-II helped to establish the link between obesity and death from breast, colorectal, and other cancers.
    • The possible role of aspirin in cancer prevention: In the early 1990’s, CPS-II was the first prospective study to find a link between regular aspirin use and lower risk of colorectal cancer, a finding confirmed by many later studies. These results opened the door to ongoing studies in the U.S. and internationally to find out if aspirin might lower risk of other cancers and to better understand the overall risks and benefits of aspirin use.
    • The evidence basis for the Society’s Guidelines on Nutrition and Physical Activity for Cancer Prevention: Our studies showing that high red and processed meat and alcohol intake, low physical activity, and longer sitting time increase risk of cancer or mortality have contributed to the scientific evidence basis for the Society’s Guidelines on Nutrition and Physical Activity for Cancer Prevention. 
    • The connection between air pollution and mortality: Findings from CPS-II contributed substantially to the scientific evidence associating increasing levels of specific types of air pollution with higher deaths rates from cardiovascular disease and lung cancer. These studies are cited prominently by both the Environmental Protection Agency and World Health Organization in policies and recommendations for U.S. and world-wide air pollution limits.
    • The identification of important genetic mutations associated with certain cancers: CPS-II data and biospecimens have been included in the identification or validation of nearly every confirmed breast, prostate, and pancreatic cancer genetic variant known to date. This work has led to a better understanding of family history of these cancers. The long-term aim of this research is to identify men and women at particularly high risk of the disease who may benefit most from enhanced screening, lifestyle modifications, and/or chemoprevention.
    FUTURE DIRECTIONS of the Cancer Prevention Studies
    Society researchers continue to study the CPS-II cohort and, in the future, will begin to study the new CPS-3 cohort to learn even more about cancer risks. Future research avenues include:

    • Cancer risk factors among those aged 65 and older: Given the increasing number of adults aged 65 years and older in the U.S. – this population is expected to go from 40.2 million in 2010 to a projected 88.5 million by 2050 – we will leverage the large size, long-term follow-up and older age of CPS-II participants to study factors associated specifically with cancer risk and with longevity in the elderly.
    • Predictors of early onset cancer: The large number of younger women and men in CPS-3 will allow us to study predictors of early onset cancers, such as premenopausal breast cancer.​​
    • Further study of second-hand smoke and e-cigarettes: We will investigate the effects of second hand smoke exposure during childhood on adult cancer risk. In addition, we are beginning new research to determine how e-cigarette use may influence the smoking of regular cigarettes.
    • Additional investigation into obesity: With nearly 28% of U.S. adults being obese, we will study the evolving role of diet, physical activity, aging, and the environment on changes in overweight and obesity to better inform cancer prevention programs. In addition, given the increasing number of adults who have lived with obesity throughout adolescence and young adulthood, we will examine long-term obesity in relation to cancer incidence and survival.
    • Risk factors for specific molecular subtypes: Collection of tumor tissue specimens will allow us to identify risk factors for specific molecular subtypes of colorectal, prostate, hematologic, ovarian, and breast cancers (for example estrogen receptor positive breast cancer), leading to development of better targets for prevention.
    • Cancer survivorship: With more than 14 million cancer survivors alive today in the U.S. and an estimated 19 million by 2024, we will utilize the information collected from CPS study participants both before and after a cancer diagnosis to study factors associated with cancer survivorship and to inform cancer survivorship guidelines.​​
    • The relationship between lifestyle and genetics in cancer risk: Utilizing the biospecimens collected from our CPS-II and CPS-3 participants, we will study the interplay between lifestyle and genetic factors in relation to cancer risk and survival.

  • Just released: Colorectal Cancer Facts & Figures 2017-2019

    ​Despite dramatic reductions in overall colorectal cancer incidence and mortality, striking disparities by age, race, and tumor subsite remain. That's according to the latest edition of Colorectal Cancer Statistics and its companion publication, Colorectal Cancer Facts & Figures 2017-2019, published every three years by the American Cancer Society.

    Colorectal cancer (CRC) is the third most commonly diagnosed cancer in both men and women. In 2017, there will be an estimated 95,520 new cases of colon cancer and 39,910 cases of rectal cancer diagnosed in the U.S.

    While the numbers for colon cancer are fairly equal in men (47,700) and women (47,820), a larger number of men (23,720) than women (16,190) will be diagnosed with rectal cancer. Incidence rates are highest in Alaska Natives (91 per 100,000) and African Americans (49 per 100,000) and lowest in Asian Americans and Pacific Islanders (32 per 100,000).

    An estimated 27,150 men and 23,110 women will die from CRC in 2017. Unfortunately, reliable statistics on deaths from colon and rectal cancers separately are not available because almost 40% of deaths from rectal cancer are misclassified as colon cancer on death certificates.

    CRC incidence rates continue to decline in people 50 and older, dropping by 32% just since 2000. This trend is thought to be largely a result of screening, which can prevent CRC by detecting and removing precancerous polyps. 

    Incidence rates are dropping fastest in people ages 65 and older and for tumors located in the distal colon, while the drop is slowest for people ages 50 to 64 and for rectal tumors. For example, there was only a 9% decline in the incidence of rectal tumors in men ages 50 to 64 and no decline in women that age compared to 38% and 41% declines in men and women, respectively, ages 65 and older.

    Incidence rates in people 50 and older are dropping in every state, with the decline exceeding 5% annually from 2009 to 2013 in seven states (Nebraska, Maine, Rhode Island, Delaware, Massachusetts, South Dakota, and California). Notably, declines are slowest in states with the highest incidence (e.g., Kentucky, Mississippi, and Louisiana).

    In a stark contrast to the CRC incidence trends in those 50 and older, incidence rates among people younger than 50 continue to rise, increasing by 22% from 2000 to 2013. While the reasons for the increase have yet to be confirmed, factors thought to play a role include increasing rates of excess body weight, as well as changes in lifestyle patterns that precipitated the obesity epidemic, like unhealthy dietary patterns and a sedentary lifestyle.

    Similar to incidence patterns, CRC death rates decreased by 34% in people 50 and over during 2000-2014, but increased by 13% in those under 50. ​

    National Health Interview Survey (NHIS) data indicate that from 2013 to 2015, screening with any guideline-recommended test increased from 53% to 58% in those ages 50 to 64, from 65% to 68% in those 65 and older, and from 59% to 63% in both age groups combined. This rise, which follows a plateau in screening between 2010 to 2013, translates to an additional 3,785,600 adults (>50 years) screened in 2015. If screening prevalence remains at the 2015 rather than the 2013 level, an estimated 39,700 additional CRC cases and 37,200 deaths will be prevented through 2030.

    The authors of the report conclude that reducing inequalities in colorectal cancer and accelerating progress can be achieved by ensuring equitable, high-quality treatment for all patients, effecting pervasive lifestyle modifications, and increasing initiation of screening at age 50 for people at average risk and earlier for those with a family history of CRC or advanced adenomas.


  • ACS Study: Colorectal cancer rates have risen dramatically in Gen X and Millennials

    A new Society study finds that compared to people born around 1950, when colorectal cancer risk was lowest, those born in 1990 have double the risk of colon cancer and quadruple the risk of rectal cancer.

    The study appearing in the Journal of the National Cancer Institute finds colorectal cancer (CRC) incidence rates are rising in young and middle-aged adults, including people in their early 50s, with rectal cancer rates increasing particularly fast. As a result, 3 in 10 rectal cancer diagnoses are now in patients younger than age 55. We suspect this is due to the complex relationship between obesity, an unhealthy diet, and lack of physical activity.

    "Trends in young people are a bellwether for the future disease burden," said Rebecca Siegel, MPH., strategic director, surveillance information services, Intramural Research, who led the study. "Our finding that colorectal cancer risk for millennials has escalated back to the level of those born in the late 1800s is very sobering. Educational campaigns are needed to alert clinicians and the general public about this increase to help reduce delays in diagnosis, which are so prevalent in young people, but also to encourage healthier eating and more active lifestyles to try to reverse this trend."

    Overall, CRC incidence rates have been declining in the U.S. since the mid-1980s, with steeper drops in the most recent decade driven by screening. Recently though, studies have reported increasing CRC incidence in adults under 50, for whom screening is not recommended for those at average risk. However, these studies did not examine incidence rates by 5-year age group or year of birth, so the scope of the increasing trend had not been fully assessed.

    To get a better understanding, investigators used "age-period-cohort modeling," a quantitative tool designed to disentangle factors that influence all ages, such as changes in medical practice, from factors that vary by generation, typically due to changes in behavior. They conducted a retrospective study of all patients 20 years and older diagnosed with invasive CRC from 1974 through 2013 in the nine oldest Surveillance, Epidemiology, and End Results (SEER) program registries. There were 490,305 cases included in the analysis.

    The study found that after decreasing since 1974, colon cancer incidence rates increased by 1% to 2% per year from the mid-1980s through 2013 in adults ages 20 to 39. In adults 40 to 54, rates increased by 0.5% to 1% per year from the mid-1990s through 2013.

    Rectal cancer incidence rates have been increasing even longer and faster than colon cancer, rising about 3% per year from 1974 to 2013 in adults ages 20 to 29 and from 1980 to 2013 in adults ages 30 to 39. In adults ages 40 to 54, rectal cancer rates increased by 2% per year from the 1990s to 2013. In contrast, rectal cancer rates in adults age 55 and older have generally been declining for at least 40 years, well before widespread screening.

    Opposing trends in young versus older adults over two decades have closed a previously wide gap in disease risk for people in their early 50s compared to those in their late 50s. Both colon and rectal cancer incidence rates in adults ages 50 to 54 were half those in adults ages 55 to 59 in the early 1990s, but in 2012 to 2013, they were just 12.4% lower for colon and were equal for rectal cancer.

    In addition, the authors suggest that the age to initiate screening people at average risk may need to be reconsidered. They point out that in 2013, 10,400 new cases of CRC were diagnosed in people in their 40s, with an additional 12,800 cases diagnosed in people in their early 50s. "These numbers are similar to the total number of cervical cancers diagnosed, for which we recommend screening for the 95 million women ages 21 to 65 years," said Rebecca.

    People younger than 55 are 58% more likely to be diagnosed with late-stage disease than older people. 
    The authors say this is largely due to delayed follow-up of symptoms, sometimes for years, because cancer is typically not on the radar of young adults or their providers. Rebecca says health care providers should educate young patients about healthy lifestyle behaviors, and patients should be aware of colorectal cancer signs and symptoms and report any changes.
    The most common signs and symptoms include:
    •     A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days​
    •     A feeling that you need to have a bowel movement that is not relieved by doing so​
    •     Rectal bleeding
    •     Dark stools, or blood in the stool
    •     Cramping or abdominal (belly) pain
    •     Weakness and fatigue
    •     Unintended weight loss

    New guidelines needed?

    The Society sets colorectal screening guidelines using an independent guidelines development group that regularly reviews all available data and determines whether our current guidelines should stay the same or be updated. This group will review this new data, as well as any other new research findings, to determine whether a change in our screening recommendations is warranted. 

     

  • Tobacco-Free Generation Campus Initiative: TODAY is the deadline for fall grants

    ​In partnership with the CVS Health Foundation, the American Cancer Society is now accepting online applications for the next round of Tobacco-Free Generation Campus Initiative grants. ​

    The fall grant cycle will run through February 28, 2017, with the names of grant recipients announced in May 2017. ​Learn more here.
    The deadline for applications is Tuesday, Feb. 28, 2017, 5 p.m. ET.
    Of the roughly 20 million college and university students in the U.S., more than one million are projected to die prematurely from cigarette smoking. While approximately 90% of smokers start by age 18, fully 99 % start by age 26, underscoring the importance of supporting those in the young adult age group with more effective prevention and cessation efforts while eliminating exposure to secondhand smoke and all tobacco use in their learning environments.
    To address this issue, the Society last fall launched a bold new initiative – the Tobacco-Free Generation Campus Initiative (TFGCI) – which will provide grants to accelerate and expand the adoption and implementation of 100% smoke- and tobacco-free policies on college and university campuses across the nation. Over the next three years, the $3.6 million multi-year program will award grants to 125 colleges and universities.
    This initiative, under the direction of our Center for Tobacco Control, is being supported by the CVS Health Foundation. It kicked off last falll with the awarding of grants to 20 colleges and universities.  

  • TODAY: Countdown to 2018. The pre-show begins at 1 p.m. ET

    ​Today's the day! Our big colon cancer awareness event in New York City kicks off with a pre-show beginning at 1 p.m. ET, leading up to the formal program with Rich Wender, MD, our chief cancer control officer, at 2 p.m. ET.

    Participating will be well-known journalist Katie Couric, whose first husband died of colon cancer at age 42;  actor Luke Perry; country music artist Craig Campbell; and professional race car driver Scott Lagasse, Jr., all of whom will share their personal experiences with the disease.

    Register now to watch the 2 - 3 p.m. segment, brought to you by our talented multimedia team.​

    To register for the live broadcast from Hard Rock Times Square and gain access to the interactive Q&A, visit CRCCountdown.org. Additionally, the following will be broadcasted via Facebook Live:

    1 – 2 p.m. - Pre-show "Blue Carpet" broadcast by Mayo Clinic (Facebook.com/MayoClinic) including interviews with Dr. Paul Limburg, Craig Campbell, Luke Perry, Scott Lagasse, Jr. and Exact Sciences CEO Kevin Conroy​

    1 - 2 p.m. -  ACS of NY & NJ will be doing its own pre-event Facebook Live (Facebook.com/cancernynj​) from the blue carpet starting at 1 p.m. 

    1:45 p.m. - Pre-Show Performance by Craig Campbell (Facebook.com/CraigCampbellTV)

    2 p.m. - Katie Couric welcome and interviews with Luke Perry, Anjee Davis, president of Fight CRC, and Rich Wender, MD, our chief medical officer. Celebrity-survivor panel interviews to follow in the second half of the show. (Facebook.com/AmericanCancerSociety and Facebook.com/FightCRC)

    4 p.m. -  NASDAQ bell ringing ceremony (Facebook.com/NASDAQ and Facebook.com/FightCRC​)

    Countdown to 2018 is brought to you by . . ,

    The Countdown to 2018 live broadcast is presented by Fight Colorectal Cancer (Fight CRC), the American Cancer Society, and the National Colorectal Cancer Roundtable (NCCRT), an organization co-founded by the ACS and the Centers for Disease Control and Prevention. 

    Mayo Clinic, The Entertainment Industry Foundation's National Colorectal Cancer Research Alliance, Stand Up To Cancer, and Exact Sciences have also collaborated to plan the event. 

    "We're thrilled to have this opportunity to publicly recognize some of the individuals and organizations that are truly making a difference in the fight against colorectal cancer," said Mary Doroshenk, director of the NCCRT. "The work of our 80% by 2018 partners, including our National Achievement Award winners, is invaluable. If we can reach a nationwide screening rate of 80% by 2018, we estimate that 277,000 cases and 203,000 colorectal cancer deaths would be prevented by 2030. But to do that, we all need to keep working together to get more adults screened."

    In the next year, the colorectal cancer community hopes to see even more of the 23 million Americans who need to be screened for colorectal cancer undergo this potentially life-saving procedure.

    For more information and instructions on screening for colorectal cancer, visit cancer.org.

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