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Two new ACS studies report surge in colorectal cancer screening and early diagnosis in US adults 45-49

In a new study led by ACS, scientists found that after a stable 15-year trend, diagnoses of local-stage colorectal cancer (CRC) rose steeply in adults aged 45-49 years old during 2019 to 2022 in the United States, including a 50% relative increase from 2021 to 2022 (from 11.7 to 17.5 cases per 100,000). Local or early stage means the cancer is confined to the original site where it started and usually has no symptoms. The study was published in the Journal of the American Medical Association (JAMA).

 

“These findings contrast with consistent increases of distant-stage diagnoses in this age group,” said Elizabeth Schafer, MPH, associate scientist, surveillance and health equity science, and lead author of the study. “It is promising news because the uptick of cases is likely due to first-time screening in the wake of new recommendations for younger average-risk adults to begin testing for colorectal cancer earlier.”

The recommended age to begin CRC screening was lowered from 50 to 45 years by ACS in 2018 and the United States Preventive Services Task Force (USPSTF) in 2021.

In support of these findings, another ACS-led study, also published in JAMA, reports that CRC screening among U.S. adults 45-49 years of age increased by 62% from 2019 to 2023.

“It’s not only thrilling to see the increase in colorectal cancer screening among younger adults, but also how it likely ties into rises in earlier stage diagnosis as noted in the other ACS led paper,” said Jessica Star, MPH, MA, associate scientist, cancer risk factors and screening surveillance research at ACS, and lead author of this study. “However, we still have a long way to go. Screening for colorectal cancer in ages 45-49 remains suboptimal and has not increased equitably by both educational attainment and insurance status.”

“These studies further demonstrate the importance of people having access to comprehensive health insurance, which covers evidence-based preventive services,” said Lisa A. Lacasse, president of ACS CAN. “With more than 2 million people in America expected to be diagnosed with cancer in 2025, it’s more important than ever to make sure that everyone can access necessary screenings. ACS CAN will continue to advocate at the state and federal level to expand access for all because it isn’t just good policy, it’s lifesaving.”

Other ACS researchers contributing to these studies include senior authorsRebecca Siegel, MPH, and Dr. Priti Bandi, and co-authors Dr. Hyuna Sung, Dr. Ahmedin Jemal, and Dr. Robert Smith.

  • Unmet social needs linked to low trust in cancer information from health professionals

    In a new study led by ACS scientists found that unmet social needs of adults in the United States were associated with a substantial reduction in trust of cancer information from doctors and the healthcare system. Unmet social needs include insecurity in housing, food, and/or transportation access, which affect health and well-being. The study was published in the journal Psycho-Oncology.

    “Public trust in health authorities is so essential because it influences uptake of health recommendations like routine cancer screening and vaccination,” said Dr. Jordan Baeker Bispo, principal scientist, cancer disparity research at ACS, and lead author of the study. “Social inequality is an important driver of medical mistrust. These findings are important as we need to better understand this dynamic in the context of cancer information sharing and cancer control.”

     

    “Addressing social needs in the clinical setting may enhance patient trust in cancer messaging from providers,” Baeker Bispo added. “Many health systems have adopted social needs screening programs to help patients access the resources they need beyond the clinic walls. These programs could have a positive downstream impact on communication about cancer control by enhancing the trustworthiness of providers and health systems at large.” 

    “Evidence shows that patient navigation can bridge a number of gaps and address diverse needs across patient populations. When it comes to cancer care, patient navigation offers support to manage and traverse an often overwhelming and scary prognosis by increasing understanding of treatment options,” said Lisa A. Lacasse, president of ACS CAN.

    Other ACS researchers contributing to the study include Jessica ​​Star, MPH, Dr. Ahmedin Jemal, and senior author Dr. Farhad Islami.

  • Weather disasters increase risk for US drug supply chain disruption

    In 2024, Hurricane Helene triggered a nationwide shortage of the country’s intravenous (IV) fluids after damaging a facility in North Carolina. A similar IV fluid shortage was caused when Hurricane Maria hit Puerto Rico in 2017. A new, nationwide study led by ACS scientists found that nearly two-thirds of all pharmaceutical-producing facilities in the US were located in a county that experienced at least one weather disaster declaration. These disasters, like hurricanes, wildfires, and floods, posed risks for disruptions to facilities active in all aspects of the drug supply chain. The study was published in the Journal of the American Medical Association (JAMA).

    “Drug shortages following weather disasters demonstrate how the pharmaceutical supply chain is not yet resilient to climate-related disruptions,” said Dr. Leticia Nogueira, scientific director, health services research, and senior author of the study. “A limited number of facilities may manufacture significant shares of key therapeutics. This could put many people in need of lifesaving drug treatment at risk of disruptions or delays in care.”

    “These findings underscore the importance of recognizing climate-related vulnerabilities and the urgent need for supply chain transparency that allows integration of disaster risk management strategies into strategic resource allocation throughout the pharmaceutical supply chain,” added Nogueira. “Moving forward, threats must be examined and proactively mitigated to prevent critical health care disruptions.”

    “Life-saving cancer drugs, especially older generic sterile injectable drugs, have been in chronic shortages due to a combination of factors, including economic reasons and natural disasters. ACS CAN has been working with lawmakers and federal agencies to address systemic vulnerabilities and create a more resilient system to ensure patients can access the medications they need without disruptions to their care. This study illustrates the need for redundancy in the drug supply chain,” said Mark E. Fleury, PhD, principal, policy development - emerging science at ACS CAN. “ACS CAN helps to lead a drug shortage task force that includes over 20 organizations working to create data-driven solutions to drug shortages.”

  • Screenings rise, early colorectal diagnoses follow

    ACS released two studies showcasing the surge in colorectal cancer screening and early diagnosis among younger adults. 

    In the first study, scientists found that after a stable 15-year trend, diagnoses of local-stage colorectal cancer (CRC) rose steeply in adults aged 45 – 49 years old during 2019 to 2022 in the United States, including a 50% relative increase from 2021 to 2022 (from 11.7 to 17.5 cases per 100,000). Local or early stage means the cancer is confined to the original site where it started and usually has no symptoms. The study is published Aug. 4 in the Journal of the American Medical Association (JAMA).

    “These findings contrast with consistent increases of distant-stage diagnoses in this age group,” said Elizabeth Schafer, MPH, associate scientist, Surveillance and Health Equity Science, and lead author of the study. “It is promising news because the uptick of cases is likely due to first-time screening in the wake of new recommendations for younger average-risk adults to begin testing for colorectal cancer earlier.”

    The recommended age to begin CRC screening was lowered from 50 to 45 years by ACS in 2018 and the United States Preventive Services Task Force (USPSTF) in 2021.

    In support of these findings, a second ACS led study also published Aug. 4 in JAMA reports that CRC screening among US adults 45 – 49 years of age increased by 62% from 2019 to 2023.

    “It’s not only thrilling to see the increase in colorectal cancer screening among younger adults, but also how it likely ties into rises in earlier stage diagnosis as noted in the other ACS led paper,” said Jessica Star, MPH, MA, associate scientist, Cancer Risk Factors and Screening Surveillance Research, and lead author of this study. “However, we still have a long way to go. Screening for colorectal cancer in ages 45 – 49 remains suboptimal and has not increased equitably by both educational attainment and insurance status.”

    Other ACS researchers contributing to these studies include senior authors Rebecca Siegel, MPH, and Dr. Priti Bandi, and co-authors Dr. Hyuna Sung, Dr. Ahmedin Jemal, and Dr. Robert Smith.

  • Survival disparities increase for patients without health insurance following FDA approval of immune checkpoint inhibitors for advanced cancer, data shows

    ​In a new study released on July 7, ACS researchers found that the introduction of immune checkpoint inhibitors (ICIs) following FDA approval was associated with a widening survival disparity between people without health insurance and those with private insurance, newly diagnosed with advanced stage melanoma, non-small cell lung cancer (NSCLC), or renal cell carcinoma (kidney cancer). ICIs are a type of advanced immunotherapy and work by helping the immune system better find and attack cancer cells in the body. While offering promising outcomes for many patients, ICIs are also among the highest-cost cancer drugs. The study was published in the Journal of the American Medical Association (JAMA) Network Open.

    “These findings are concerning, especially as ICIs are being used more frequently in treating people with both early and late-stage cancers,” said Dr. Jingxuan Zhao, senior scientist, health services research at ACS, and lead author of the study. “ICIs can be lifesaving; however, cancer patients without health insurance coverage may be unable to afford them due to their high costs.”

    “Health policies expanding access to insurance coverage options and making new treatments more affordable are needed. Expanding Medicaid to individuals without health insurance coverage may improve their access to effective cancer treatments that are also costly, such as ICIs,” Dr. Zhao added.

    “Having comprehensive, affordable health insurance is a major determining factor in surviving cancer, especially as promising new – but also costly – treatments, like ICIs, become available. That’s why ACS CAN has long advocated for increased access to quality, affordable health coverage – made increasingly urgent with recent Congressional action that significantly cuts Medicaid funding and makes affordable health insurance coverage unattainable for millions nationwide,” said Lisa A. Lacasse, president of ACS’s advocacy affiliate, ACS CAN.

    ACS researcher Dr. Robin Yabroff contributed to this study.

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  • Research finds racially and economically segregated communities increase advanced-stage breast and cervical diagnoses

    ​In a new study released on July 23, ACS scientists found that people living in racially and economically segregated neighborhoods in New York City (NYC) were more likely to be diagnosed with advanced-stage breast and cervical cancer. Colorectal cancer was studied, but no disparities were found. This study is the first to use census-tract data—the most granular geographic level available from cancer registries—to examine how racialized economic segregation influences advanced-stage diagnoses of all three major screenable cancers at once. The findings are published in the Journal of the National Cancer Institute (JNCI).​​​

    “Our research shows that structural barriers in segregated neighborhoods continue to delay diagnosis for breast and cervical cancers—even among individuals eligible for screening,” said Dr. Qinran Liu, post-doctoral fellow, cancer disparities research at ACS, and lead author of the study. “But there is positive news. We found no disparities in stage at diagnosis for colorectal cancer. This may in part reflect the impact of local equity-focused initiatives for early detection of colorectal cancer in NYC. However, the results for colorectal cancer may not be applicable to other areas, especially those without such early detection initiatives.”

    “Our findings have direct implications for cancer prevention and early detection efforts by identifying neighborhoods with the greatest disparities in stage at diagnosis,” Dr. Liu added. “This information can inform targeted resource allocation and guide interventions such as patient navigation services and investments in healthcare infrastructure—strategies that can facilitate earlier diagnosis with the goal of improving outcomes.”

    “This study underscores the role of demographic data in identifying disparities in cancer risk, incidence, diagnosis, and outcomes, and helping inform tailored strategies and outreach efforts to address these disparities,” said Lisa A. Lacasse, president of ACS’s advocacy affiliate ACS CAN. “Policies that ensure the timely collection and reporting of complete and accurate demographic data, along with policies that increase access to timely, affordable care, are key to saving lives. Protecting federal funding for the National Center for Chronic Disease Prevention and Health Promotion and the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention is essential to ensure the continuation of lifesaving programs that provide millions of cancer screenings, support state cancer registries, and deliver critical prevention, early detection and survivorship services to communities across the country.”

    Other ACS researchers contributing to the study include Dr. Daniel Wiese, Dr. Jordan Baeker Bispo, Dr. Ahmedin Jemal, and senior author Dr. Farhad Islami.

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  • Study suggests firefighters face increased mortality rates for several cancers

    ​It’s estimated that more than 15 million firefighters protect the inhabitants of 60 countries worldwide. Though the hazardous exposures encountered by firefighters vary, potential exposures include several known or suspected carcinogens. After more than thirty years of follow-up, a new study released by ACS researchers on July 28, found that firefighters are at an increased risk of mortality from skin, kidney, and other types of cancer. This research follows a 2022 review by the International Agency for Research on Cancer (IARC) that found sufficient evidence that occupation as a firefighter causes mesothelioma and bladder cancer, but limited or inadequate evidence for causation for all other cancer types. The ACS study was published in the International Journal of Epidemiology.​

    “Our findings support the growing body of research linking firefighter exposures to cancer risk,” said Dr. Lauren Teras, senior scientific director, epidemiology research at ACS and lead author of the study. “The associations with skin, kidney, prostate, and colorectal cancer notably help to fill gaps for cancers that were considered to have limited or inadequate evidence in the previous IARC review.”

    Because cancers often take many years to develop, the authors note this research highlights the advantages of studies like the ACS Cancer Prevention Study-II that follow participants for decades and can account for other factors like smoking and socioeconomic status. The higher risk of dying from lung cancer was only clear after studying participants for 30 years. The study also calls attention to the importance of proper personal protective equipment for the skin, as the rates of fatal skin cancers were higher among firefighters in this study population.

    “Although this isn’t favorable news, this study shines a spotlight on the long-term risks firefighters face beyond the immediate dangers of fighting a fire. Continued efforts to safeguard the health of firefighters by increasing access to cancer screening, early detection, and prevention are paramount,” Dr. Teras added. “This population plays a crucial role in our communities as first responders and protectors of life and property.”

    Other ACS researchers contributing to the study include Dr. Ryan Diver, Dr. Robert Smith, Dr. William Dahut, Ellen Mitchell, James Hodge, Emily Deubler, and senior author Dr. Alpa Patel.

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  • The new edition of Cancer Atlas released

    ​Today, the American Cancer Society announced the release of The Cancer Atlas, 4th Edition, a collaborative effort to uncover global cancer patterns and stark inequalities in addressing the burden of the disease. Produced by ACS and the International Agency for Research on Cancer (IARC), The Cancer Atlas reports that an estimated 50% of all cancer deaths worldwide are attributed to modifiable risk factors. These findings will be presented at the Cancer Prevention Research Conference 2025, hosted by ACS and Cancer Research United Kingdom (CRUK) in London, from June 25 to 27.  

    The Cancer Atlas presents the most up-to-date scientific data and evidence-based consensus across the entire cancer continuum. More than 70 leading experts and scientists from 35 institutions worldwide contributed to the book’s 47 chapters. As with previous editions, the 4th edition of The Cancer Atlas is grouped into three sections: Risk Factors, The Burden, and Taking Action. Additional chapters address timely and emerging essential topics, including Alcohol, Climate Change and Cancer, and Health System Resilience.
     
    “This global collaboration to produce the 4th edition of The Cancer Atlas is critical in advancing the American Cancer Society’s vision to end cancer as we know it, for everyone,” said Dr. Ahmedin Jemal, ACS senior vice president, surveillance & health equity science and lead editor of the report. “A substantial proportion of cancer in each country can be prevented by implementing resource-stratified cancer prevention and control measures, including health promotion, tobacco control, and vaccination. However, such measures are not implemented optimally in many countries because of a lack of political will.” 

    Globally, there are 19 million people diagnosed with cancer and 10 million deaths each year (excluding non-melanoma skin cancer). Without intervention, these numbers could rise to over 33 million cases and 18 million deaths by 2050, solely due to the aging and growth of the population. Lung cancer continues to be the most commonly diagnosed cancer and the leading cause of cancer death worldwide, killing about 1.8 million people every year. Still, over 1 billion people worldwide use tobacco products due to the incomplete implementation of proven effective tobacco control measures.
     
    “The Cancer Atlas brings attention to some of our most pressing challenges and biggest opportunities to address the global cancer burden,” said Dr. William Dahut, ACS chief scientific officer. “Together, we can leverage this research to lessen cancer’s footprint on our global community by increasing education, prioritizing screening and prevention, and improving care.”  

    Additional highlights from the report include: 

    • Many lower-income countries are experiencing a sharp rise in incidence of lung, colorectal, and breast cancers in the wake of increasing prevalence of risk factors associated with economic development (e.g., smoking, unhealthy diet, alcohol use, excess body fatness and physical inactivity, and lower fertility), although infection-related cancers (e.g., cervical cancer) still prevail. 

    • Cervical cancer remains the leading cause of cancer death among women in 29 countries in sub-Saharan Africa. Less than 10% of women aged 30-49 years, in many of these countries, have ever had screening, compared to over 80% in most Western countries. Coverage of the highly effective HPV vaccine ranges widely from 3% in Central and Southern Asia to 86% in Australia and New Zealand.

    • Cancer death rates are disproportionately higher in many low-income countries due to poorer survival. Over 90% of the population in low- and middle-income countries lack access to safe and timely surgical care; and 23 low-and middle-income countries with populations over 1 million, mostly in sub-Saharan Africa, did not have access to radiotherapy.

    • Among young adults, colorectal cancer incidence rates are rising in many high-income countries in contrast to a decrease in older adults due to reduced smoking and screening uptake. The increase may in part reflect the obesity epidemic and consumption of an unhealthy diet. 

    • Universal health coverage (UHC) ensures access to quality health services without financial strain, yet in 2021, around 4.5 billion people (57% of the world population) still lacked full essential coverage. Implementing an essential set of cancer services as part of UHC could save more than 7 million lives by 2030.

    The Cancer Atlas is available in print and digital formats. It was designed to ensure user-friendly, accessible, and downloadable descriptions and graphics that can be easily used by cancer-control advocates; government, private, and public health agencies; policymakers; patients and survivors; and the general public.  

    Other ACS editors for the 4th edition of The Cancer Atlas are Dr. Hyuna Sung and Kieran Kelly.  

    The 2026 Cancer Prevention Research Conference will be held in Atlanta, Georgia. 

  • Study finds Medicaid expansion increased Medicaid coverage, early-stage cancer diagnosis and survival among adults 65 and older

    A new study by researchers at ACS shows Medicaid expansion was associated with an increase in Medicaid coverage, early-stage cancer diagnoses, and improved two-year survival among patients diagnosed with cancer aged 65 years and older. The findings were presented at this year’s American Society of Clinical Oncology (ASCO) annual meeting in Chicago.

    In the report, led by Kewei Sylvia Shi, MPH, associate scientist, health services research at ACS, researchers identified patients 65 years or older using the National Cancer Database. They analyzed data of newly diagnosed patients with cancer between 2010 and 2022 residing in areas with a median household income below 200% of the federal poverty level. Researchers applied a quasi-experimental difference-in-differences design, with multivariable linear probability models, to compare the changes in the percentage of dual-eligible or Medicaid-only coverage, early stage at diagnosis, and two-year survival post (vs. pre) Medicaid expansion in expansion states compared with non-expansion states.

    Study results included a total of 1,461,540 patients with cancer, with 881,692 patients from expansion states and 579,848 patients from non-expansion states. After adjusting for sociodemographic characteristics, the percentage of patients with dual or Medicaid-only coverage increased from 10.3% to 11.3% in expansion states and decreased from 9.4% to 8.1% in non-expansion states, resulting in a net increase of 1.25 percentage points associated with Medicaid expansion. Differences were more pronounced among patients over 85 years, females, non-Hispanic Black, metropolitan residents, and those with comorbidities.

    Early-stage (0,I,II) cancer diagnoses decreased more in non-expansion states (55.6% to 53.1%) than in expansion states (53.5% to 51.9%), resulting in a net 1.00 percentage points increase. The protective effects of Medicaid expansion were stronger for lung and bronchus and oral cavity and pharynx cancers.

    Two-year overall survival rates increased from 58.8% to 62.4% in expansion states and from 59.2% to 62.5% in non-expansion states, leading to a net benefit of 0.77 percentage points. Improvements were most notable for stage IV, lung and bronchus, kidney, and bladder cancers.

    Researchers stress these findings underscore the spillover benefits of Medicaid expansion in supporting low-income elderly populations and the importance of indirect benefits when evaluating Medicaid expansion’s broader impact.
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