​Report: smoking rates, alcohol use, physical inactivity decreased during COVID-19.

The American Cancer Society released the latest in its Cancer Facts & Figures suite of publications, Cancer Prevention and Early Detection Facts & Figures, 2023-2024. The report found both favorable and unfavorable changes in major cancer risk factors, preventive behaviors and services, and screenings in the United States during the COVID-19 pandemic. 

A few key highlights between 2019 and 2021: 

• Smoking and heavy alcohol consumption declined. Smoking prevalence among adults, for example, declined from 14% to 12%.
• Physical inactivity declined and obesity prevalence increased. Obesity prevalence increased in 18 of 50 states, overall from 32 to 34%.
• Use of important cancer prevention tools such as human papillomavirus vaccination and stool testing for colorectal cancer screening increased. Yet cervical cancer screening also declined.
• Disparities by racial/ethnic and socioeconomic status persisted. Uninsured persons are between 28% to 60% less likely to be up to date with recommended cancer screenings compared to privately insured persons in 2021.

The findings were published today in the journal Cancer Epidemiology, Biomarkers & Prevention as well as in the biennial ACS Cancer Facts and Figures report. The review is one of the only sources that looks at major modifiable cancer risk factors, HPV and HepB vaccinations, and cancer screening test use. 

“These latest findings give us a mixed bag concerning progress in the fight to help reduce the cancer burden in adults in the US,” said Dr. Priti Bandi, ACS scientific director, cancer risk factors and screening surveillance research and co-author of the study. “As more years of data are collected, it will be clearer whether these contrasting changes are transient or not.”

Why this report is important

We know 45% of the 609,820 cancer deaths projected to occur in the US in 2023 are expected to be attributable to modifiable cancer risk factors, such as: 

• Cigarette smoking
• Excess body weight
• Alcohol intake
• Physical inactivity
• Unhealthy diet
• and obesity

These risk factors are potentially all avoidable through lifestyle changes. Cancer screening tests can further prevent thousands of additional cancer cases and deaths. This latest Cancer Prevention and Early Detection Facts & Figures report offers a look at progress toward those modifiable cancer risk factors and behaviors.

“Ongoing efforts to reduce modifiable risk factors and improve receipt of screening are warranted,” said Dr. Ahmedin Jemal, ACS senior vice president, surveillance and health equity science and senior author of the study. “We also must target our interventions among individuals of racially/ethnically diverse groups and socioeconomic position who continue to be greatly affected by cancer.”

Jessica Star is lead author of the report. Other ACS researchers contributing to the study include: Dr. Farhad Islami, Dr. Nigar Nargis, Dr. Robin Yabroff, Adair Minihan, and Dr. Robert Smith.

To read more highlights of the report or for more information, please see the media release, the journal article, or the report itself.