One of the most important responsibilities of the National Cancer Institute is communicating our nation’s progress against cancer to the public. The Cancer Trends Progress Report is a classic exemplar of fulfilling that part of our mission. An online summary of trends in US cancer control measures, this web-based report provides up-to-date information on a range of topics across the cancer control continuum—from disease prevention to cancer death or survivorship—and data to help us track the successful implementation of research-based methods of early detection and risk reduction into practice.
The Cancer Trends Progress Report draws on data from numerous federal departments and agencies, including the Environmental Protection Agency, the Department of Agriculture, and several offices and agencies within the Department of Health and Human Services, including the Agency for Toxic Substances and Disease Registry, the Centers for Disease Control and Prevention, the Office of Disease Prevention and Health Promotion, the Substance Abuse and Mental Health Administration, and the National Institute on Alcohol Abuse and Alcoholism. This report is developed with consultation from federal partners, consumer advocates, non-profits, and others.
As the report details, the nation is making progress toward major cancer-related targets. The rate of death from all cancers combined continues to decline among both men and women, among all major racial and ethnic groups, and for the most common types of cancer, including colon, lung, female breast, and prostate cancers.
This steady improvement in mortality is partly reflected in progress in diagnosing certain cancers at an earlier stage through increased screening. Along with early detection for breast, cervical, and colorectal cancers, this report now also includes screening rates for lung and prostate cancers. We will continue to monitor any changes in these rates as well as their status according to current screening recommendations from the US Preventive Services Task Force (USPSTF). Improved treatment options have contributed to increased cancer survival. On our page for ovarian cancer treatment, you can see how a higher rate of patients are receiving lifesaving chemotherapy. The Cancer Trends Progress Report also has trends related to risk factors and healthy behaviors. For example, the rate of secondhand smoke exposure has decreased significantly as the proportion of smoke-free homes and persons covered by indoor worksite policies prohibiting smoking has risen since the early 1990s. As for exercise, the percentage of adults reporting no physical activity in their leisure time has decreased.
Despite these improvements, the nation is losing ground in other critical areas that demand attention. A substantial proportion of cancers could be prevented through changes in behavior, making prevention a key focus of the report. Up to one-third of cancer cases in the United States are related to excess weight or obesity, physical inactivity, and/or poor nutrition, and thus could be avoided. Cancers caused by cigarette smoking and heavy use of alcohol are largely preventable. Certain cancers related to infectious agents, such as oncogenic types of the human papillomavirus (HPV), the hepatitis B and C viruses, and the human immunodeficiency virus, could be prevented through behavioral changes, the use of protective vaccinations, or antiviral treatments. For example, HPV vaccines prevent persistent infection by the most common types of HPV that cause cancer. Even so, not enough children in the United States are being properly vaccinated against HPV. Only 55 percent of girls and 44 percent of boys aged 13-17 years received the recommended two-dose HPV vaccine series in 2016.
The percentage of adults who are at a healthy weight decreased, and the percentage of adults who are overweight or obese increased. Nearly 40 percent of adults aged 20 years and older were obese in 2016 (an increase from 23 percent in 1991), 32 percent were overweight, and only 27 percent were at a healthy weight.
Avoiding carcinogens is crucial to reducing the risk of cancer. This report also tracks exposure to cancer-causing agents that exist as pollutants in our air, food, water, and soil, including arsenic, benzene, cadmium, nitrate, and radon. Homes at risk for radon exposure, the second-leading cause of lung cancer, have increasing rates of using a working radon mitigation system.
The combination of an aging population and improvements in cancer screening and treatment means more Americans will be cancer survivors in the coming years. As the number of cancer survivors grows and expected survival time increases, the health behaviors of these individuals are becoming an important focus of attention. Adoption or maintenance of healthy lifestyles after a cancer diagnosis has the potential to reduce both cancer- and non-cancer-related morbidity. Unfortunately, too many cancer survivors still smoke cigarettes. This population could benefit from increased access to resources that will help them quit smoking and remain tobacco-free.
Finally, the economic burden of cancer is considerable and important to monitor. As the US population ages and newer technologies and treatments become available, national expenditures for cancer will continue to rise. National and state cancer control strategies should be informed by evidence concerning economic burden and statistical models of the impact of interventions.
Researchers and cancer control professionals can use the Cancer Trends Progress Report to elicit research ideas and set priorities for cancer control program planning to advance cancer control progress. We at NCI, along with our partners in this initiative, hope that you will find this report to be a valuable reference tool and a stimulus for action. We must not forget that the numbers in this report reflect the lives and struggles of millions of our fellow citizens. NCI remains committed to advancing scientific progress and facilitating its application on behalf of each of them. This report reflects our overarching mission: we support cancer research to help all people live longer, healthier lives.
Robert Croyle, Ph.D.
Director, Division of Cancer Control and Population Sciences
National Cancer Institute