BACKGROUND AND PURPOSE:

• Deaths due to cancer have declined over time due to improvements in prevention, screening and treatment
• Goddard et al. (JAMA Oncology, 2024) quantified the contributions of prevention, screening, and treatment toward the reduction in cancer deaths for breast, cervical, colorectal, lung, and prostate cancers

METHODS:

• Model-based study using population-level data
  • Cancer mortality rates from SEER cancer registry
  • US mortality rates from the National Center for Health Statistics
• Interventions
  • Primary prevention via smoking reduction (lung)
  • Screening
    • Interception prior to cancer (cervix and colorectal)
    • Early detection (breast, cervix, colorectal, and prostate)
  • Therapy (breast, colorectal, lung, and prostate)
• Study design
  • Model inputs were based on
    • National risk factor data | Cancer incidence | Cancer survival and mortality due to other causes | Dissemination and effects of prevention, screening and treatment
  • Simulated or modeled data using parameters derived from multiple birth cohorts of the US population were used
• Primary outcome
  • Estimated cumulative number of cancer deaths averted with interventions vs no advances

RESULTS:

• Cancer deaths averted (Breast | Cervical | Colorectal | Lung | Prostate) between 1975 and 2020: 5.94 million deaths
• 8 of 10 of these averted deaths were due to cancer prevention and screening: 4.75 million deaths
• The contribution of each intervention to mortality reduction varied by cancer site
  • Breast cancer
    • Reduction due to prevention and/or screening: 25% of deaths
    • Reduction due to treatment advances: 75%
  • Cervical cancer
    • Reduction due to prevention and/or screening: 100% of deaths
    • Reduction due to treatment advances: negligible
  • Colorectal cancer
    • Reduction due to prevention and/or screening: 79% of deaths
    • Reduction due to treatment advances: 21%
  • Lung cancer
    • Reduction due to prevention and/or screening: 98% of deaths
    • Reduction due to treatment advances: 2%
  • Prostate cancer
    • Reduction due to prevention and/or screening: 56% of deaths
    • Reduction due to treatment advances: 44%

CONCLUSION:

• Since 1975, the majority of averted cancer deaths were due to improvements in prevention or screening although results varied with cancer type
• The authors state

Despite progress, efforts to further reduce the US cancer burden will require increased dissemination of effective interventions and development of new technologies and discoveries

Future efforts should continue to invest significantly in prevention and screening strategies as part of a comprehensive plan to accelerate progress and reduce cancer mortality

Learn More – Primary Sources:

Estimation of Cancer Deaths Averted From Prevention, Screening, and Treatment Efforts, 1975-2020