By Dr. Chinta Sidharthan Reviewed by Lily Ramsey, LLM Dec 6 2024
A study estimates 5.94 million deaths were prevented across five major cancers, highlighting the critical role of early detection and prevention in reducing mortality.
Study: Estimation of Cancer Deaths Averted From Prevention, Screening, and Treatment Efforts, 1975-2020 . Image Credit: Chinnapong/Shutterstock.com
In a recent study published in JAMA Oncology, a research team led by scientists from the National Institutes of Health in the United States (U.S.) examined the impact of various cancer control strategies, including prevention, screening, and treatment, on cancer mortality rates in the U.S. between 1975 and 2020.
The study modeled data for five major cancer types and quantified the number of lives saved through these efforts, highlighting the contributions of each intervention in lowering death rates. Background
The past few decades have seen significantly lower mortality rates associated with cancers due to the advancements in cancer prevention, early detection, and treatment.
Tobacco control programs, routine cancer screenings, and targeted therapies have played critical roles in combating common cancers. Lung cancer deaths have declined markedly due to reduced smoking prevalence, while cervical cancer outcomes have improved through widespread screening and vaccination efforts.
Similarly, early detection methods such as mammography and colonoscopy have enhanced survival rates for breast and colorectal cancers, respectively.
However, there remains substantial challenges in ensuring equitable access to these interventions and addressing cancers with limited therapeutic options. Furthermore, despite the progress, there remain significant gaps in our understanding of the relative effectiveness of these strategies across different cancers. About the study
The present study used simulation models to evaluate the effectiveness of cancer prevention, screening, and treatment interventions on mortality rates from breast, prostate, lung, colorectal, and cervical cancers in the U.S. between 1975 and 2020.
The data were derived from population-level statistics and modeled using parameters designed by the Cancer Intervention and Surveillance Modeling Network. Related StoriesNew study explores heart risks of cancer immunotherapyCancer therapy may raise heart attack and stroke risks by disrupting immune regulation in arteriesLung cancer screening with CT can identify coronary artery calcium
Additionally, mortality data from the Surveillance, Epidemiology, and End Results program and the National Center for Health Statistics were used to establish baseline cancer trends without any of the interventions.
The models simulated cancer-specific scenarios across different timeframes and interventions. Four primary scenarios were evaluated — no interventions, prevention or screening only, treatment only, and the combined impact of prevention, screening, and treatment.
The scenarios accounted for evolving practices, such as the impact of tobacco control policies on lung cancer and the introduction of mammography and human papillomavirus (HPV) testing for breast and cervical cancers, respectively.
The interventions considered in the study included tobacco cessation efforts for lung cancer prevention, screening for colorectal and prostate cancers using colonoscopy and prostate-specific antigen (PSA) testing, and advances in systemic therapies, such as targeted drugs for breast cancer.
The simulations analyzed the effects of these strategies on cancer incidence, progression, and survival over time.
Furthermore, the contribution of each intervention was isolated and assessed in the presence or absence of other measures. The analysis also spanned multiple birth cohorts to ensure a comprehensive representation of demographic trends. Major findings
The study reported that cancer prevention and screening were the most significant contributors to reducing mortality, averting an estimated 5.94 million deaths across five cancer types between 1975 and 2020.
Screening and prevention efforts accounted for 80% of the total lives saved, while the advances in cancer treatment contributed the remaining 20%.
The researchers also found that lung cancer mortality showed the largest reduction, with tobacco control measures being responsible for 98% of the 3.45 million lung cancer deaths averted.
Furthermore, cervical cancer deaths were almost eliminated through effective screening programs. In contrast, colorectal cancer mortality declined primarily due to early detection and polyp removal, which accounted for 79% of the 940,000 deaths averted.
Screening efforts also contributed to 56% of the 360,000 deaths averted in prostate cancer cases, with treatment advances accounting for the rest.
However, breast cancer presented a different trend, with advances in breast cancer treatment playing a dominant role in mortality prevention, accounting for 75% of the 1.03 million deaths averted. In comparison, screening was responsible for the remaining 25% of lives saved.
The analysis also highlighted the disparities in intervention effectiveness across cancer sites. In the case of cervical cancer, prevention and screening proved highly effective due to the availability of reliable diagnostic tools and early-stage interventions.
In contrast, lung cancer treatment was found to have a limited impact on preventing mortality, underscoring the importance of preventive measures such as tobacco cessation. Conclusions
To summarize, the study highlighted the transformative role of prevention and screening in reducing cancer mortality over the last 45 years. Tobacco control, routine screenings, and therapeutic advances have collectively saved millions of lives, although their impact varies by cancer type.
Overall, the results demonstrated that while substantial progress has been made in reducing cancer mortality, continued efforts in prevention and screening are critical.
The study also emphasized the need for innovative therapies and broader dissemination of existing interventions to achieve further reductions in cancer-related deaths. Journal reference:
Katrina, Feuer, E. J., Mandelblatt, J. S., Meza, R., Holford, T. R., Jeon, J., LansdorpVogelaar, I., Gulati, R., Stout, N. K., Howlader, N., Knudsen, A. B., Miller, D., CaswellJin, J. L., Schechter, C. B., Etzioni, R., TrenthamDietz, A., Kurian, A. W., Plevritis, S. K., Hampton, J. M., & Stein, S. (2024). Estimation of Cancer Deaths Averted From Prevention, Screening, and Treatment Efforts, 1975-2020. JAMA Oncology. doi: 10.1001/jamaoncol.2024.5381.
https://jamanetwork.com/journals/jamaoncology/article-abstract/2827241