Managing risk factors while ensuring everyone has access to quality care could result in 1.3 million fewer cancer deaths by 2035, according to a new paper from the American Cancer Society (ACS). While overall mortality has declined, significant health disparities in progress against cancer have also been exposed.
The reduction, which would equate to a drop in the US’ overall cancer mortality rate of 38.3 percent when compared to 2015 levels, is the 2035 challenge goal target set by the ACS.
“A summary evaluation of the 2015 ACS challenge goal showed that overall US mortality from all cancers combined declined 26 percent over the period from 1990 to 2015,” states the American Cancer Society 2035 Challenge Goal on Cancer Mortality Reduction, published in CA: A Cancer Journal for Clinicians.
In contrast, though, “over the past decades… ACS scientists and researchers from other agencies have reported substantial disparities in progress against cancer among populations defined by race/ethnicity, region of residence, and socioeconomic status.”
Not all populations benefit equally
“These findings suggest that not all segments of the US population have benefited equally from advances in cancer prevention, early detection and treatments, and that the US cancer mortality can be lowered considerably by applying known interventions equitably and broadly.”
ACS researchers used various sources of data, including the Surveillance, Epidemiology and End Results database, the National Centre for Health Statistics and the 2005 and 2015 National Health Interview Surveys, to predict future death rates and feasible cancer reduction levels.
They found that people with a college education had experienced the largest reduction in cancer mortality. This was thanks, in part, to fewer cancer risk behaviors and having better access to quality healthcare.
“If overall cancer death rates from 2020 through 2035 nationally decline at the pace of those of college graduates, then death rates in 2035 in the United States will drop by 38.3 percent from the 2015 level, and by 54.4 percent from the 1990 level,” predicts the paper, which has set its goal as a 40 percent reduction by 2035.
“Achieving this goal could lead to approximately 1.3 million fewer cancer deaths than would have occurred from 2020 through 2035, and 122,500 fewer cancer deaths in 2035 alone.”
The war on cancer
Future progress in what the ACS called the “war on cancer” depends on the extent to which policymakers and the American public can “join together … to provide adequate healthcare to all”.
The authors say: “The greatest pay-off in terms of cancer deaths prevented is through continued work on tobacco control, followed by an effort to control excess body weight.
“This would require a change in the behavior of the US population and culture of a magnitude very similar to that of the changes regarding smoking since the mid-1960s.”
This would also reduce incidence, morbidity, and mortality from several other chronic conditions, such as cardiovascular disease and Type 2 diabetes, as well as cut America’s healthcare costs.
Previous studies, it goes on, have shown a substantial number of Americans receive less than optimal care, and this needed to be addressed.
“Widespread and equitable access to, and utilization of, high-quality care, both preventive and therapeutic, is necessary to achieve the 2035 challenge goal of reducing cancer mortality from the 2015 level,” it concludes.
Free full text of the paper can be found here: https://www.ncbi.nlm.nih.gov/pubmed/31066919
Ma, J., Jemal, A., Fedewa, S. A., Islami, F., Lichtenfeld, J. L., Wender, R. C., … & Brawley, O. W. (2019). The American Cancer Society 2035 challenge goal on cancer mortality reduction. CA: a cancer journal for clinicians.