Prevention and screening were a major factor in saving lives for five types of cancer

Press release

Thursday, December 5, 2020

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The NIH model examined the impact of individual cancer screening and treatment, as well as their combined effects.

Between 1975 and 2020, screening and prevention efforts prevented 4.75 million deaths from five types of cancer: lung, prostate, colorectal, breast. NCI

Improvements in cancer screening and prevention have prevented more cancer deaths combined than any treatment advance in the past 45 years, according to a study by the National Institutes of Health. The study was published on December 5, 2024. JAMA OncologyThe researchers looked at deaths from breast, colorectal, and lung cancers that could have been prevented through screening and prevention. The researchers focused on five types of cancer because they are the leading causes of cancer death and there are a wide range of prevention, early detection, and/or treatment strategies available. These five cancers accounted for nearly half of new cancer deaths and diagnoses in recent years.

Katrina A., co-director of the study: "While many may assume that advances in treatment account for the majority of the reduction in mortality from these five cancers when combined, it is surprising how much screening and prevention contribute to the reduction in mortality." B. Goddard, Ph.D., is director of the Division of Cancer Control and Population Sciences at NCI. Eight out of 10 preventable deaths from these five cancers over the past 45 years are due to advances in screening and prevention.

Smoking cessation was the most effective prevention strategy, preventing 3.45 million lung cancer deaths. In each case, screening and prevention prevented the greatest number of deaths from lung, prostate, cervical, and colorectal cancers. Advances in treatment prevented most breast cancer deaths.

W. Kimryn Rathmell MD Ph.D. is the director of the NCI. She said that to reduce cancer deaths, we need to combine prevention, screening, and treatment advances. This study will help us better understand which strategies have been shown to be most effective in reducing cancer death rates. We can then build on the momentum and increase their use across the United States.

The researchers used cancer mortality statistics and statistical models to calculate the relative contribution of screening and prevention to deaths averted from cancers such as breast, prostate, cervical, colorectal and lung cancers between 1975 and 2020.

The modelling revealed that between 1975 and 2025, 5.94 million cancer-related deaths could have been prevented. Prevention and screening interventions were responsible for 4.75 million, or 80%, of these prevented deaths.

Cancer sites differed in their contributions to prevention, screening, and treatment.

• From 1975 to 2020, 1 million deaths from breast cancer were prevented (out of the 2.71 million that would have occurred in the absence of any intervention). Therapeutic advances contributed to 34 of these deaths and mammography screening contributed to the remainder.
• Tobacco control efforts prevented 98,133 (out of 9.2 million) lung cancer deaths. Treatment advances accounted for the remaining 2,133.
• Cervical cancer screening tests (such as the Pap test or the HPV test, also known as human papillomavirus) and removal of precancerous lesions have prevented 160,000 of the 370,000 deaths.
• Removal and screening of polyps that could lead to cancer accounted for 79,100 of the 940,000 lives saved. Therapeutic advances accounted for 21,100.
• PSA screening contributed to 56% of prostate cancer deaths avoided (out of 1.01 million) and therapeutic advances to 44%.

"These results suggest that we need to continue to develop robust strategies and approaches in all of these areas," Dr. Goddard noted. It is not just therapeutic advances, prevention and screening that contribute to reducing cancer deaths.

The authors noted that newer screening and prevention strategies such as the HPV vaccine and lung cancer screening were not widely used during the study period and may have further reduced cancer death rates. Making cancer screenings more accessible (such as self-collection HPV tests) and developing new treatments are other ways to reduce cancer deaths.

The authors acknowledged that fewer than 50% of cancer-related deaths occur in the five sites studied. The findings from these cancers are unlikely to apply to cancers for which screening or prevention interventions do not work.

NCI Division of Cancer Prevention Director Philip E. Castle, Ph.D., said, "We must maximize the use of screening and prevention for these cancers to benefit all Americans, especially underserved communities, and to develop new prevention and screening strategies to prevent deaths from other very deadly cancers such as pancreatic and ovarian cancers."

The authors also noted that their findings were based on U.S. population averages and therefore could not be generalized to certain population groups. This study did not take into account possible harms that the interventions could cause, including false positives and overdiagnosis, or other outcomes such as quality.

The National Cancer Institute: NCI leads the National Cancer Program, NIH, in its efforts to reduce the prevalence of cancer and improve the lives of cancer patients and their families through cancer research, development of new interventions, and training and mentoring of researchers. Please visit the NCI website for more information about cancer. cancer.gov Call the NCI Contact Center at 1-800-4CANCER (800-422-6237).

The National Institutes of Health: The NIH is the medical research agency of the United States Department of Health and Human Services. It is comprised of 27 institutes and centers. The NIH, the nation's medical research agency, is the primary federal agency that conducts and supports basic, translational, and clinical medical research. It also studies the causes, treatment, and cures of common and rare diseases. Visit the NIH for more information about its programs and services. www.nih.gov.

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