A study spearheaded by the National Institutes of Health (NIH) has demonstrated that progress in cancer prevention and screening has significantly reduced mortality rates in five common cancer types over the last 45 years, surpassing the impact of advancements in treatment. Published on December 5, 2024, in JAMA Oncology, the research examines how prevention, screening, and treatment collectively contributed to fewer deaths from breast, cervical, colorectal, lung, and prostate cancers.
The NIH team scrutinized both the individual and combined influences of prevention, screening, and treatment enhancements in these cancers, which are major causes of cancer mortality and have established strategies for prevention, early detection, or management. In recent times, these cancers account for nearly half of all diagnosed cases and cancer-related fatalities.
“Many people credit advancements in treatment as the primary reason for decreasing death rates for these five cancers. However, it is quite revealing how significantly prevention and screening play a role in mortality reduction,” stated co-lead investigator Katrina A. B. Goddard, director of the NCI’s Division of Cancer Control and Population Sciences. “Prevention and screening alone are responsible for averting eight out of every ten cancer deaths over the past four and a half decades.”
Among prevention methods, smoking cessation proved particularly effective, preventing 3.45 million lung cancer deaths by itself. The research further determined that in cervical, colorectal, lung, and prostate cancers, prevention and screening nearly single-handedly averted most deaths, whereas in breast cancer, treatment advances were the primary factor.
“It is essential that we continue to combine effective prevention and screening methods with groundbreaking treatment advancements to further decrease cancer mortality,” emphasized W. Kimryn Rathmell, director of the NCI. “This research will help us ascertain which approaches are most successful in cutting cancer deaths, enabling us to expand and utilize these strategies nationwide.”
The study relied on statistical modeling and cancer mortality data to assess to what extent prevention, screening, and treatment interventions contributed to reducing deaths from breast, cervical, colorectal, lung, and prostate cancers from 1975 to 2020.
The analysis showed a total of 5.94 million deaths were avoided between 1975 and 2020 due to these interventions, with prevention and screening responsible for a significant 4.75 million, or 80%, of these averted deaths.
Detailed findings per cancer type include:
– **Breast cancer:** Of the 2.71 million potential deaths, 1 million were averted between 1975 to 2020, with treatment advances contributing to 75% of the reduced deaths and mammography screening to the rest.
– **Lung cancer:** Tobacco control efforts were credited with saving 98% of the 3.45 million lives, out of 9.2 million potential deaths.
– **Cervical cancer:** Screening interventions, including Pap and HPV testing, averted all of the 160,000 avoided deaths.
– **Colorectal cancer:** Screening and polyp removals accounted for 79% of the 940,000 deaths averted.
– **Prostate cancer:** Among the 360,000 lives saved, 56% were due to PSA screening.
Dr. Goddard highlighted the importance of maintaining strong, comprehensive approaches in prevention, screening, and treatment to continue reducing cancer mortality.
Advancements like HPV vaccination and lung cancer screening weren’t widely adopted during the study period and could help further reduce deaths. Opportunities for further reduction include making screenings more accessible and developing innovative treatments.
Authors noted the study focused on only five cancer types, representing less than half of all cancer fatalities, and cautioned that results may not apply to other cancers lacking effective preventative or therapeutic options.
“Broadening the reach of prevention and screening strategies ensures that Americans from diverse backgrounds, particularly underserved groups, can benefit,” said co-lead investigator Philip E. Castle, director of NCI’s Division of Cancer Prevention. There’s also a significant potential for novel prevention methods to address other deadly cancers.
Data from this study is based on broad U.S. population averages and may not necessarily reflect specific groups. Additionally, considerations of intervention drawbacks, such as false positives and overdiagnosis, or quality of life impacts, were not within the study’s scope.