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ACS Report: Half of Cancer Deaths Preventable

At least half of all cancer deaths could be avoided if we only did what we know works to prevent the disease. That's the conclusion of the 2006 edition of Cancer Prevention and Early Detection Facts & Figures, a yearly American Cancer Society report.

Cutting out tobacco, making use of cancer screening tests, reducing levels of obesity and overweight, and improving nutrition and physical activity could go a long way to lowering the number of cancer deaths in the United States, the report says.

"This year, for the first time, there was a drop in the reported number of actual cancer deaths in the US," said Carolyn Runowicz, MD, national volunteer president of the American Cancer Society. "Although we are winning the 'war on cancer,' there is a remarkable opportunity to save hundreds of thousands of lives and to reduce suffering from this disease with lifestyle changes and an increased use of proven screening strategies."

The US has made progress against tobacco, the report shows. Smoking is declining, and the number of cigarettes smoked per person is lower now than it has been since the start of World War II. Still, more than 23% of men and more than 18% of women were smokers in 2004. About 22% of teenagers reported being smokers in 2003.

To push those rates down, the report calls for higher tobacco taxes, more clean-air laws that restrict smoking in public places, better access to smoking cessation tools like counseling hotlines and medication, and more advertising to discourage tobacco use.

That last item may be particularly important for keeping children away from cigarettes. The report cites several studies that show exposure to tobacco promotions raises the likelihood that kids will smoke. The tobacco industry spends more than $15 billion a year on advertising and promotion, the report says.

Americans Getting Heavier
Other lifestyle changes could also have a dramatic impact on cancer deaths. The ACS report estimates that about one-third (188,277) of those deaths in 2006 will be due to poor nutrition, lack of exercise, and excess weight.

Physical activity is known to reduce the risk of breast cancer and colon cancer, while eating lots of fruits and vegetables can lower the risk of cancers of the mouth, throat, esophagus, lung, stomach, colon, and rectum, the report says. American Cancer Society guidelines for nutrition and physical activity call for adults to get at least 30 minutes of moderate physical activity, 5 or more days per week, and eat at least 5 servings of fruits and vegetables each day.

Getting regular exercise and eating right can help maintain a health body weight. An American Cancer Society study released in 2003 showed that being overweight or obese raises the risk of dying from numerous different cancers.

Unfortunately, Americans are getting heavier. More than half of US adults were overweight or obese in 2004, and the number of overweight or obese kids has tripled in the past 30 years.

Many factors have contributed to these trends, the report says. Among them: cheap, readily available junk food; more spread-out communities that are not conducive to walking; and cuts in school physical education classes and recess.

Mammograms, Pap Screens, and Colon Tests
"Aside from avoiding tobacco and maintaining a healthy body weight cancer screening is the most important thing people can do to reduce their chances of dying from cancer," the report says.

But too few Americans get the tests they need.

Colorectal cancer is a glaring example. Screening can detect colon polyps before they ever develop into cancer; removing these growths can prevent the disease entirely. Even if a polyp has progressed to cancer, screening can find the tumor at an early stage, when treatment is likely to be more effective. Proper screening could save more than half of the 55,170 people expected to die from colon cancer in 2006, according to the report.

Yet fewer than half of Americans 50 or older have gotten one of the recommended screening tests for colon cancer. The rate is even lower among people who have no health insurance.

Rates for mammograms and Pap tests are better, but still not ideal.

In 2003, slightly less than 70% of women 40 and older reported having a mammogram in the past 2 years. The American Cancer Society recommends annual mammograms for women in this age group because they can find breast cancer before a tumor is big enough to be felt by hand. Likewise, Pap tests can detect cervical cancer at an early stage. In 2003 about 80% of women 18 and older reported getting a Pap test in the past 3 years.

As with colon cancer, women with no insurance are less likely to get mammograms and Pap tests. The National Breast and Cervical Cancer Early Detection Program, run by the Centers for Disease Control and Prevention, helps provide these screening tests for low-income and uninsured women in all 50 states. However, the program only reaches about 20% of women between the ages of 50 and 64 who are eligible for it.

The report says screening rates can be improved by raising awareness of the need for screening among the general public and by helping doctors advise their patients about screening with reminder systems and similar tools. The report also calls for public policy initiatives to make screening a routine part of health care and provide services to the uninsured.