How Many People Are Affected By Cancer Each Year – Home > AACR Cancer Progress Report > AACR Cancer Progress Report 2019: Table of Contents > Cancer Prevention: Identifying Risk Factors
The overall cancer death rate in the United States has declined steadily over the past two decades, and the number of people diagnosed with cancer has reached a record high. However, it is estimated that 606,880 people will die from cancer in 2019. Almost half of these deaths are attributable to cancers caused by modifiable risk factors (46).
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Through decades of research, we have identified several factors that increase a person’s risk of developing and/or dying from cancer, including smoking, being overweight, poor diet, exposure to ultraviolet (UV) radiation, and certain pathogenic infections (see Figure 2 ). In fact, 40 percent of cancer cases diagnosed in the United States in 2014 were caused by modifiable risk factors (46). Given that some of these risk factors can be avoided, many cases of cancer are preventable. Many of the same risk factors lead to poor outcomes after a cancer diagnosis. Therefore, lifestyle changes such as smoking cessation and increased physical activity can improve health outcomes in cancer patients and survivors (see Promoting Healthy Behaviors).
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The development and implementation of public education and policy initiatives designed to eliminate or reduce the effects of preventable causes of cancer has reduced cancer incidence and mortality in the United States. For example, tobacco control efforts since the 1960s have led to significant reductions in smoking and smoking-related diseases, including lung cancer. Despite these measures, the prevalence of some major cancer risk factors remains high (47), particularly among segments of the US population that experience cancer health disparities, such as racial and ethnic minorities, people of lower socioeconomic status, and others. low educational attainment (see sidebar on disparities in burden of preventable cancer risk factors). Thus, we must identify more effective strategies to disseminate our current knowledge of cancer prevention and implement evidence-based interventions to reduce the burden of cancer for everyone.
Cigarette smoking is a major preventable cause of cancer because it exposes individuals to many harmful chemicals that damage DNA and induce genetic and epigenetic changes that lead to cancer development (53–55). Smoking increases the risk of developing 17 types of cancer in addition to lung cancer (see Figure 3). Fortunately, quitting at any age can reduce these risks. In fact, the health benefits begin within weeks of quitting, and 10 years after quitting, all smoking-related cancers are reduced by 50 percent (56) (57). Thus, one of the most effective ways to reduce a person’s risk of developing cancer and other smoking-related diseases such as cardiovascular, metabolic, and lung diseases is to quit or stop smoking.
Thanks to the implementation of the Nationwide Tobacco Control Initiative, smoking among adults in the United States has steadily declined, reaching an all-time low of 14 percent in 2017—a 67 percent reduction since 1965 (18). Exposure to secondhand smoke, which increases the risk of lung cancer among nonsmokers, has also decreased significantly over the past three decades (58). Consequently, tobacco-related cancers are declining, and a recent report suggests that if smoking rates continue to decline in the future, annual lung cancer deaths will decrease by 63 percent over the next 50 years (48)(59).
Despite these positive trends, it cannot be overlooked that 34 million adults still smoke in 2017 (18). There are also striking sociodemographic disparities in smoking behavior (see sidebar on Disparities in the Burden of Preventable Risk Factors for Cancer). Thus, researchers, advocates, and policymakers must continue to work together to identify population-level interventions such as tobacco price increases, public health campaigns, age and marketing restrictions, counseling and medication, and smoking cessation. Legislation to reduce the burden of smoking and smoking-related cancers in the United States. For example, 17 US states have passed laws raising the minimum legal age for the sale of tobacco products to 21, based on evidence that nearly 95 percent of adult smokers report trying their first cigarette by age 21. This is a very important strategy. To reduce the burden of tobacco use, as a recent report estimated that raising the minimum age to purchase all tobacco products to 21 would prevent 223,000 deaths, including 50,000 lung deaths, among people born between 2000 and 2019 nationwide. cancer (60).
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Use of other combustible tobacco products (eg, cigars), smokeless tobacco products (eg, chewing tobacco and cigarettes), and water pipes (hookah) also have adverse health effects, including cancer (64). Electronic cigarettes (e-cigarettes) are a rapidly growing tobacco product. An alarming trend in recent years has been the popularity of e-cigarettes among US teens and young adults. E-cigarettes were first introduced to the US market in 2007 and are the most commonly used tobacco product among US middle and high school students as of 2014 (65) (See sidebar E-cigarettes: What have we learned and what do we need to know?).
The recent increase in e-cigarette use among youth coincides with the popularity of the JUUL brand of e-cigarettes, which are shaped like USB flash drives and can be used discreetly in schools or public places (67). These products come in flavors that deliver extremely high levels of nicotine, a highly addictive substance that appeals to young people and is harmful to the developing brain (71). According to recent studies, many users are unfortunately unaware that they are exposed to nicotine in the same way as smokers (72)(73). There is evidence that e-cigarette use may act as a gateway to combustible tobacco smoking by youth (66)(74). Thus, it is alarming that between 2017 and 2018, e-cigarette use among high school and middle school students increased by nearly 80 percent and 50 percent, respectively (68). It appears that current policies to limit the spread of e-cigarettes among young people are inadequate.
Last year, the FDA proposed several restrictions on e-cigarettes to limit youth access, and in December 2018, the US Surgeon General’s Office declared e-cigarette use among youth an epidemic (see Tobacco Product Use). All stakeholders need to continue to work together to identify long-term health outcomes associated with e-cigarettes and to identify new strategies to implement population-level regulations to reduce e-cigarette use among youth and young adults.
In US adults, 20 percent of new cancer cases and 16 percent of cancer deaths are related to overweight or obesity, poor diet, physical inactivity, and excessive alcohol use (46). Being overweight or obese in adulthood increases a person’s risk of developing 15 types of cancer. Conversely, being physically active reduces the risk of eight types of cancer (see Figure 4). Therefore, maintaining a healthy weight, being physically active, and eating a balanced diet are effective ways to reduce a person’s risk of developing or dying from cancer (see Sidebar Keeping a Healthy Weight, Being Physical, and Reducing Cancer Risk. Active and Balanced dietary intake). Determining the ways in which obesity, poor diet, and physical inactivity increase cancer risk is an area of active research.
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The prevalence of obesity continues to rise in the United States and around the world. According to recent estimates, nearly 40 percent of adults in the United States are obese (47), and nearly 5 and 10 percent of cancers in men and women over the age of 30 may be related to obesity (19) . Worldwide, excess body weight is responsible for approximately 4 percent of all cancer cases (75). In addition to cancer, obesity increases the risk of several other health problems, including type 2 diabetes, high blood pressure, heart disease, stroke, liver disease, and kidney disease (76).
Complex and interrelated factors, ranging from socioeconomic and environmental influences to individual lifestyle factors, contribute to obesity. However, there is ample evidence that consumption of high-calorie, energy-dense foods and beverages and lack of physical activity play a significant role (76). In the United States, more than 5 percent of newly diagnosed cancer cases among adults are related to poor nutrition (80). Low consumption of healthy foods such as whole grains, fruit, nuts and seeds, high consumption of sugary drinks and unhealthy foods such as red and processed meat, in fact, are responsible for one in five deaths worldwide. cause. (81).
As recommended in the 2015–2020 Dietary Guidelines for Americans by the US Department of Health and Human Services and the US Department of Agriculture, intensive efforts by all stakeholders are required to increase the number of people consuming a balanced diet. (82). An initiative that has been effective in reducing rates of obesity and severe obesity among adults