Ever wonder what would happen to cancer in this country if we all did better at what we do every day?
The American Cancer Society has an answer in a recently published paper in our journal CA: A Cancer Journal for Clinicians, and it may surprise you what we could accomplish if we set our minds to the task.
We recently reported that between 1990 and 2015, the cancer death rate declined by 27%. That’s a remarkable accomplishment. However, we still have a long way to go. Too many of us experience the burdens and losses from cancer. All of us want to see this disease in its many forms vanquished.
Our researchers looked at what would happen if all of us had the same cancer risk as college graduates in the United States, then came up with an estimate of how that would impact deaths from cancer from 2015 and 2035.
The answer: we could reduce deaths from cancer by close to another 40% beyond what we have already accomplished. That would be a total of over 54% from 1990. And it would mean 1.3 million fewer premature deaths from cancer between 2020 and 2035. Remarkably, it would mean 122,500 fewer deaths from cancer in 2035 alone.
Just think about what that means to all of us, our loved ones, our friends, our colleagues, to the nation.
So that becomes a remarkable challenge. Can we actually achieve it? The answer to that question is more complicated.
The researchers considered the health outcomes of college graduates as the benchmark for the goal. It’s difficult to know exactly what it is that makes the risk of cancer death substantially lower in people who graduate from college, however there are some clues: they smoke less, exercise more, and eat better for starters. They have lower rates of obesity. They also generally have health insurance, frequently through their place of employment. They are more likely to be screened for cancer. And because they are more likely to be employed and have higher incomes, they are more likely to have access to high quality health care.
We know that not everyone has benefitted equally from the advances in cancer care. We also know that not everyone has health insurance and access to quality care. Those are major barriers to reducing the burden of cancer for all, and they must be addressed.
This is the prescription for the country that this research recommends:
1) Smoking levels decrease to those with a master’s degree
2) Body mass index—a measure of overweight and obesity—drops to the level of the 1970s (look at an old photograph if you want to know what people looked like back then)
3) Adult Americans increase their consumption of fruits and vegetables by about 3 ounces a day, their dietary fiber by 10 grams (about 1/3 of an ounce) a day, and their dietary calcium by 200 mg a day
4) Reduce consumption of red meat and processed meat on average by about 50 grams per day (a little over 1 ½ ounces)
5) Reduce alcohol beverage consumption by one drink per day (most of us have no idea that alcohol consumption increases cancer risk to the extent that it does)
6) Increase moderate/vigorous physical activity by about 40-60 minutes of walking/hiking per week, and
7) Use tamoxifen or raloxifene in women between the ages of 35-79 who are at higher risk of breast cancer
If you read that list carefully, you begin to realize that we could do this if we set our minds and hearts to it. College graduates aren’t perfect, and neither are the rest of us. However even a modest change in our habits could lead to real improvements in lowering our risk of a cancer death, not to mention improving the outlook for a host of other illnesses as well.
What you don’t see on this list are some of the things that could take us beyond that 40% goal. Things like new treatments such as immunotherapy, which is just beginning to have an impact on cancer death rates. Things like lung cancer screening, which has been shown to reduce deaths from lung cancer however has had a slow uptake in this country. Things like advances in the early detection of cancer where promising research is suggesting a day when a blood test may replace some complex and uncomfortable screening tests. And HPV vaccination, which could not only reduce the risk of cervical and other cancers but could also reduce the burden of the testing and treatment of pre-cancers that women undergo after an abnormal cervical cancer screening test.
Achieving the goal of a 40% reduction in cancer deaths by 2035 is not easy. And the reality is this estimate is based on the premise that all of us start doing what we need to do right now. That’s not likely to happen, and we realize that. However, if we don’t challenge ourselves to do better we know for certain we will never get there.
We are pretty good these days at accepting challenges. Maybe it’s time we declared a challenge for ourselves—and our nation. We know one thing for certain: if we accept that challenge, we will have better health to show for it.