Improvements in cancer prevention and screening have successfully prevented more deaths from five combined cancer types over the last 45 years than the advancements in treatment, according to a modeling study. The research examined the decrease in deaths from breast, cervical, colorectal, lung, and prostate cancers attributed to a mix of prevention, screening, and treatment innovations.
Recent advancements in cancer prevention and screening have led to a significant reduction in deaths from five major cancer types over the past 45 years, surpassing the impact of treatment improvements. This finding comes from a modeling study conducted by researchers at the National Institutes of Health (NIH), published on December 5, 2024, in JAMA Oncology. The study examined the prevention of deaths linked to breast, cervical, colorectal, lung, and prostate cancers, which are among the leading causes of cancer-related fatalities, as there are established methods for prevention, early detection, and/or treatment. Collectively, these five cancers account for nearly half of all new cancer diagnoses and deaths in recent years.
“Although many might think that advancements in treatment have been the primary factor in reducing mortality rates for these cancers, our findings reveal the significant role of prevention and screening,” said co-lead investigator Katrina A. B. Goddard, Ph.D., who is the director of NCI’s Division of Cancer Control and Population Sciences. “A staggering 80% of the deaths prevented from these cancers in the last 45 years were due to improvements in prevention and screening.”
One particular prevention strategy, smoking cessation, was responsible for the majority of averted deaths, preventing approximately 3.45 million deaths from lung cancer alone. When analyzed individually, prevention and screening accounted for most deaths prevented in cervical, colorectal, lung, and prostate cancers, while treatment advancements had a more significant impact on breast cancer.
“To lower cancer mortality rates effectively, it is essential to integrate robust strategies in prevention and screening along with treatment advancements,” stated W. Kimryn Rathmell, M.D., Ph.D., director of NCI. “This research will enhance our understanding of the most effective strategies in reducing cancer deaths, allowing us to build on this progress and expand the use of these methods throughout the United States.”
The researchers utilized statistical models alongside cancer mortality data to evaluate the contributions of prevention, screening, and treatment advancements to the deaths averted from these five cancers between 1975 and 2020.
The study revealed that a total of 5.94 million deaths were averted from these cancers from 1975 to 2020. Of this number, 4.75 million deaths, or 80%, were due to prevention and screening efforts.
The contributions from prevention, screening, and treatment differed by cancer type:
- For breast cancer, out of 2.71 million expected deaths without intervention, 1 million were averted, with treatment improvements responsible for 75% and screening contributing the rest.
- In lung cancer, smoking control measures accounted for 98% of the 3.45 million deaths averted out of 9.2 million total potential deaths, with treatment advancements accounting for the balance.
- In cervical cancer, all 160,000 averted deaths (from a potential 370,000) were due to screening methods like Pap tests and HPV testing, along with the removal of precancerous lesions.
- For colorectal cancer, 940,000 deaths were prevented (from 3.45 million), with 79% from screening and removal of precancerous polyps, while treatment advancements contributed 21%.
- In prostate cancer, out of 1.01 million potential deaths averted, screening via PSA tests accounted for 56%, and treatment advancements contributed 44%.
“These results underline the necessity of maintaining effective strategies across prevention, screening, and treatment,” emphasized Dr. Goddard. “It’s a combination of these efforts, not just treatment alone, that is crucial for reducing cancer mortality.”
The researchers noted that newer prevention and screening methods, such as HPV vaccinations and lung cancer screenings, were not widely utilized during the study period but could further decrease cancer death rates. Enhancing accessibility to screening—such as offering self-collection HPV tests—and innovating new treatment approaches also present opportunities for reducing cancer fatalities.
The authors acknowledged that the five cancers studied account for less than half of all cancer-related deaths, suggesting that the findings may not be applicable to all cancers, especially those without effective prevention, screening, or treatment options.
“We must optimize the deployment of prevention and screening measures for these five cancers so that all Americans benefit, particularly underserved populations, while also innovating new prevention and screening strategies to reduce deaths from extremely lethal cancers like pancreatic and ovarian cancers,” explained co-lead investigator Philip E. Castle, Ph.D., M.P.H., director of NCI’s Division of Cancer Prevention.
The authors also pointed out that the conclusions drawn are based on population averages in the U.S. and may not be applicable to specific groups. Additionally, the study did not evaluate the potential negative effects of interventions, such as false positives or overdiagnosis during screening, nor did it assess other outcomes like quality of life.
