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Research & Evidence
An estimated 42% of all cancer cases and nearly one-half of all cancer deaths in the United States in 2014 were attributable to evaluated risk factors, many of which could have been mitigated by effective preventive strategies.
Proportion and Number of Cancer Cases and Deaths Attributable to Potentially Modifiable Risk Factors in the United States
CA: A Cancer Journal for Clinicians
Drope, J., Cahn, Z., Kennedy, R., Liber, A. C., Stoklosa, M., Henson, R., Douglas, C. E. and Drope, J. "Key issues surrounding the health impacts of electronic nicotine delivery systems (ENDS) and other sources of nicotine." CA: A Cancer Journal for Clinicians, September 29, 2017.
Over the last decade, the use of electronic nicotine delivery systems (ENDS), including the electronic cigarette or e-cigarette, has grown rapidly. More youth now use ENDS than any tobacco product. This extensive research review shows that there are scientifically sound, sometimes competing arguments about ENDS that are not immediately and/or completely resolvable. However, the preponderance of the scientific evidence to date suggests that current-generation ENDS products are demonstrably less harmful than combustible tobacco products such as conventional cigarettes in several key ways, including by generating far lower levels of carcinogens and other toxic compounds than combustible products or those that contain tobacco. To place ENDS in context, the authors begin by reviewing the trends in use of major nicotine-containing products. Because nicotine is the common core—and highly addictive—constituent across all tobacco products, its toxicology is examined. With its long history as the only nicotine product widely accepted as being relatively safe, nicotine-replacement therapy (NRT) is also examined. A section is also included that examines snus, the most debated potential harm-reduction product before ENDS. Between discussions of NRT and snus, ENDS are extensively examined: what they are, knowledge about their level of “harm,” their relationship to smoking cessation, the so-called gateway effect, and dual use/poly-use.
"AACR Cancer Progress Report." Philadelphia: American Association for Cancer Research, September 13, 2017.
With the number of cancer cases diagnosed in the United States rising every year, it is vital that the AACR increases public awareness about cancer and the importance of research for improving health and saving lives from cancer. The annual AACR Cancer Progress Report is a cornerstone of these educational efforts and the AACR’s work to advocate for increased funding for the federal agencies that are vital for fueling progress against cancer— in particular, the National Institutes of Health (NIH), the National Cancer Institute (NCI), and the Food and Drug Administration (FDA).
The Report is released in September of each year and highlights advances over the past 12 months in the prevention, detection, diagnosis, and treatment of cancer. It also includes the personal experiences of cancer survivors who have benefited from these advances. Together with the developments described in the report, these survivor stories provide hope for a much brighter future for cancer patients and their loved ones.
Scott Gottlieb, M.D., and Mitchell Zeller, J.D. "A Nicotine-Focused Framework for Public Health." New England Journal of Medicine, August 6, 2017.
Despite extraordinary progress in tobacco control and prevention, tobacco use remains the leading cause of preventable disease and death in the United States. Combustible cigarettes cause the overwhelming majority of tobacco-related disease and are responsible for more than 480,000 U.S. deaths each year. Indeed, when used as intended, combustible cigarettes kill half of all long-term users.
Hines, Jonas Z. MD ; Steven C. Fiala, MPH ; Katrina Hedberg, MD. "Electronic Cigarettes as an Introductory Tobacco Product Among Eighth and 11th Grade Tobacco Users — Oregon, 2015." CDC Morbidity and Mortality Weekly Report (MMWR), June 16, 2017.
During 2011–2015, increased electronic cigarette (e-cigarette) and hookah use offset declines in cigarette and other tobacco product use among youths (persons aged <18 years)
Maura L. Gillison, Tatevik Broutian, Barry Graubard, Robert Pickard, Zhen-Yue Tong, Weihong Xiao, Lisa Kahle, Anil Chaturvedi; Ohio State University, Columbus, OH; National Cancer Institute, Rockville, MD; The Ohio State University, Columbus, OH; Informat. "Impact of HPV vaccination on oral HPV infections among young adults in the U.S.." Meeting Library, ASCO University, June 5, 2017.
The incidence of HPV-positive oropharyngeal cancers has risen in recent decades among US men. The potential impact of HPV vaccines on oral HPV infections has yet to be evaluated in efficacy-trials or surveillance studies.
HPV vaccination substantially reduced vaccine-type oral HPV infection prevalence among young adults (ages 18-33 years) in the US population during 2011-2014. However, due to low vaccine uptake, population-level effectiveness was modest overall and particularly low in men.
Ralph S. Caraballo, PhD ; Paul R. Shafer, MA ; Deesha Patel ; Kevin C. Davis, MA ; Timothy A. McAfee, MD. "Quit Methods Used by US Adult Cigarette Smokers, 2014–2016." Centers for Disease Control and Prevention, April 13, 2017.
Quitting cigarette smoking greatly reduces the risk of developing smoking-related diseases; although the health benefits are greater for people who stop at earlier ages, there are benefits at any age (1). The use of electronic cigarettes (e-cigarettes) has increased in the United States (2). Little is known about how the rise in e-cigarette use, particularly among current and former adult cigarette smokers, may have affected quitting behaviors. This study assessed common methods used to try to quit cigarettes among a nationally representative online sample of US adult current smokers surveyed from April 2014 through June 2016.
Commissioned by Bristol-Myers Squibb. "Cancer in the Workplace." The Economist Intelligence Unit , February 17, 2017.
The impact of cancer looks set to continue to grow for organisations in the decades ahead. Experts predict continued growth in the numbers of the working population affected by cancer as populations age and earlier diagnosis and better treatment of the disease lead to improved survival rates. If employers are to continue to provide an environment in which they can attract and retain talented staff, they must take action.
Dutra, Lauren M.; Stanton A. Glantz, Nadra E. Lisha, Anna V. Song. "Beyond experimentation: Five trajectories of cigarette smoking in a longitudinal sample of youth." February 9, 2017.
The first goal of this study was to identify the most appropriate measure of cigarette smoking for identifying unique smoking trajectories among adolescents; the second goal was to describe the resulting trajectories and their characteristics.
Tobacco-induced disease remains the leading preventable cause of death in the United States, with minorities bearing a disproportionate burden of the disease burden. Because 80% of adult smokers begin smoking before age 18, tobacco control efforts often focus on preventing adolescents from smoking their first cigarette. However, only one-third of youth who experiment with cigarettes ever become regular smokers. As a result, these programs miss a key opportunity to prevent the transition from experimentation to established smoking, which may occur in the mid-to-late 20s. In combination with growing recognition that young adulthood (ages 18 to 25) is a critical period of vulnerability, particularly due to significant life changes such as starting college, separating smokers into different trajectories (patterns of smoking) and identifying when escalation and de-escalation occurs can inform efforts to prevent transition to regular smoking.
"Cancer Facts and Figures 2017." American Cancer Society, January 2017.
Estimated numbers of new cancer cases for 2017, excluding basal cell and squamous cell skin cancers and in situ carcinomas except urinary bladder.
Estimates are not available for Puerto Rico.
Note: State estimates are offered as a rough guide and should be interpreted with caution. State estimates may not add to US total due to rounding.
Elissa Meites, MD; Allison Kempe, MD; Lauri E. Markowitz, MD. "Use of a 2-Dose Schedule for Human Papillomavirus Vaccination — Updated Recommendations of the Advisory Committee on Immunization Practices." Centers for Disease Control and Prevention, December 16, 2016.
This report provides recommendations and guidance regarding use of HPV vaccines and updates ACIP HPV vaccination recommendations previously published in 2014 and 2015
"E-cigarette use among youth and young adults : a report of the Surgeon General.." U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, December 8, 2016.
This report confirms that the use of electronic cigarettes (or e-cigarettes) is growing rapidly among American youth and young adults. While these products are novel, we know they contain harmful ingredients that are dangerous to youth. Important strides have been made over the past several decades in reducing conventional cigarette smoking among youth and young adults. We must make sure this progress is not compromised by the initiation and use of new tobacco products, such as e-cigarettes.
Maki Inoue-Choi, PhD, MS; Linda M. Liao, PhD, MPH; Carolyn Reyes-Guzman, PhD, MPH; Patricia Hartge, ScD; Neil Caporaso, MD; Neal D. Freedman, PhD, MPH. "Association of Long-term, Low-Intensity Smoking With All-Cause and Cause-Specific Mortality in the National Institutes of Health–AARP Diet and Health Study." JAMA Internal Medicine, December 5, 2016.
A growing proportion of US smokers now smoke fewer than 10 cigarettes per day (CPD), and that proportion will likely rise in the future. The health effects of smoking only a few CPD over one’s lifetime are less understood than are the effects of heavier smoking, although many smokers believe that their level is modest.
Berko, Jeff MPH; Goetzel, Ron Z. PhD; Roemer, Enid Chung PhD; Kent, Karen MPH; Marchibroda, Janet MBA. "Results From the Bipartisan Policy Center's CEO Council Physical Activity Challenge to American Business." Journal of Occupational & Environmental Medicine, December 2016.
Physical inactivity is a major public health threat: inactive adults are at an elevated risk of early death, heart disease, stroke, type 2 diabetes, and depression. Despite these dire consequences, fewer than half of American adults meet the recommended guidelines for daily physical activity. Sedentary jobs contribute to this problem, but the workplace also presents an opportunity for intervention.
Bergouignan, Audrey , Kristina T. Legget, Nathan De Jong, Elizabeth Kealey, Janet Nikolovski, Jack L. Groppel, Chris Jordan, Raphaela O’Day, James O. Hill and Daniel H. Bessesen. "Effect of frequent interruptions of prolonged sitting on self-perceived levels of energy, mood, food cravings and cognitive function." International Journal of Behavioral Nutrition and Physical Activity, November 3, 2016.
While physical activity has been shown to improve cognitive performance and well-being, office workers are essentially sedentary. We compared the effects of physical activity performed as (i) one bout in the morning or (ii) as microbouts spread out across the day to (iii) a day spent sitting, on mood and energy levels and cognitive function.
Song, Mingyang, MD, ScD; Edward Giovannucci, MD, ScD. "Preventable Incidence and Mortality of Carcinoma Associated With Lifestyle Factors Among White Adults in the United States." JAMA Oncology, September 1, 2016.
Lifestyle factors are important for cancer development. However, a recent study has been interpreted to suggest that random mutations during stem cell divisions are the major contributor to human cancer.
Conclusions and Relevance: A substantial cancer burden may be prevented through lifestyle modification. Primary prevention should remain a priority for cancer control.