In a comprehensive new report published in Cancer Epidemiology, Biomarkers & Prevention, researchers from the American Cancer Society (ACS) have unveiled a complex landscape of cancer-related risk factors and preventive measures among U.S. adults in the wake of the COVID-19 pandemic. While some promising trends, notably a sustained decrease in cigarette smoking and rebounds in certain cancer screenings, were observed, other areas remain concerningly stagnant or even worsening. This mixed progress underscores the critical need for renewed public health strategies to address persistent disparities and overlooked prevention opportunities, particularly in cervical cancer control.
Tobacco use, long recognized as one of the most potent modifiable cancer risks, has continued its historic decline through 2023, with cigarette smoking prevalence dropping to approximately 11%. Yet, this aggregate improvement masks persistent inequities. Elevated smoking rates remain entrenched among American Indian/Alaska Native populations, Black males, individuals with lower educational attainment, and bisexual females—groups that face systemic barriers to cessation support and targeted interventions. Moreover, the use of menthol-flavored cigarettes, which are known to enhance nicotine addiction and impede quitting efforts, remains disproportionately high within Black and bisexual smoker populations, where usage rates exceed two-thirds.
The appeal of flavored tobacco products extends beyond adults, significantly impacting youth tobacco initiation. Nearly 90% of current high school tobacco users reported consuming flavored products, with e-cigarettes and nicotine pouches topping the list. This trend poses a formidable challenge to tobacco control, as flavored products are specifically engineered to increase youth uptake and hinder cessation, ultimately undermining decades of public health progress. The persistence of these patterns emphasizes the urgent need for robust regulatory actions and culturally competent cessation resources tailored to at-risk demographics.
In parallel, cancer screening behaviors revealed a variegated pattern of recovery following pandemic-linked disruptions. Breast cancer screening rates rebounded strongly to surpass pre-pandemic levels, reaching an encouraging 80% of eligible adults by 2023. Likewise, colorectal cancer (CRC) screening demonstrated measurable gains, with 60% overall participation, segmented into 54% colonoscopy and 11% stool-based testing uptake. These improvements reflect enhanced accessibility and possibly greater public awareness catalyzed by ongoing public health initiatives.
However, cervical cancer screening lags notably behind, with only 73% of eligible women up to date as of 2021—figures that have not only stalled but actually continued a decades-long decline since the early 2000s. This persistent underutilization poses significant public health risks, given cervical cancer’s preventability through timely screening and early intervention. The stagnation in cervical screening rates hints at systemic barriers such as limited healthcare access, socioeconomic disparities, and perhaps gaps in patient education or provider recommendation patterns.
Complementing these screening data, the study highlights a concerning stagnation in HPV vaccination uptake. Adolescents aged 13 to 17 years saw no significant increase in vaccination completion between 2021 and 2023, plateauing at around 61%. This arrest of progress disrupts an otherwise upward trajectory noted in prior years and is likely attributable to pandemic-related healthcare disruptions and vaccine access challenges. Considering HPV’s etiological role in numerous cancers beyond cervical—such as oropharyngeal and anal cancers—this trend represents a critical missed opportunity in cancer prevention efforts.
Beyond behavioral factors, the report draws attention to entrenched lifestyle contributors with multifaceted impacts on cancer risk. Rates of excess body weight remain alarmingly high and stable, with approximately 72% of U.S. adults classified as overweight or obese—40% obese and 32% overweight. This prevalence reflects the complex interplay between genetic susceptibility, environmental influences, dietary habits, and physical activity levels. Importantly, the pandemic period did not see meaningful improvements, signaling a need for intensifying obesity prevention and management strategies within cancer control frameworks.
Physical inactivity compounds these risks; less than half of adults met recommended physical activity guidelines in 2022, with a significant subset—approximately 27%—engaging in no leisure-time physical exercise. These patterns have well-established links to increased risks of multiple cancer types, emphasizing that sedentary lifestyles remain a public health priority. Behavioral modifications at both the individual and community levels will be essential to counteract these dimensions of cancer risk.
Alcohol consumption patterns add another layer of complexity. Heavy alcohol use was reported at stable levels (6%) during 2022, mirroring figures from 2020. However, this behavior disproportionately affects middle-aged females of higher socioeconomic status, White racial backgrounds, and bisexual orientation—highlighting the nuanced distribution of risk behaviors across sociodemographic groups. Considering alcohol’s carcinogenic properties, these insights necessitate targeted interventions addressing alcohol reduction as a cancer prevention strategy.
The intertwined nature of these risk factors—smoking, obesity, inactivity, alcohol use—and preventive behaviors—screenings, HPV vaccination—reflects a multifactorial cancer prevention challenge. Approximately 40% of cancer cases in the U.S. are attributable to modifiable risk factors, including seven cancer-causing infections such as HPV, emphasizing the need for integrated, multi-pronged public health solutions.
To address these challenges, the ACS emphasizes strengthening access to preventive services. Cancer screening programs, HPV vaccination initiatives, and comprehensive tobacco cessation support require expansion and equitable distribution to reach historically underserved populations. Moreover, the report underscored the critical role of federal funding and policy support in sustaining preventive efforts, as recent budgetary cuts threaten to undermine hard-won gains in tobacco control and screening outreach.
The report’s authors advocated for legislative measures such as the Screening for Communities to Receive Early and Equitable Needed Services (SCREENS) for Cancer Act, which aims to reauthorize and expand the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). This program is vital for delivering screenings and treatment to low-income, uninsured, and underinsured women—a population disproportionately vulnerable to cancer disparities.
In addition to policy advocacy, tools like ACS’s CancerRisk360 provide personalized risk assessments and actionable prevention tips, helping individuals navigate lifestyle modifications and screening options. Campaigns like “I Love You, Get Screened” encourage conversations about cancer prevention among loved ones, fostering community-driven awareness.
Overall, the ACS report presents a detailed snapshot of recent trends in cancer prevention behaviors and risk factors, revealing encouraging shifts alongside persistent and emerging challenges. Addressing these complex patterns will require coordinated public health initiatives, targeted research, equitable resource allocation, and continued advocacy. Maintaining momentum in tobacco control, reinforcing screening programs, and expanding HPV vaccination are critical pillars to reducing cancer burden and achieving equitable outcomes across diverse populations in the United States.
Subject of Research: Cancer risk factors, preventive behaviors, and screening trends post-COVID-19 pandemic in U.S. adults.
Article Title: Smoking Rates Continue Historic Drop, but Cervical Cancer Prevention is Lagging.
News Publication Date: Not explicitly provided.
Web References:
American Cancer Society: https://www.cancer.org
ACS CancerRisk360: http://acscancerrisk360.cancer.org/
ACS 2024 Cancer Prevention and Early Detection Facts & Figures: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-prevention-and-early-detection-facts-and-figures/2024-cped-files/cped-2024-cff.pdf
Linked journal article: https://doi.org/10.1158/1055-9965.EPI-24-1835
References:
ACS researchers and contributors, report published in Cancer Epidemiology, Biomarkers & Prevention.
Image Credits: American Cancer Society.
Keywords: Cervical cancer, cancer prevention, smoking cessation, HPV vaccination, cancer screening, colorectal cancer, breast cancer, obesity, physical activity, tobacco control, public health disparities.
Tags: American Cancer Society report findingscancer-related preventive measures in the U.S.cervical cancer prevention challengescigarette smoking decline statisticsCOVID-19 impact on cancer screeningsflavored tobacco products usage trendshealth inequities in cancer risk factorsmenthol cigarette addiction issuesnicotine addiction in youthpublic health strategies for cancer preventionsystemic barriers to smoking cessationtobacco use disparities among populations
