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A new study led by researchers at the National Institutes of Health (NIH) reveals that advances in cancer prevention and screening have played a larger role in reducing deaths from five major cancers over the past 45 years than improvements in treatment. Published in JAMA Oncology on December 5, 2024, the study highlights the significant impact of prevention strategies like smoking cessation and early detection methods on saving lives.
The study focused on breast, cervical, colorectal, lung, and prostate cancers—some of the most common causes of cancer death. Researchers found that, from 1975 to 2020, a total of 5.94 million deaths were averted due to a combination of prevention, screening, and treatment. However, 80% of these deaths were prevented through advances in prevention and screening, rather than treatment.
“Although many people may believe that treatment advances are the major driver of reductions in mortality from these five cancers combined, the surprise here is how much prevention and screening contribute to reductions in mortality,” said Katrina A. B. Goddard, Ph.D., co-lead investigator and director of NCI’s Division of Cancer Control and Population Sciences.
The study reveals that smoking cessation efforts, which contributed significantly to lung cancer prevention, were responsible for 3.45 million of the deaths averted. Other key prevention and screening strategies, such as mammography for breast cancer and HPV testing for cervical cancer, also made substantial contributions to reducing mortality.
The findings indicate that, for certain cancers, prevention and screening have been more effective than treatment advances. For example, cervical cancer deaths were almost entirely prevented by screening programs, while lung cancer deaths were primarily a result of tobacco control efforts. In contrast, breast cancer deaths were more impacted by treatment innovations, with mammography screening also playing a role.
For colorectal cancer, most of the deaths averted were due to screening and the removal of precancerous polyps. In prostate cancer, PSA testing and treatment advances worked in tandem to reduce mortality.
While the study focused on cancers with available prevention and screening strategies, researchers stress that there is still work to be done. “To reduce cancer death rates, it’s critical that we combine effective strategies in prevention and screening with advances in treatment,” said W. Kimryn Rathmell, M.D., Ph.D., director of the NIH’s National Cancer Institute.
The study also points to future opportunities for reducing cancer deaths. Recent innovations like HPV vaccination and lung cancer screening could further enhance survival rates, while making screening more accessible to underserved populations could help close existing gaps in health equity.
However, the study’s authors caution that the results are based on population averages and may not apply to all demographic groups. They also acknowledge the limitations of the study, including the potential harms of screening such as false positives and overdiagnosis, and the need for further research into the effectiveness of interventions for other lethal cancers like those of the pancreas and ovary.
As researchers continue to develop and refine prevention, screening, and treatment strategies, the goal remains clear: to reduce cancer deaths through a multifaceted approach that includes both technological advancements and widespread access to lifesaving interventions.
For more information, refer to the study, “Estimation of Cancer Deaths Averted From Prevention, Screening, and Treatment Efforts, 1975-2020,” published in JAMA Oncology (2024).
