Improvements in cancer prevention and screening have averted more deaths from five cancer types combined over the past 45 years than treatment advances, according to a modeling study led by researchers at the National Institutes of Health (NIH).
The study, published December 5, 2024, in JAMA Oncology, looked at deaths from breast, cervical, colorectal, lung, and prostate cancer that were averted by the combination of prevention, screening, and treatment advances. The researchers focused on these five cancers because they are among the most common causes of cancer deaths and strategies exist for their prevention, early detection, and/or treatment. In recent years, these five cancers have made up nearly half of all new cancer diagnoses and deaths.
A single prevention intervention, smoking cessation, contributed the lion’s share of the deaths averted: 3.45 million from lung cancer alone. When considering each cancer site individually, prevention and screening accounted for most deaths averted for cervical, colorectal, lung, and prostate cancer, whereas treatment advances accounted for most deaths averted from breast cancer.
The researchers used statistical models and cancer mortality data to estimate the relative contributions of prevention, screening, and treatment advances to deaths averted from breast, cervical, colorectal, lung, and prostate cancers between 1975 and 2020.
In total, the modeling showed, 5.94 million deaths were averted from these five cancers between 1975 and 2020. Of these, prevention and screening interventions accounted for 4.75 million, or 80%, of the averted deaths.
The individual contributions of prevention, screening, and treatment varied by cancer site:
- In breast cancer, 1 million deaths (out of 2.71 million that would have occurred in the absence of all interventions) were averted from 1975 to 2020, with treatment advances contributing to three-quarters of the deaths averted and mammography screening contributing to the rest.
- In lung cancer, prevention through tobacco control efforts accounted for 98% of the 3.45 million deaths averted (out of 9.2 million), and treatment advances accounted for the rest.
- In cervical cancer, the 160,000 deaths averted (out of 370,000) were entirely through cervical cancer screening (i.e., Pap and HPV, or human papillomavirus, testing) and removal of precancerous lesions.
- In colorectal cancer, of the 940,000 deaths averted (out of 3.45 million), 79% were due to screening and removal of precancerous polyps, with treatment advances accounting for the remaining 21%.
- In prostate cancer, of the 360,000 deaths averted (out of 1.01 million), screening via PSA testing contributed 56% and treatment advances contributed 44%.
