A new report from the American Cancer Society details cancer control efforts and outlines improvements as well as gaps in preventive behavior that contribute to cancer mortality. Increasing rates of obesity observed since the early 1980s appear to have slowed in the past decade, particularly among women and girls, but nearly one in five adolescents and about one in three adults is obese. Vaccination against the virus that causes cervical cancer is up, but smoking declines have stalled. Meanwhile, proven cancer screening tests remain underutilized, particularly in un- and under-insured populations. The report, Cancer Prevention & Early Detection Facts & Figures (CPED), says social, economic, and legislative factors profoundly influence individual health behaviors, and that meeting nationwide prevention goals will require improved collaboration among government agencies, private companies, nonprofit organizations, health care providers, policy makers, and the American public.

Much of the suffering and death from cancer could be prevented by more systematic efforts to reduce tobacco use, improve diet and physical activity,  reduce obesity,  and expand the use of established screening tests. The American Cancer Society estimates that in 2011 about 171,600 cancer deaths will be caused by tobacco use alone. In addition, approximately one-third of the 572,210 cancer deaths expected to occur in 2011 are attributed to poor nutrition, physical inactivity, overweight, and obesity.

Regular use of some established screening tests can prevent the development of cancer through identification and removal or treatment of premalignant abnormalities; screening tests can also improve survival and decrease mortality by detecting cancer at an early stage when treatment is more effective.

The American Cancer Society has published Cancer Prevention & Early Detection Facts & Figures (CPED) annually since 1992 as a resource to strengthen cancer prevention and early detection efforts at the local, state, and national levels. CPED complements the Society’s flagship publication,  Cancer Facts &  Figures,  by disseminating information related to cancer control.  Cancer prevention and early detection are central to the American Cancer Society’s mission and its 2015 goals. The mission of the Society is to save lives from cancer by helping people stay well and get well, by finding cures, and by fighting back.

In 1999, the American Cancer Society set challenge goals for the US that, if met, would substantially lower cancer incidence and mortality rates and would improve the quality of life for all cancer survivors by the year 2015. The Society also has developed nationwide objectives for prevention and early detection that set the framework for achieving the 2015 goals. These objectives can be achieved by improved collaboration among government   agencies,  private   companies,  other   nonprofit organizations,  health care providers,  policy makers,  and the American public.

Social,  economic,  and legislative factors profoundly influence individual health behaviors.  For example,  the price and availability of healthy foods,  the incentives and opportunities for regular   physical   activity   in   schools   and   communities,  the content of advertising aimed at children, and the availability of insurance coverage for screening tests and treatment for tobacco addiction all influence individual choices. These issues not only affect a person’s cancer risk,  but also the risk of other major diseases. The Society has joined forces with the American Heart Association and the American Diabetes Association to identify strategies that will improve prevention and early detection efforts for all of the major chronic diseases in the US.

Public policy and legislation at the federal, state, and local levels can increase access to preventive health services,  including cancer screening. At both the federal and state levels, the Society has advocated for laws requiring insurers to provide coverage for recommended cancer screening in health care plans, such as coverage for the full range of colorectal cancer screening tests.

At the state level,  the Society has spearheaded campaigns to protect nonsmokers from tobacco smoke in public places. These and other community,  policy,  and legislative initiatives are highlighted in this publication.

Since 1992, the American Cancer Society has published CPED as a resource to strengthen cancer prevention and early detection efforts at the local, state, and national levels. Below are highlights of this year’s report.

Tobacco Use

  * Smoking rates in U.S. adults and youth have stalled. Among adults, the smoking rate remained unchanged in the past 6 years (2009: 20.6%). Among high school students, the smoking prevalence did not change significantly between 2003 and 2009 (19.5%), but use of smokeless products is increasing in some groups. Smoking among middle school students also did not change between 2006 and 2009 (5.2%).

  * States’ funding for tobacco control ($517.9 million) in 2011 was the lowest amount allocated since the 1999 Master Settlement Agreement (MSA), with only 2% of states’ revenue from tobacco taxes and the MSA allocated for tobacco control.

  * Federal tobacco control funding to some extent offset declines in states’ funding. Several federal tobacco control initiatives, including U.S. Food and Drug Administration regulations and funding for tobacco control, went into effect in 2010. Provisions for tobacco dependence treatment coverage in the Affordable Care Act for previously uninsured individuals, Medicare, and Medicaid recipients either went into effect in 2010 or will be implemented in upcoming years.

  * As tobacco marketing and sales become more restrictive due to regulations, the industry is moving toward unregulated venues and products. For example, point-of-source advertising and promotions are increasingly being targeted by the industry, as are products such as small cigars that are not subject to the same regulations governing cigarette sales and marketing.