Last year, there were an estimated 61,170 new cancer cases in Georgia, according to ACS.
The COVID-19 pandemic caused delays in cancer diagnosis and treatment as many missed cancer screenings. While experts say that could potentially lead to cancers being diagnosed at a more advanced stage, and ultimately more people dying from cancer, authors of the report said the impact is not yet clear and will be answered “gradually over many years.”
Lung cancer remains the No. 1 leading cause of cancer death overall among Georgians. Reduced smoking rates, earlier screening, and advances in treatment have helped improve the survival rates for lung cancer, extending the life for many people with this disease.
Colon cancer, which was once a more distant cause of cancer death in both men and women, is now a leading cause of cancer death for men and women under 50. It ranks first for men under 50, and second for women under 50. The rapid rise in colon cancer deaths is puzzling because the rate of colon cancer has been dropping among older adults, likely due to more people being screened with colonoscopies and lower rates of smoking.
Experts don’t know what’s causing the jump in cases among younger adults but some risk factors including obesity and a lack of physical activity could be playing a role.
“I don’t think we know why we’re seeing an uptick in colorectal cancer,” said Dr. Walter Curran, who last week joined Piedmont Healthcare as chief of the Piedmont Oncology Institute. He called the study “a remarkable document.”
“I’m sure once this is out, it’s going to put additional pressure on the need for early screening,” he said. “You know, at what age should men and women get colonoscopy and with what frequency?” He said researchers need to dig into the cancer data to understand the role family history or a history of obesity may play.
The U.S. Preventive Services Task Force recommends that most people should start colorectal cancer screening by 45. But if you have a close relative who was diagnosed with this cancer, screening should start at 40 — or 10 years before the immediate family member was diagnosed. For example, someone whose parent was diagnosed with colon cancer at 42 should begin their own screenings at age 32.
Dr. Ahmedin Jemal, senior vice president of surveillance and health equity science at the American Cancer Society and senior author of the study, said at a press conference that more screening of adults in their 40s is key to reversing this trajectory. He said ACS research found about one-third of adults diagnosed before 50 have a family history or genetic predisposition to colon cancer, adding that these people should begin screening before age 45.
The ACS researchers projected number of new cancer diagnoses in the U.S. for 2024 will top 2 million (2,001,140) for the first time. For the report, researchers compiled the most recent data on population-based cancer occurrence and outcomes using incidence data collected by central cancer registries through 2020 and mortality data collected by the National Center for Health Statistics through 2021.
Dr. William Dahut said better screening may be playing some role in diagnosing more cancers but other factors, especially rising obesity rates, are likely driving the rise in cancer. Liver cancer, for example, is on the rise but is not picked up by routine screenings.
“Some of this may be a window into what’s happening with the obesity epidemic,” said Dahut, who said obesity is clearly linked to many types of cancer including postmenopausal breast cancer, colon cancer and kidney cancer. “Cancer is driven by obesity.”
Other highlights from the ACS report include the following:
—Cervical cancer incidence rates are decreasing steeply in women in their 20s, who were first to receive the human papilloma virus (HPV) vaccine, but have increased in women 30-44 years old by 1.7% per year from 2012 through 2019, highlighting the need for more emphasis on screening in young women, as well as broader uptake of the vaccine, according to the report. In 2022, HPV vaccination coverage in adolescents 13-17 years ranged from 39% in Mississippi to 85% in Rhode Island. In Georgia, 62% of girls in this age range received all recommended doses of the vaccine.
–Mortality rates continue to increase by 2% per year for uterine corpus (endometrial) cancer, one of the few cancers with increasing mortality. Steeper increases in women of color are widening racial disparities, with the death rate now two times higher in Black women (9.1 per 100,000) than in White women (4.6 per 100,000).
–Cancer patients are getting younger: the proportion of diagnoses in people who are middle-aged (50-64 years) increased from 25% in 1995 to 30% in 2019-2020, whereas the proportion 65 years and older decreased from 61% to 58%, despite both age groups growing in the general population (from 13% to 19% for ages 50-64 years and from 13% to 17% for ages 65 and older).
– Racial disparities persist. Compared to white people, mortality rates are two‐fold higher for prostate, stomach, and endometrial cancers in Black people.
That is a significant point in the report, Curran said. Some of the disparities point to worse access to health care among Black people, he said.
About half of Georgia counties have no ob/gyn, according to state data. Ultimately, the right care for women with uterine or endometrial cancer often boils down to getting diagnosed, getting surgery, and getting that surgery early enough, Curran said. This data suggests that’s disproportionately not happening for Black women, he said.
”So most of this is access to screening, access to medical care, diagnosis at a later stage,” Curran said.
In the U.S., one in two men and one in three women will develop cancer in their lifetime.
Dr. Guilherme Cantuaria, an oncologist with Northside Hospital Cancer Institute said we need to better understand why people develop cancer and to develop more effective treatments — cancer drugs that are more effective, cheaper, and less toxic with fewer side effects.
“People will read this report and think we’ve got all these new drugs and we are doing extremely well. We fail to mention, that these drugs are targeted drugs with precision oncology and immunotherapy. I am all for them. I use all of them. But they have had a limited impact. They don’t work with every cancer,” Cantuaria said.
Dr. William Dahut, chief scientific officer at the American Cancer Society, said 42% of cancers are preventable with key risk factors including cigarette smoking, excess body weight, eating red and processed meat and too little fruits and vegetables, and being sedentary.
“Exercise alone will save lives,” said Dahut. “Getting out of your chair and walking around the room for five minutes every hour is important.”