Colorectal cancer
Overview
Colorectal cancer is the #2 cancer killer of both men and women in the US. But colorectal cancer is a preventable disease. Colorectal cancer starts with a precancerous polyp (abnormal growth) in the colon, which can be removed without surgery. The US Preventive Services Task Force recommends that adults of average risk begin screening for colorectal cancer at age 50. While screening increases as people get older, national targets for screening have not been met. Adults are likely to get screened when healthcare providers talk to them about their options. Adults ages 50–75 should talk to their doctor about when they should be screened.

People in their early 50s delay getting their first colorectal cancer screening test

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SOURCE: CDC 2018 Behavioral Risk Factor Surveillance System
Many screening test options are available

Issue Details

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Cancer and obesity
Overweight and obesity are associated with cancer
Español (Spanish)


Overview
​Overweight and obesity are associated with at least 13  different types of cancer. These cancers make up 40% of all cancers diagnosed. About 2 in 3 occur in adults 50-74 years old. Most types of these cancers associated with overweight and obesity increased from 2005-2014. More than half of Americans don’t know that overweight and obesity can increase their risk for cancer. Many things are associated with cancer, but avoiding tobacco use and keeping a healthy weight are among the most important things people can do to lower their risk of getting cancer. Some states and communities are providing support that  can help people get to and keep a healthy weight.
Some states and communities are:

  • Supporting comprehensive cancer control programs that focus on cancer prevention, education, screening, quality of care,  and survivorship.
  • Making it easier to choose healthy food options where people live, work, learn, and play.
  • Building communities that make it safer and easier for people to be physically active.
  • Partnering with business and civic leaders to make  community changes that increase healthy eating and  active living.



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Two in three US adults weigh more than recommended.
Overweight and obesity are associated with  at least 13types  of cancer.
More than 630,000 people in the U.S.  are diagnosed with  a cancer associated with overweight  and obesity.

Problem
Obesity is a leading cancer risk factor.What’s happening?

  • A higher proportion of Americans are overweight or have obesity than several decades ago. http://bit.ly/2wViN5Eexternal icon
  • Overweight and obesity can cause changes in the body
    that lead to cancer, such as increases in levels of certain hormones and inflammation.
  • People who weigh more than recommended may increase their risk of some cancers.
  • There are 13 types of cancer associated with overweight and obesity.
  • About 55% of all cancers diagnosed in women and 24% of those diagnosed in men.
  • About 2 in 3 of all cancers occur in adults ages 50 to 74.
  • New cancer cases are higher among blacks and whites compared to other race and ethnic groups.


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What Can Be Done

The Federal government is

  • Funding programs in states and communities to promote healthy eating and physical activity.
  • Studying what works in communities to make it easier for people to be more physically active and have a healthier diet.
  • Measuring trends in cancer, obesity, and related risk factors.
  • Developing and promoting guidelines on the dietary patterns and amounts of physical activity Americans need for good health.
    http://bit.ly/2vFen14external icon,   http://bit.ly/2h4TWUJexternal icon


Some states and communities are

  • Supporting comprehensive cancer control programs that focus on cancer prevention, education, screening, quality of care, and survivorship.
  • Making it easier to choose healthy food options where people live, work, learn, and play.
  • Building communities that make it safer and easier for people to be physically active making it easier to choose healthy food options where people live, work, learn, and play.
  • Partnering with business and civic leaders to make community changes that increase healthy eating and active living.


Healthcare providers can

  • Measure patients’ weight, height, and body mass index, and counsel them on keeping a healthy weight and its role in cancer prevention. http://bit.ly/2vQCzhRexternal icon
  • Refer patients with obesity to intensive programs that include a variety of activities
    to help people manage their weight.
  • Connect patients and families with community services to help them have easier access to healthy food and ways to be active.


Everyone can

  • Eat a healthy diet by following the 2015-2020 Dietary Guidelines for Americans.
    http://bit.ly/2vFen14external icon
  • Do at least 150 minutes of moderate intensity physical activity, such as brisk walking, every week. http://bit.ly/2h4TWUJexternal icon
  • Talk to their healthcare provider about losing weight or maintaining a healthy weight.
  • Get involved in community efforts to improve options for healthier foods and physical activity.
  • Lose weight, if they weigh more than recommended, to help reduce risk for some cancers and other chronic diseases.


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Cancer and Tobacco Use
​Tobacco use causes many cancers
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Overview

Tobacco use is the leading preventable cause of cancer and cancer deaths. It can cause not only lung cancer — but also cancers of the mouth and throat, voice box, esophagus, stomach, kidney, pancreas, liver, bladder, cervix, colon and rectum, and a type of leukemia. Each year, 660,000 people in the US are diagnosed with and 343,000 people die from a cancer related to tobacco use. We have made progress: more than 1 million tobacco-related cancer deaths have been avoided since 1990 because of comprehensive cancer and tobacco control programs, early detection of cancer, and improvements in cancer treatment. However, not all states or all people have experienced the benefits of these efforts. When states make greater and longer investments in comprehensive cancer and tobacco control programs, fewer people use tobacco and get or die from tobacco-related cancers.
States and communities can:

  • Support comprehensive cancer control programs focusing on cancer prevention, education, screening, access to care, support for cancer survivors, and good health for all.
  • Fund comprehensive tobacco prevention and control programs at CDC-recommended levels.
  • Make tobacco cessation treatments more available to people who want to quit.
  • Protect nonsmokers from secondhand smoke in all indoor public places and worksites, including all restaurants, bars, and casinos.


Tobacco use causes at least 12 types of cancer.
Cancers linked to tobacco use make up 40% of all cancers diagnosed.
Cigarette smoking causes 3 in 10 of all cancer deaths.

Problem

People are still dying from cancers caused by tobacco use.

People who use tobacco or are exposed to secondhand smoke are more likely to get and die from cancer.

  • Tobacco smoke has at least 70 chemicals that cause cancer, also known as carcinogens.
  • Lung and colorectal cancers make up more than half of all cancers linked to tobacco use.
  • Secondhand smoke exposure causes about 7,300 lung cancer deaths among nonsmoking adults each year.


Tobacco use is the leading preventable cause of cancer and cancer deaths.

  • About 3 in 10 cancer deaths are caused by cigarette smoking. Lung cancer is the leading cause of cancer death for both men and women.
  • Quitting tobacco use at any age can reduce the risk of getting or dying from cancer.
  • Getting screened for cancer can lead to fewer people getting or dying from some tobacco-related cancers (cervix, colorectal, and lung).



SOURCE: CDC Vital Signs, November, 2016
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SOURCE: CDC Vital Signs, November, 2016

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​What Can Be Done

The Federal government is

  • Requiring most insurance plans to cover recommended cancer screenings, vaccinations, as well as counseling and medications to help people quit tobacco use at no cost to the patient through the Affordable Care Act.
  • Funding state tobacco and cancer prevention and control programs to help reduce the number of people who get cancer caused by tobacco use.
  • Funding programs that increase cervical and colorectal cancer screening rates.
  • Regulating manufacturing, marketing, and distribution of tobacco products.
  • Encouraging smokefree places that protect nonsmokers from secondhand smoke.
  • Funding and promoting educational campaigns about tobacco use, information, and proven resources to help people quit tobacco use.


States and communities can

  • Support comprehensive cancer control programs focusing on cancer prevention, education, screening, access to care, support for cancer survivors, and good health for all. www.cdc.gov/cancer/ncccp
  • Fund comprehensive tobacco prevention and control programs at CDC-recommended levels. www.cdc.gov/tobacco/stateandcommunity/best_practices
  • Make tobacco cessation treatments more available to people who want to quit.
  • Protect nonsmokers from secondhand smoke in all indoor public places and worksites, including all restaurants, bars, and casinos.


Healthcare providers can

  • Ask all patients whether they use tobacco products, advise those who do not use them not to start, encourage those who do to quit, and provide help with quitting.
  • Help patients understand what cancer screening tests are needed and are best for them. Make sure their patients are screened on time.
  • Let patients know that there is no risk-free level of exposure to secondhand smoke and advise them to avoid it.
  • Know which screening and counseling services are reimbursable to their practice.


Everyone can

  • Quit using tobacco or never start. Quitting at any age will help you avoid getting cancer. Ask a healthcare provider for help quitting and call 1-800-QUIT-NOW or go to www.smokefree.govexternal icon for free assistance.
  • Encourage friends, family, and coworkers to quit using tobacco.
  • Teach children and adolescents about the health risks of tobacco use and secondhand smoke exposure.
  • Make their home and vehicle 100% tobacco free and not allow anyone to use any tobacco products around children.
  • Learn what cancer screening tests and vaccines are right for them and their family.


Issue Details

Preventing Melanoma
Communities Play a Vital Role
Español (Spanish)

Skin cancer is the most common form of cancer in the US. In 2011, there were more than 65,000 cases of melanoma, the most deadly form of skin cancer. Melanoma can spread to other parts of the body and causes over 9,000 deaths every year. People who die of melanoma lose an average of 20 years of life expectancy. Melanoma can be caused by too much exposure to ultraviolet (UV) rays from sun or sources such as indoor tanning. Without additional prevention efforts, melanoma will continue to increase in the next 15 years. Communities and policy makers play a major role in these skin cancer prevention efforts.

Communities and policymakers can:

  • Increase shade at playgrounds, public pools, and other public spaces.
  • Promote sun protection in recreation areas, including the use or purchase of hats, sunscreen, and sunglasses.
  • Encourage employers, childcare centers, schools, and colleges to educate employees and students about sun safety and skin protection.
  • Restrict the availability and use of indoor tanning by minors.



Problem

Melanoma is increasing.Melanoma skin cancer is common and costly.

  • People of any skin color can get skin cancer and people with lighter skin are at higher risk.
  • More than 65,000 melanoma skin cancers were diagnosed in the US in 2011.
  • Melanoma can be disfiguring and even deadly; deaths increase with age and are higher for men than women.
  • The annual cost for treating melanoma has grown faster than the annual treatment costs for all cancers combined.
  • The annual cost of treating new melanoma patients is projected to triple from 2011 through 2030 (from $457 million to $1.6 billion).
  • Using proven community skin cancer prevention programs could prevent an estimated 21,000 melanomas and save $250 million per year by 2030.


UV exposure causes more than 90% of melanomas in the US.

  • Tans and sunburns are the body’s response to damage from UV exposure. A tan is a sign of damaged skin.
  • More than 1 in 3 Americans report getting sunburned every year.
  • Indoor tanning exposes people to more intense UV rays than the sun. About 6,200 melanomas are estimated to be caused each year by indoor tanning.
  • Nearly 1 of 3 young non-Hispanic white women ages 16–25 uses indoor tanning each year.



Source: CDC Vital Signs, Morbidity and Mortality Weekly Report, June 2015.
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What Can Be Done
​
Federal government is

  • Requiring most health plans to cover recommended skin cancer prevention counseling at no out-of-pocket cost (such as co-pays or deductibles) through the Affordable Care Act.
  • Requiring indoor tanning equipment to:
    • Meet special requirements for how these devices are designed and made.
    • Carry visible warning: people under age 18 should not use the device.
    • Include warning statements in marketing materials about the risk of using the device.


Health care provider recommendations for skin cancer counselingThe US Preventive Services Task ForceExternalExternal recommends that doctors and other health care providers counsel people ages 10–24 with fair skin about the dangers of UV rays and how to prevent skin cancer.

Communities and policymakers can

  • Increase shade at playgrounds, public pools, and other public spaces.
  • Promote sun protection in recreation areas, including the use or purchase of hats, sunscreen, and sunglasses.
  • Encourage employers, childcare centers, schools, and colleges to educate employees and students about sun safety and skin protection.
  • Restrict the availability and use of indoor tanning by minors.


Employers, childcare centers,schools, and colleges can

  • Provide sun protection such as shade structures, sunscreen, and protective clothing for students and employees.
  • Change policies that restrict sun protection, including school bans on wearing hats outdoors.
  • Protect workers and students by scheduling activities before or after midday hours.
  • Relocate activities and provide structures to increase shade when possible.
  • Discourage indoor tanning and restrict its use on campuses.


Everyone can

  • Understand that tanned skin is damaged skin.
  • Protect themselves and their families by:
    • Wearing a wide-brimmed hat, sunglasses, and protective clothing outdoors.
    • Finding shade, especially during midday hours.
    • Using broad-spectrum sunscreen with SPF 15 or higher, even on cloudy days. SunscreenExternal is most effective when used with other sun protection and reapplied as directed.
  • Avoid sunbathing and indoor tanning.


The Guide to Community Preventive ServicesExternal
 recommends community-wide programs that combine education, mass media campaigns, and policy changes to increase skin protection.
Science Behind the Issue


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Cervical Cancer is Preventable
Español (Spanish)

November 2014
4,000

More than 4,000 women die of cervical cancer each year.
93%
As many as 93% of cervical cancers could be prevented by screening and HPV (human papillomavirus) vaccination.
8 Million
In 2012, 8 million US women ages 21 to 65 reported they had not been screened for cervical cancer in the last 5 years.


More than 12,000 women get cervical cancer every year. Up to 93% of cervical cancers are preventable. Human papillomavirus (HPV) vaccination helps prevent infection with the HPV types that cause most cervical cancers. The Papanicolaou (Pap) test screens for abnormal cells that may develop into cancer and the HPV test screens for the HPV virus that causes these cell changes. Even though screening works, 10% of women in the US in 2012 reported they had not been screened in the last 5 years. Every visit to doctors and nurses is an opportunity to discuss cervical cancer prevention. No woman should die of cervical cancer.

Doctors, nurses, and health systems can:

  • Help women understand what screening tests are best for them and when they should get screened.
  • Screen or refer all women as recommended at any visit.
  • Make sure patients get their screening results and the right follow-up care quickly.
  • Use reminder-recall systems to help doctors, nurses, and patients remember when screening and HPV vaccination are due.
  • Strongly recommend that preteens and teens get vaccinated against HPV.



Problem

Too many women have not been screened.To prevent more deaths, screening efforts must continue.

  • Widespread use of the Pap test led to dramatic declines in deaths from cervical cancer. Deaths from cervical cancer did not continue to decrease in the US from 2007 to 2011.
  • The percentage of women screened decreased slightly from 2008 to 2010. The HPV vaccine can reduce risk of cervical cancer.
  • HPV causes most cervical cancers.
  • Only 1 in 3 girls and 1 in 7 boys had received the recommended 3 doses of the HPV vaccine in 2013.
  • Adolescents are not getting HPV vaccination as often as other recommended vaccines, even though it is safe and effective.


Almost there: fewer missed opportunities can help get women ages 21 to 65 screened.

  • More than 50% of all new cervical cancers are in women who have never been screened or have not been screened in the previous 5 years of their lives.
  • About 7 in 10 women who have not been screened in the last 5 years have a regular doctor and had health insurance.



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View larger image and read text description.
 View larger image and read text description.

​What Can Be Done

Federal government is

  • Through the Affordable Care Act:
    • Ensuring that most health plans cover cervical cancer screening as recommended at no additional cost to the patient.
    • Ensuring that most health plans cover HPV vaccination as recommended for males and females at no additional cost to the patient.
    • Helping people sign up for insurance coverage offered in the Health Insurance Marketplace.
    • Investing in community health centers to expand women’s access to health care services.
  • Increasing access to immunizations through the Vaccines for Children (VFC) program.
  • Supporting federal programs that increase cervical cancer screening rates. National Breast and Cervical Cancer Early Detection Program, Title X Family Planningexternal icon


Doctors, nurses, and health systems can

  • Help women understand which screening tests are best for them and when to get them.
  • Screen or refer all women as recommended at any visit.
  • Make sure patients get their screening results and the right follow-up care quickly.
  • Use reminder-recall systems to help doctors, nurses, and patients remember when screening and HPV vaccination are due.
  • Strongly recommend that preteens and teens get vaccinated against HPV.


Women can

  • Learn about screening options and get the test that is right for them and follow-up on any abnormal results.
  • Encourage other women to be screened for cervical cancer.
  • Contact their local health department to learn how they can get screened for cervical cancer.
  • Use every health care visit to ask if it’s time to get screened.
  • Get their sons and daughters vaccinated against HPV as recommended.


State and local public health can

  • Encourage women to get screened by working with state Medicaid programs, community health centers, and community-based groups.
  • Help women get screened, get medical appointments, and get treated as needed.
  • Promote reminder-recall systems for screening and HPV vaccination.
  • Promote recommended screening options and HPV vaccines to the public.

 
Science Behind the Issue


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