Cite: JAMA Intern Med. Published online February 27, 2023. doi:10.1001/jamainternmed.2023.0015
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Question What is the association of cardiovascular health (CVH) levels, estimated by the American Heart Association’s Life’s Essential 8 score, with life expectancy free of major chronic diseases?
Findings In this cohort study of 135 199 adults from the UK Biobank study, high CVH level was associated with substantially longer life expectancy free of 4 major chronic diseases (cardiovascular disease, diabetes, cancer, and dementia) in both men and women. Furthermore, the disease-free life expectancy was similar between low and other socioeconomic groups among participants with high CVH.
Meaning These findings support improvement in population health by promoting a high CVH level, which may also narrow health disparities associated with socioeconomic status.
Author(s): Xuan Wang, MD, PhD1; Hao Ma, MD, PhD1; Xiang Li, MD, PhD1; et al
Experts have warned that Europe faces a “cancer epidemic” unless urgent action is taken to boost treatment and research, after an estimated 1m diagnoses were missed during the pandemic.
The impact of Covid-19 and the focus on it has exposed “weaknesses” in cancer health systems and in the cancer research landscape across the continent, which, if not addressed as a matter of urgency, will set back cancer outcomes by almost a decade, leading healthcare and scientific experts say.
A report, European Groundshot – Addressing Europe’s Cancer Research Challenges: a Lancet OncologyCommission, brought together a wide range of patient, scientific, and healthcare experts with detailed knowledge of cancer across Europe.
One unintended consequence of the pandemic was the adverse effects that the rapid repurposing of health services and national lockdowns, and their continuing legacy, have had on cancer services, on cancer research, and on patients with cancer, the experts said.
“To emphasise the scale of this problem, we estimate that about 1m cancer diagnoses might have been missed across Europe during the Covid-19 pandemic,” they wrote in The Lancet Oncology. “There is emerging evidence that a higher proportion of patients are diagnosed with later cancer stages compared with pre-pandemic rates as a result of substantial delays in cancer diagnosis and treatment. This cancer stage shift will continue to stress European cancer systems for years to come.
What did this new study show about the effectiveness of colonoscopies?
In this study, about 12,000 people in Sweden, Poland and Norway got colonoscopies. They saw a 31% reduction in their risk of colon cancer and a 50% reduction in their risk of dying from colon cancer compared with people who were not invited to get a colonoscopy.
Was that about what would be expected?
Some US studies have suggested that colonoscopies are even more effective. One study followed nearly 90,000 health care professionals for 22 years. Some of them chose to receive a screening colonoscopy, and some did not. The researchers estimated that screening colonoscopy was associated with a 40% reduction in the risk of getting colon cancer and a 68% reduction in the risk of dying of colon cancer.
Why would there be different success rates in the three European countries compared with the US?
Dominitz says one reason might be that most people in the European study didn’t have sedation when they got their colonoscopies. Only 23% of the patients in the European study received sedation, but virtually everyone having a colonoscopy in the US gets it. Colonoscopies can be uncomfortable, and doctors might, without even realizing it, be less thorough if people are in pain. Thoroughness – getting the scope into the folds and crevices of the colon – is important for finding growths called polyps. The more polyps doctors are able to find, the more they can reduce the person’s risk of being diagnosed with or dying from colon cancer.
John Hancock wants to find out what happens when life insurance insureds get a blood test that might reveal early signs of about 50 different types of cancer.
The Boston-based Manulife subsidiary is working with Munich Re and other reinsurers to offer a pilot program that will pay either 50% or 100% of the cost of Grail’s Galleri cancer screening test for insureds in the John Hancock Vitality wellness program.
John Hancock will not get individual test results for the insureds who use the pilot program, nor will the program results affect the participants’ coverage, premiums or Vitality points.
ProPublica’s analysis of five years of modeled EPA data identified more than 1,000 toxic hot spots across the country and found that an estimated 250,000 people living in them may be exposed to levels of excess cancer risk that the EPA deems unacceptable.
The agency has long collected the information on which our analysis is based. Thousands of facilities nationwide that are considered large sources of toxic air pollution submit a report to the government each year on their chemical emissions.
But the agency has never released this data in a way that allows the public to understand the risks of breathing the air where they live. Using the reports submitted between 2014 and 2018, we calculated the estimated excess cancer risk from industrial sources across the entire country and mapped it all.
The EPA’s threshold for an acceptable level of cancer risk is 1 in 10,000, meaning that of 10,000 people living in an area, there would likely be one additional case of cancer over a lifetime of exposure. But the agency has also said that ideally, Americans’ added level of cancer risk from air pollution should be far lower, 1 in a million. Our map highlights areas where the additional cancer risk is greater than 1 in 100,000 — 10 times lower than the EPA’s threshold, but still high enough to be of concern, experts say.
Author(s): Al Shaw and Lylla Younes, Additional reporting by Ava Kofman
Publication Date: last updated 15 Mar 2022, accessed 16 Mar 2022
Citation: JNCI: Journal of the National Cancer Institute, Volume 113, Issue 12, December 2021, Pages 1648–1669, https://doi.org/10.1093/jnci/djab131
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Overall cancer incidence rates (per 100 000 population) for all ages during 2013-2017 were 487.4 among males and 422.4 among females. During this period, incidence rates remained stable among males but slightly increased in females (AAPC = 0.2%, 95% confidence interval [CI] = 0.1% to 0.2%). Overall cancer death rates (per 100 000 population) during 2014-2018 were 185.5 among males and 133.5 among females. During this period, overall death rates decreased in both males (AAPC = −2.2%, 95% CI = −2.5% to −1.9%) and females (AAPC = −1.7%, 95% CI = −2.1% to −1.4%); death rates decreased for 11 of the 19 most common cancers among males and for 14 of the 20 most common cancers among females, but increased for 5 cancers in each sex. During 2014-2018, the declines in death rates accelerated for lung cancer and melanoma, slowed down for colorectal and female breast cancers, and leveled off for prostate cancer. Among children younger than age 15 years and adolescents and young adults aged 15-39 years, cancer death rates continued to decrease in contrast to the increasing incidence rates. Two-year relative survival for distant-stage skin melanoma was stable for those diagnosed during 2001-2009 but increased by 3.1% (95% CI = 2.8% to 3.5%) per year for those diagnosed during 2009-2014, with comparable trends among males and females.
Conclusions
Cancer death rates in the United States continue to decline overall and for many cancer types, with the decline accelerated for lung cancer and melanoma. For several other major cancers, however, death rates continue to increase or previous declines in rates have slowed or ceased. Moreover, overall incidence rates continue to increase among females, children, and adolescents and young adults. These findings inform efforts related to prevention, early detection, and treatment and for broad and equitable implementation of effective interventions, especially among under resourced populations.
Author(s): Farhad Islami, MD, PhD, Elizabeth M Ward, PhD, Hyuna Sung, PhD, Kathleen A Cronin, PhD, Florence K L Tangka, PhD, Recinda L Sherman, PhD, Jingxuan Zhao, MPH, Robert N Anderson, PhD, S Jane Henley, MSPH, K Robin Yabroff, PhD, Ahmedin Jemal, DVM, PhD, Vicki B Benard, PhD
Publication Date: 8 July 2021
Publication Site: Journal of the National Cancer Institute
As with heart disease, we see improvement at all ages, but the percentage improvement is not as high with cancer as it was with heart disease.
One of the biggest things, though, is how death rates go up by age group. I will use 2020Q1 cause of death rates to make comparisons, as these are in the SOA report, and the COVID impact didn’t come fully until 2020Q2.
Heart disease death rate for those aged 85+ was 3766 per 100K, and those aged 75-84 was 986. That’s a ratio of 3.8.
Cancer deaths for those aged 85+ was 1562 per 100K, and those aged 75-84 was 1004. That’s a ratio of 1.6.
Two things to note:
Cancer death rate for those age 75-84 was higher than the heart disease death rate for the same group
Heart disease death rates climb much more rapidly than cancer death rates by age
During the first wave of the pandemic — from March 15 to May 31 — there was a significant decrease in screening for three major cancers in Ontario compared to the same period in 2019, according to Ontario Health:
A 97 per cent decrease in screening for mammograms through the Ontario Breast Screening Program.
An 88 per cent decrease in Pap tests through the Ontario Cervical Screening Program.
A 73 per cent decrease in fecal tests through ColonCancerCheck.
Alberta Health says the number of Albertans diagnosed with cancer decreased by 23 per cent for the period of March to September 2020 as compared to the same period in 2019.
