Almost half of cancer deaths are preventable

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Deaths due to preventable factors

A new study has revealed that smoking, being overweight, abusing alcohol, and other risk factors are responsible for almost half of all cancer deaths worldwide

Nearly half of deaths due to cancer can be linked to preventable risk factors, including the three leading risks: smoking, abusing alcohol consumption or having a high body mass index

The research was published Thursday in The Lancet journal and revealed that 44.4 percent of all cancer deaths and 42 percent of healthy years lost could be attributable to risk factors that can be prevented.

"To our knowledge, this study represents the largest effort to date to determine the global burden of cancer attributable to risk factors, and it contributes to a growing body of evidence aimed at estimating the risk-attributable burden for specific cancers nationally, internationally, and globally," Dr. Chris Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington, and his colleagues wrote in the study.

The research analyzed the link between risk factors and cancer, the second leading cause of death globally, using information from the Institute for Health Metrics and Evaluation's Global Burden of Disease project.

It collects and analyzes global data on disability and deaths. Murray and his colleagues zeroed in on cancer deaths and disability across 204 countries from 2010 to 2019 and examined 23 cancer types and 34 risk factors.

Tracheal, bronchus and lung cancer for both men and women are the leading cancers in terms of risk-attributable deaths globally in 2019, the researchers found.

The data revealed that risk-attributable cancer deaths are mounting, as they increased by 20.4 percent worldwide from 2010 to 2019. In 2019, the leading five regions in terms of risk-attributable death rates were central Europe, North America, East Asia, Western Europe, and southern Latin America.

"These findings highlight that a substantial proportion of cancer burden globally has potential for prevention through interventions aimed at reducing exposure to known cancer risk factors but also that a large proportion of cancer burden might not be avoidable through control of the risk factors currently estimated," the researchers wrote. "Thus, cancer risk reduction efforts must be coupled with comprehensive cancer control strategies that include efforts to support early diagnosis and effective treatment."

In an email to CNN, Dr. William Dahut, chief scientific officer for the American Cancer Society, wrote that the new study "clearly delineates" the importance of primary cancer prevention, although he did not take part in the new research.

"Modifying behavior could lead to millions more lives saved greatly overshadowing the impact of any drug ever approved," he wrote, adding, "The continued impact of tobacco despite approximately 65 years of a linkage to cancer remains very problematic."

Dahut noted that although tobacco in the United States is used less than in other countries, cancer deaths linked to tobacco continue to be a major problem and disproportionately impact certain states.

The International Journal of Cancer published a separate study earlier this month, which revealed that the estimated proportion of cancer deaths in 2019 attributable to smoking in adults between 25 and 79 years old ranged from 16.5 percent in Utah to 37.8 percent in Kentucky. The estimated total lost earnings due to cigarette smoking-attributable cancer deaths ranged from $32.2 million in Wyoming to $1.6 billion in California.

"In addition, it is no secret that alcohol use as well as the dramatic increase in the median BMI will lead to significant numbers of preventable cancer deaths," Dahut added. "Finally, cancer screening is particularly important in those at increased risk as we move to a world where screening is precision based and adaptable."

An editorial that was published alongside the new study in The Lancet showed that preventable risk factors associated with cancer tend to be patterned according to poverty.

"Poverty influences the environments in which people live, and those environments shape the lifestyle decisions that people are able to make. Action to prevent cancer requires concerted effort within and outside the health sector. This action includes specific policies focused on reducing exposure to cancer-causing risk factors, such as tobacco and alcohol use, and access to vaccinations that prevent cancer-causing infections, including hepatitis B and HPV," the editorial said.

"The primary prevention of cancer through eradication or mitigation of modifiable risk factors is our best hope of reducing the future burden of cancer," it added.

"Reducing this burden will improve health and wellbeing, and alleviate the compounding effects on humans and the fiscal resourcing pressure within cancer services and the wider health sector."

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New cancer treatment offers hope

Oncologists in the UK discover that combining immunotherapy with guadecitabine, a novel investigational medicine, can reverse cancer's resistance to immunotherapy

A newly discovered cancer treatment can stop the disease from advancing in patients who are resistant to immunotherapy.

Immunotherapy is a type of cancer treatment that employs the immune system to target and kill cancer cells. It can save lives when other treatment choices, such as surgery, radiotherapy, or chemotherapy, have failed. Treatment cannot, however, benefit all patients, and some tumors can adapt to resist it.

Oncologists in the United Kingdom have discovered that combining immunotherapy with guadecitabine, a novel investigational medicine, can reverse cancer's resistance to immunotherapy. They discovered that patients who were anticipated to die after exhausted all therapy options lived far longer.

The combination of immunotherapy medicine pembrolizumab and next-generation DNA hypomethylating agent guadecitabine slowed the progression of cancer in more than a third of patients enrolled in the early phase 1 trial. The findings were published in the Journal for ImmunoTherapy of Cancer.

The combination could become an effective weapon against different forms of cancer, experts revealed at the Institute of Cancer Research and Royal Marsden NHS foundation trust.

Patients in the trial, from the Royal Marsden and University College London hospital, included those with lung, breast, prostate, and bowel cancer.

Treatment

The study used pembrolizumab and guadecitabine to treat 34 cancer patients, 30 of whom had their tumors analyzed for immune activity and cancer growth. Every three weeks for three years, they had an injection of guadecitabine for four days in a row – and pembrolizumab on the first of those days.

Pembrolizumab is an immune checkpoint inhibitor drug that has already proved successful in treating a range of cancers, including lung and skin cancers. However, tumors can develop resistance to it and some patients who initially benefit will eventually get sicker.

The study lead, Anna Minchom, a clinical scientist at the Institute of Cancer Research and a consultant medical oncologist at the Royal Marsden, said: “Immunotherapy has shown amazing promise in cancer care over the last decade, but it doesn’t work well in all cancers and cancers can often become resistant. This combination might be a way to target their cancer even after it has stopped responding to immunotherapy.”

Guadecitabine may help overcome this resistance, doctors, researchers and scientists involved in the trial have discovered.

37% record no tumor progression

The tumor stopped progressing in 37% of the 30 patients whose cancer activity was studied, during 24 weeks or more. Prior to the experiment, three-fifths of the cohort (60%) were resistant to immunotherapy. Almost four in ten (39%) did not become ill as a result of the drug combination.

The new treatment could help lung cancer patients. Of those resistant to immunotherapy, half had their disease controlled for 24 weeks or more.

A patient from Dorset, Alison Sowden, was diagnosed with lung cancer four years ago and was told she had a year to live, but then received pembrolizumab for three years. She is now free of cancer.

“I know there is a chance that my cancer may come back and develop resistance to treatment, so it is reassuring to know research efforts aiming to reverse cancer’s resistance to immunotherapy are under way,” she said.

“I hope this new experimental drug combination will eventually make it to the clinic and help people who have developed resistance to pembrolizumab.”

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