Public Health Research and Cancer
The Importance of Cancer Public Health Research
Cancer and the many issues associated with it have a significant impact on public health at multiple levels in the United States. The years of life lost due to premature deaths, the economic burden due to lost productivity and the costs associated with illness and therapy, and the long-term effects of cancer and its treatment on the quality of life of survivors take a national toll. In addition, cancer’s impact on public health is expected to continue growing as the US population ages.
Although cancer affects individual patients and their families in different ways, studying its impact on large populations can provide important information that influences practices, policies, and programs that directly affect the health of millions of people in the United States each year.
NCI supports research focused on uncovering population-wide trends in cancer, improving the delivery of cancer care, and designing interventions at the individual and population levels to improve cancer prevention, screening, treatment, and survivorship.
NCI-funded research has contributed to major improvements in public health and cancer control. For example:
- Thanks in part to research funded by NCI, the prevalence of cigarette smoking is at its lowest point in the last 30 years. Policies informed by scientific evidence have helped reduce tobacco-related deaths and diseases around the world. In 1964, the prevalence of regular tobacco smoking among adults was 42%. By 2017, it had declined to 14%. Tobacco use is linked to at least 15 cancer types, and eliminating smoking in the United States would eliminate almost one-third of the nation’s cancer deaths as well as alleviate the burden of cardiovascular and other tobacco-related diseases.
- Thanks to NCI’s Surveillance, Epidemiology, and End Results (SEER) program, authoritative data on the burden of cancer in the United States (including incidence, mortality, and survival trends of different cancer types) have been collected and published since 1973. Understanding these trends has helped to focus research efforts and public policies.
- Epidemiology studies supported by NCI have contributed to the identification of hereditary cancer syndromes, such as Lynch syndrome and Li-Fraumeni syndrome, leading to strategies to identify patients at increased risk and improved clinical care.
The Future of Cancer Public Health Research
The goal of public health research is to generate knowledge about how to monitor and change individual and collective behavior and to ensure that knowledge is translated into practice and policy rapidly, effectively, and efficiently.
Bold NCI goals include preventing all HPV-associated cancers, eliminating the incidence of cancers caused by tobacco use, dramatically reducing cancer disparities, and realizing major improvements in the quality of life of cancer survivors in the future.
Additional investments in cancer control, population health, and survivorship research will continue to reduce cancer risk, incidence, and mortality and improve the lives of cancer survivors and the general population.
NCI’s Plan for Research on Public Health and Cancer Control
NCI prepares an Annual Plan & Budget Proposal for the President and Congress that describes the Institute’s scientific priorities and promising opportunities from across the research continuum. Included in the plan is the following strategic vision and approach for improving research on public health and cancer control.
All population groups will benefit equally from advances in cancer research.
Cancer will continue to grow as a major public health issue in the United States as the population ages. More research and innovation across the spectrum of cancer—from prevention to detection and diagnosis to treatment and survivorship—is essential to:
1) Develop public health interventions to reduce the risk of cancer
It has been estimated that 30%–50% of cancers diagnosed today could be prevented by reducing exposure to tobacco smoke and other environmental carcinogens, maintaining a healthy body weight, and receiving recommended cancer screenings and vaccinations. Identifying innovative ways to help people change their behaviors and make healthy lifestyle choices will have dramatic impacts. Our major objectives include:
- Further reducing tobacco use among all population groups and better understanding the health effects of electronic nicotine delivery devices (e-cigarettes) and alternative tobacco delivery methods (such as smokeless tobacco)
- Developing behavioral and informational interventions to reduce obesity and reduce the risk of obesity-associated cancers
- Studying how physical activity influences cancer incidence and patient outcomes and translating the knowledge gained into effective interventions for individuals at risk, patients undergoing treatment, and survivors who have completed treatment
- Developing interventions to increase the use of proven and effective cancer prevention strategies (such as HPV vaccination) and screening methods (including colorectal and lung cancer screening)
2) Support research to reduce cancer disparities
Certain populations, including specific racial/ethnic groups and rural populations, suffer disproportionately from some cancers. There are many reasons for these disparities, including biological factors and inadequate implementation of cancer prevention and treatment interventions in health care practice. Our major objectives include:
- Developing innovative, portable, low-cost technologies for cancer screening and diagnosis in a doctor’s office, a clinic, or other local care setting
- Developing smoking cessation interventions targeted to socioeconomically disadvantaged populations that could be made scalable for broad population impact
- Evaluating the effectiveness of a single-dose HPV vaccine and of different formulations of these vaccines that do not require refrigeration to increase HPV vaccine uptake, especially among medically underserved populations
- Enhancing participation of racial/ethnic minorities and the underserved in NCI-sponsored clinical trials
3) Ensure that cancer survivors have the highest possible quality of life
Many cancer survivors suffer from health problems caused by the disease or its treatment that require additional and, perhaps, ongoing care. Survivors of childhood cancers, on average, will have to deal with these effects for much longer than adult survivors. Our major objectives include:
- Understanding the short- and long-term adverse effects of cancer and its treatment and developing interventions to reduce their impact on patients
- Identifying risk factors, including genetic factors, that contribute to differences between patients in the occurrence and intensity of adverse effects, including the risk of second or recurrent cancers
- Investigating what role, if any, other health problems (comorbidities) play on treatment-related adverse effects so we can more effectively care for the whole patient
- Developing interventions to promote healthy behaviors among cancer survivors to improve both health outcomes and quality of life