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2024

CISNET modeling informs new breast cancer screening guidelines

April 30, 2024 - JAMA Network Tweet

The United States Preventive Services Task Force (USPSTF) is a volunteer group of medical professionals who make recommendations about how, when, and who to screen for certain types of diseases like cancer. In a new paper published in JAMA, researchers used the Cancer Intervention and Surveillance Modeling Network (CISNET), which uses data from the Surveillance, Epidemiology, and End Results (SEER) Program, to explore the benefits and costs of new breast cancer screening strategies.

Before changing its screening guidelines, the USPSTF recommended women between 50 and 74 years old get a mammogram every two years and suggested doctors should discuss starting breast cancer screening earlier for patients at higher risk. The researchers modeled thirty-six different breast cancer screening strategies and estimated factors, including the number of deaths prevented, to evaluate each strategy. Each strategy included different screening age ranges, how often a patient goes for screening, and the technology used to look for breast cancer.

The screening strategies that saved the most lives started between the ages of 40 and 45 and continued every other year (biennially) through age 74 or 79. Both digital mammograms and digital breast tomosynthesis (or “DBT,” also sometimes known as a 3D mammogram) were effective in preventing breast cancer death, but DBT had slightly fewer false positives. Black women saw better survival with every studied strategy, and the researchers suggest annual screening for black women may further help reduce breast cancer disparities. With these findings, the USPSTF now recommends women get a mammogram every other year between the ages of 40 and 74.

Prostate cancer survivors who consume a plant-based diet have a higher quality of life

February 13, 2024 - American Cancer Society Tweet

A healthy diet is one of the pillars of good health, regardless of a given patient’s cancer diagnosis. Healthy diets are usually defined by consuming a variety of foods, including a large proportion of plant-based foods like fruits, vegetables, beans, and whole grains. In a recent publication in Cancer, researchers compared the diets of prostate cancer survivors and their quality of life.

The researchers analyzed survey data about the diet and quality of life of prostate cancer survivors. They separated study participants into groups based on the amount of plant-based foods in their diets. The researchers found patients who had a higher percentage of plant-based foods in their diets had better urinary, bowel, sexual, and hormonal function after prostate cancer treatment. The Surveillance, Epidemiology, and End Results (SEER) Program is acknowledged for supporting cancer registries that provided prostate cancer data.

History of financial hardship events linked to later stage cancer diagnosis

February 6, 2024 - Journal of Clinical Oncology Tweet

Financial vulnerability—when a person has limited savings, high debt, or insufficient income to meet spending obligations—touches almost every aspect of life, including housing, healthcare, education, food, and more. In 2021, the Federal Reserve found that 32% of adults in the United States could not afford an emergency $400 expense, while another study found one in three adults did not get a medical test or treatment because of the cost. In a recent publication in the Journal of Clinical Oncology, researchers at multiple institutions, including the Division of Cancer Control and Population Sciences at the National Cancer Institute, explored the relationship between a patient’s financial hardship history and the stage of cancer at diagnosis.

The researchers combined cancer case data from the Surveillance, Epidemiology, and End Results (SEER) Program with financial data from LexisNexis to study the association between previous financial hardship events and cancer stage at diagnosis. Out of the 101,649 de-identified patients within this combined dataset, 36.2% had at least one hardship event—such as bankruptcy, eviction, and/or a lien—before being diagnosed with cancer. The researchers found people who experienced one of these events before a cancer diagnosis had a higher risk of being diagnosed with advanced stage disease. Financial barriers may have inhibited access to routine doctor visits and screenings.

However, the researchers note this question gets complicated when including factors like race and income. Blacks had twice the number of financial hardship events compared to Whites, reflecting longstanding issues of inequality and systemic racism. But while Black women were more likely than White women to be diagnosed with advanced cancer, Black men were less likely than White men to get an advanced stage diagnosis. And, while the highest proportion of financial hardship events—45%—happened to people in the lowest income group, 27% of people in the highest income group also experienced financial hardship events before their cancer diagnosis. With these findings, the researchers highlight the importance of considering patient financial history to assist this particularly vulnerable population.

SEER data drives American Lung Association Report on Lung Cancer

January 17, 2024 - American Lung Association

The American Lung Association (ALA) released the State of Lung Cancer report for 2023. The ALA report examines lung cancer trends in new cases, survival rates, screening, treatments, and racial and ethnic disparities on a state-by-state basis. The report cites the Surveillance, Epidemiology, and End Results (SEER) Program as one of the primary data sources for this report.

As seen in other cancer reports from the American Cancer Society and SEER Program, researchers and health care providers continue making progress against lung cancer. The ALA report notes that survival rates increased from 22% to 26.6% over the previous five years. However, despite expanded screening guidelines, screening rates for individuals at high risk of lung cancer, including current and former smokers, remain low. Also, racial and ethnic disparities continue, with people of color being less likely to be diagnosed early or receive surgery compared to whites.

For more information about lung cancer trends across the United States, read the report from the American Lung Association. Also visit our Cancer Stat Facts sheet on lung cancer and State Cancer Profiles for lung cancer rates in your state.

Improved treatments lower breast cancer mortality, according to SEER-based models

January 16, 2024 - JAMA Network Tweet

The cancer mortality rate gives us important information about how we are doing in the fight against cancer. A low mortality rate usually means screening and treatment strategies are working well. However, it can be hard to say exactly why the mortality rate for some cancers is low. For example, catching cancer in early stages through better screening strategies and technologies can give patients the best chance of long-term survival. Also, better cancer treatments can help later-stage patients live longer. Researchers used the Cancer Intervention and Surveillance Modeling Network (CISNET) to understand how each of these factors contributed to the improvements seen in breast cancer mortality from 1975 to 2019.

The breast cancer mortality rate dropped by 58% from 1975 to 2019. With several models, which accounted for screening strategies and treatment advancements, the researchers could estimate how each of these factors helped reduce the breast cancer mortality rate. Imagine a pie chart breaking down the reasons for improving breast cancer mortality. The chart has three sections—treatments for stage I to stage III breast cancer, screening strategies, and treatment for metastatic breast cancer. The researchers found advancements in treatments for stage I to stage III breast cancer contributed almost half of the pie chart. Screening strategies and treatment advancements for metastatic breast cancer contributed about a quarter of the pie chart each.