Trends of cancer associated with modifiable behavior in the U.S.: Is there a difference based on age, gender, or race?

Abstract

1542 Background: To examine trends in modifiable behaviorally related cancers among men and women in the United States. Methods: Data were obtained from the United States Cancer Statistics (USCS) database for all cancers diagnosed between 2001 and 2017. Alcohol-associated cancers, HPV-associated, obesity-associated, physical inactivity-associated, and tobacco-associated were defined using ICD-O-3 site codes. SEER*Stat 8.3.8 and Joinpoint regression program 4.8.0.1 were used to calculate the trends of associated cancers expressed per 100,000. Results: In 2017 the incidence of cancers in women associated with alcohol, smoking and obesity were 168/100,000, 134/100,000 and 121/100,000 respectively. Based on analysis of trends of women from 2001 to 2017, alcohol, smoking and physical inactivity related cancers decreased with an annual percent change (APC -0.51%, -0.96%, -0.92% respectively, p < 0.001). However, there was no significant change in obesity, HPV, or post menopausal female breast cancer related cancers (APC: 0.07%, 0.09%, -0.08% respectively, p = 0.303, 0.181, 0.569). Based on age, in women less than 65, rates of obesity related cancers are increasing. Based on racial groups, all rates of cancer associated with modifiable factors are decreasing, however Hispanic women have an increasing rate of obesity related cancers (APC 0.46%, p < 0.001). When examining differences in region, all rates of cancer are decreasing or unchanged except the south has an increasing rate of obesity related cancer (APC 0.28%, p < 0.001). Using a projection model, obesity will become the highest incidence cancer in Hispanic women by 2035, surpassing alcohol and tobacco. In 2017 the incidence of cancers in men associated with tobacco, obesity, and alcohol were 209/100,000, 111/100,000 and 81/100,000 respectively. Based on analysis of trends in men alcohol, smoking, physical inactivity and obesity related cancers decreased (APC -1.42%, -1.59%, -3.15%, -0.41% respectively, p < 0.001). HPV related cancers have increased (APC 2.36%, p < 0.001). In men less than 60 years old, the rates of obesity related cancers are increasing. Using a prediction model, obesity is predicted to surpass tobacco as the most common social cause of cancer in 2020 for men 35-39, 2024 in men 40-44 and in 2030 in men 45-49. Conclusions: In women, most modifiable factors associated with cancer are decreasing except in obesity and HPV related cancers. In men, these rates of cancer are decreasing except HPV related cancers. However, rates of obesity related cancers are on the rise in Hispanic women and younger men. Obesity is set to become the major modifiable factor for many associated cancers.