Overall cancer death rates continue to decline in men and women for all racial and ethnic groups in the United States, according to the latest Annual Report to the Nation on the Status of Cancer.
From 2003 to 2018, under the leadership of Dr. Bob Croyle as Director of the Division of Cancer Control and Population Sciences at the National Cancer Institute (NCI), declines in lung cancer death rates accelerated, and death rates for melanoma declined considerably in more recent years. Also during that time, tobacco prevalence declined from 21.5% to 13.7%.
“The most gratifying thing is how we’re doing on the bottom line—cancer mortality rates,” Croyle said. “That’s our most complete report card measure. Our cancer rates have been coming steadily down, a lot of that due to reductions in tobacco use. The challenge is going to be maintaining that going forward, particularly because we know a number of cancers are obesity-related.”
Other concerns include the spike in sales of tobacco products during the COVID-19 pandemic and the complexity of vaping products.
The annual report is a collaborative effort among NCI, CDC, American Cancer Society and the North American Association of Central Cancer Registries. It shows a decrease in death rates for 11 of the 19 most common cancers among men, and for 14 of the 20 most common cancers among women, over the most recent period (2014-2018). Declining trends in death rates accelerated for lung cancer during this period. During that time, UW-CTRI conducted research funded by NCI to help people quit tobacco use, the number one risk factor for lung cancer.
In December, Croyle will retire knowing he has had an incredible impact on public health.
“It has been an honor and privilege to work with Bob over the years,” said UW-CTRI Director Dr. Michael Fiore, “both personally and as a center. We’re proud of our collaboration to help people quit tobacco use, the leading preventable cause of cancer.”
Among the projects on which UW-CTRI has collaborated with NCI and Croyle is via the NCI Cancer Center Cessation Initiative (C3I), part of the NCI Cancer Moonshot program. The long-term goal of this Initiative, centered at the UW Carbone Cancer Center and led by Principal Investigator Dr. Betsy Rolland, is to help cancer centers build and implement sustainable tobacco cessation treatment programs to routinely address tobacco cessation with cancer patients.
Croyle personally encouraged participating C3I centers to do more to help their patients break free of tobacco addiction. Participating centers have:
- Refined electronic medical records and clinical workflows to ensure the systematic identification and documentation of smokers and the routine delivery of evidence-based treatment to quit tobacco use.
- Overcame patient, clinician, clinic, and health-system barriers to providing tobacco treatment.
- Achieved institutional buy-in that treating tobacco use is incorporated into the standard of care.
- Created mechanisms to sustain tobacco treatment so that it continues beyond the funding period of the initiative.
- Published and presented results. This includes a 2019 article in the New England Journal of Medicine written by Croyle, Dr. Glen Morgan and Fiore, about C3I and how only about half of cancer patients are offered help by their oncology team to quit smoking.
“I think the C3I project is a good illustration of what the Cancer Moonshot is all about,” Croyle said, “to take on a complex issue and address it in an effective way. I hope it will set the tone for a nationwide impact, perhaps someday in the form of clinical practice guidelines for quality cancer care. I believe it should include cessation services for patients who use tobacco. If we can get it fully implemented in all certified cancer centers, we’ll really have made an impact.”
Croyle said NCI is working with cancer centers to track data on patients who use cannabis, modeled on C3I but on a smaller scale. NCI hopes to better understand how cannabis use affects patient health, including cancer risks.
“It is encouraging to see a continued decline in death rates for many of the common cancers,” said Dr. Karen Hacker, director of CDC’s National Center for Chronic Disease Prevention and Health Promotion. “To dismantle existing health disparities and give everyone the opportunity to be as healthy as possible, we must continue to find innovative ways to reach people across the cancer care continuum—from screening and early detection to treatment and support for survivors.”
Croyle also was a co-author of the National Action Plan for Tobacco Cessation with Fiore as Chair. The goal of the plan was to prevent three million premature deaths and help five million smokers quit. It set in motion the creation of the National Tobacco Quitline, now available across the country at 800-QUIT-NOW.
In 2012, Croyle received the American Psychological Association Presidential Citation for science and leadership and in 2021 the Distinguished Service Award from the American Society of Preventive Oncology.
“Bob’s leadership has been so critical to making this progress in the fight against cancer in America and beyond,” Fiore said. “His vision and leadership for cancer prevention and control will be greatly missed. We wish him all the best in his retirement.”
Once he retires, Croyle said he’s looking forward to spending more time with his family, including his grandkids. “I’m excited to read things that have less to do with cancer research and more to do with my other interests, like American history.”