Report: Florida is making strides on cancer treatment and prevention, but rural areas still suffer

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The Florida Cancer Control and Research Advisory Council (CCRAB) is out with its annual report detailing the State of Cancer in Florida.

It outlines tragic statistics, including the nearly 150,000 Floridians diagnosed with cancer each year, as well as detailing the six Florida Cancer Centers of Excellence for oncology care, research and education designated in 2023.

The report has been sent to Gov. Ron DeSantis, Senate President Kathleen Passidomo, House Speaker Paul Renner, State University System Chancellor Ray Rodrigues and Surgeon General Joseph Ladapo.

“There is now overwhelming evidence that cancer screenings save lives. Importantly, lung cancer screening, followed by colorectal cancer screening, and breast and cervical screenings have demonstrated remarkable numbers of lives saved if everyone who is eligible to undergo routine testing received these tests per guidelines,” the report reads.

“As such, the state’s investments in comprehensive breast and cervical screening and early detection programs is exemplary.”

But it also found a need to expand lung and colorectal cancer screenings to “further accelerate cancer prevention and early detection efforts stateside, especially among rural and underserved communities.”

The CCRAB, chartered in 1979 to advise the Legislature, Florida Board of Governors and Florida Surgeon General on ways to mitigate cancer burden in the state, serves as a steering body for statewide cancer prevention and control. It leads the consensus process every five years to produce a Florida Cancer Plan containing goals, objectives and strategies for all state cancer control stakeholders.

As it has been in the past, lung, breast and prostate cancer are the most frequently diagnosed cancers in the state.

At 445 to 460 cases per 100,000 residents, Florida’s cancer prevalence is lower than neighboring Georgia, which measured 461-503 cases per 100,000 residents, but higher than Alabama, which measured 426-444 cases per 100,000.

The 2024 annual report found that the state’s cancer death rate has decreased due to efforts to reduce tobacco use, improve access to screening and increase access to new treatments.

Lung cancer remains the deadliest form of cancer, with about 29 deaths per 100,000 residents. Breast cancer follows at about 16 deaths per 100,000, followed closely by prostate cancer and colorectal cancer. Non-Hodgkin’s Lymphoma, bladder, head and neck, cervical and melanoma cancers all have mortality rates of less than 5 per 100,000 residents.

Lung, breast, prostate, colorectal and ovarian cancers have the highest mortality rates in the state, largely due to the prevalence of such cancers metastasizing.

Still, cancer remains one of the leading causes of death in the state, second only to heart disease.

The report notes that incidence of cancer in Florida have “steadily decreased” over the past decade, but that data “artifactually shows an increase since 2016.” That’s due to “improved cancer case capture by Florida’s statewide cancer data and surveillance program.”

Metropolitan areas have, on average, lower incidences of cancer and lower mortality rates — such areas tend to have better access to care and therefore early detection and treatment options.

A color-coded map provided in the report highlights cancer mortality by county, and it paints a stark picture of the disparity between more urban areas with closer and better access to care and more rural areas that lack such access. From Pinellas County south, almost all of the counties are shaded in either light or dark blue, which indicates mortality rates of 94-150 per 100,000 residents.

North of Pinellas, most of the counties are shaded in yellow or orange, indicating mortality rates of 153-377 deaths per 100,000 residents. The counties in orange, those with the highest cancer mortality rates, are located in the state’s most rural areas, including in the Big Bend area and Panhandle (though areas around Tallahassee and Jacksonville are in various shades of blue).

Nationwide, Florida has among the lowest mortality rates, at 126-152 deaths per 100,000 residents. Alabama has among the highest, while Georgia’s mortality rate is only slightly better than Alabama’s.

The report found a need for increased prevention efforts and better access to cancer screenings in the state’s rural communities.

Pediatric cancer rates have remained relatively stagnant in recent years and children tend to fare better than older cancer patients. However, health officials continue to raise concerns about the side effects of toxic cancer treatments on youth, finding a need for safer and more effective treatments for vulnerable children.

Good news is on the horizon in terms of cancer prevention, though.

The report highlighted HPV vaccinations as a way to eliminate cervical and throat cancers in the state. That state has also made strides in early detection and treatment of precancerous tissue.

HPV vaccinations, which are administered to adolescents ages 13-17, had an administration rate of 58.9% in 2022. The state’s goal is to get that number to 80% by 2025.

However, reducing tobacco exposure — whether by reducing incidents of people smoking or reducing exposure to second-hand smoke — remains one of the most effective ways to reduce cancer burden, particularly among lethal cancers.

The report notes opportunity for further improvement by increasing health communications from Tobacco Free Florida, which is part of the state’s overall cancer plan.

To put that need into perspective, more than $587 million has been spent in the state by companies promoting tobacco use (the report does not provide a timeline for that spending). Only $37.2 million was spent on Centers for Disease Control and Prevention health communications in Florida and just $27.8 million on Tobacco Free Florida health communications.

But the report also notes Florida is growing its network of cancer centers treating disease and providing research and education on cancer.

Six Cancer Centers of Excellence were established in 2023, including Moffitt Cancer Center, the Mayo Clinic, the University of Miami Sylvester Comprehensive Cancer Center, the University of Florida Health Cancer Center, the Memorial Cancer Institute, and the Cleveland Clinic.

Three of those centers — Moffitt, University of Miami Sylvester Comprehensive Cancer Center and the University of Florida Health Cancer Center — are designated National Cancer Institute (NCI) cancer centers.

The increase in designations for the NCI is attributable to the Florida Academic Cancer Center Alliance, which is funded by the Casey DeSantis Cancer Research Program. That program’s Florida Cancer Plan objectives include increasing the number of NCI-designated cancer centers headquartered in Florida. Casey DeSantis, Florida’s First Lady, is herself a breast cancer survivor.