The American Cancer Society released a report on May 19 showing mixed results for cancer prevention in the U.S., with obesity trends beginning to level off just as states dramatically cut funding for tobacco control and long-term declines in smoking appear to have reached their limits.

The American Cancer Society’s annual report, "Cancer Prevention & Early Detection Facts & Figures" (CPED), drew extensive attention to tobacco control and marketing, noting that despite a small increase in federal funding, state monies to tobacco control programs in 2011 reached their lowest level in 12 years, when 46 states and major tobacco companies reached the Tobacco Master Settlement Agreement. Just six states currently spend half or more of what the Centers for Disease Control and Prevention (CDC) recommend for smoking prevention.

National smoking trends appear to have bottomed out after more than three decades of decline, with roughly 21 percent of Americans reporting smoking in 2009. Smoking rates among adolescents have likewise remained unchanged in the last several years, with nearly 20 percent of high schoolers and 5 percent of middle schoolers believed to smoke, according to the report.

After several decades of ballooning obesity rates among nearly all Americans, the increase appears to have slowed, notably among women and teenage girls. One in five children and one in three adults are obese in the U.S., the report found.

Heightened efforts by public health officials to improve cancer screening and prevention have yielded mixed outcomes, as initiation of human papillomavirus (HPV) vaccinations rose among adolescent girls from 25 percent in 2007 to 44 percent in 2009. Meanwhile, yearly mammography screening for women over 40 years of age has held constant at 53 percent over the last decade.

The report noted that lack of insurance or incomplete coverage remains a critical barrier to cancer screening and prevention. Despite 78 percent of women receiving Pap tests once every three years, the rate remains significantly lower among women without insurance, immigrants and those with low levels of education.

On the other side, expanded state coverage for colorectal screening has played a role in helping a majority of men undergo colorectal exams at 53 percent, up from 38 percent in 2000.

In addition to lack of access to proper care and screening for many Americans, the American Cancer Society report emphasized the need for improved coordination between government, hospitals, the private sector and the American public. The report cited key challenges such as  tobacco companies using loopholes to increase marketing in recent years and the prices of healthy foods outpacing Americans’ budgets and called for broader government influence to counter these consumer trends.