Prevalence and Review of Major Modifiable Cancer Risk Factors, HPV Vaccination, and Cancer Screenings in the United States: 2025 Update

Abstract This study presents national- and state-level prevalence of major modifiable cancer risk factors, human papillomavirus vaccination, and cancer screenings among US adults in the years during and after the COVID-19 pandemic compared with prepandemic years. Smoking prevalence declined to 11% in 2023 from 14.2% in 2019, but prevalence remained higher among American Indian/Alaska Native individuals, Black males, lower-educated individuals, and bisexual females. Menthol-flavored cigarettes, which increase smoking uptake and reduce cessation success, were used by 36.3% of currently smoking adults in 2023; this level is more than double in Black individuals (75.6%). Excess body weight prevalence during August 2021 to August 2023 (overweight: 31.8%; obesity: 40.4%) was stable compared to levels during 2017 to March 2020. Remaining unchanged from 2020, more than half (51.5%) of adults reported not meeting recommended aerobic activity levels, and 6.4% reported heavy alcohol use in 2022. Diverging from the previously increasing trend, up-to-date human papillomavirus vaccination prevalence was flat between 2021 and 2023 (61.4% in ages 13–17 years). Rebounding from declines or flat trends noted during the COVID-19 pandemic, the United States Preventive Services Task Force recommendation-concordant prevalence increased from 2019 to 2023 for breast (79.9%) and colorectal (60.4%) cancer screening. Ongoing surveillance with reliable population-representative survey datasets is essential to track progress and develop effective cancer prevention and control efforts.