Robert A. Smith

Dr. Robert A. Smith


Research Focus & Metrics

Academic Career Length

25Years (2002-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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1 March 2023 in CA: A Cancer Journal for Clinicians
Verified
Journal Article
Open access
RSRebecca L. Siegel
Rebecca L. Siegel
NWNikita Sandeep Wagle
Nikita Sandeep Wagle
ACAndrea Cercek
Andrea Cercek
RSRobert A. Smith
Robert A. Smith
AJAhmedin Jemal
Ahmedin Jemal
Colorectal cancer (CRC) is the second most common cause of cancer death in the United States. Every 3 years, the American Cancer Society provides an update of CRC statistics based on incidence from population‐based cancer registries and mortality from the National Center for Health Statistics. In 2023, approximately 153,020 individuals will be diagnosed with CRC and 52,550 will die from the disease, including 19,550 cases and 3750 deaths in individuals younger than 50 years. The decline in CRC incidence slowed from 3%–4% annually during the 2000s to 1% annually during 2011–2019, driven partly by an increase in individuals younger than 55 years of 1%–2% annually since the mid‐1990s. Consequently, the proportion of cases among those younger than 55 years increased from 11% in 1995 to 20% in 2019. Incidence since circa 2010 increased in those younger than 65 years for regional‐stage disease by about 2%–3% annually and for distant‐stage disease by 0.5%–3% annually, reversing the overall shift to earlier stage diagnosis that occurred during 1995 through 2005. For example, 60% of all new cases were advanced in 2019 versus 52% in the mid‐2000s and 57% in 1995, before widespread screening. There is also a shift to left‐sided tumors, with the proportion of rectal cancer increasing from 27% in 1995 to 31% in 2019. CRC mortality declined by 2% annually from 2011–2020 overall but increased by 0.5%–3% annually in individuals younger than 50 years and in Native Americans younger than 65 years. In summary, despite continued overall declines, CRC is rapidly shifting to diagnosis at a younger age, at a more advanced stage, and in the left colon/rectum. Progress against CRC could be accelerated by uncovering the etiology of rising incidence in generations born since 1950 and increasing access to high‐quality screening and treatment among all populations, especially Native Americans.

30 May 2018 in CA: A Cancer Journal for Clinicians
Verified
Journal Article
Closed access
PDF file
AWAndrew M. D. Wolf
Andrew M. D. Wolf
EFElizabeth T.H. Fontham
Elizabeth T.H. Fontham
TCTimothy R. Church
Timothy R. Church
CFChristopher R. Flowers
Christopher R. Flowers
CGCarmen E. Guerra
Carmen E. Guerra
RSRobert A. Smith
Robert A. Smith

20 October 2015 in JAMA
Verified
Journal Article
Open access
PDF file
KOKevin C. Oeffinger
Kevin C. Oeffinger
EFElizabeth T. H. Fontham
Elizabeth T. H. Fontham
RERuth Etzioni
Ruth Etzioni
AHAbbe Herzig
Abbe Herzig
JMJames S. Michaelson
James S. Michaelson
RWRichard Wender
Richard Wender
Breast cancer is the most common cancer in women worldwide.1 In the United States, an estimated 231 840 women will be diagnosed with breast cancer in 2015.2 Breast cancer continues to rank second, after lung cancer, as a cause of cancer death in women in the United States, and it is a leading cause of premature mortality for women. In 2012, deaths from breast cancer accounted for 783 000 years of potential life lost and an average of 19 years of life lost per death.3 Even though mortality from breast cancer has declined steadily since 1990, largely due to improvements in early detection and treatment,4 an estimated 40 290 women in the United States will die of breast cancer in 2015.2

30 July 2020 in CA: A Cancer Journal for Clinicians
Verified
Journal Article
Open access
PDF file
EFElizabeth T. H. Fontham
Elizabeth T. H. Fontham
AWAndrew M. D. Wolf
Andrew M. D. Wolf
TCTimothy R. Church
Timothy R. Church
RERuth Etzioni
Ruth Etzioni
CFChristopher R. Flowers
Christopher R. Flowers
RSRobert A. Smith
Robert A. Smith
The American Cancer Society (ACS) recommends that individuals with a cervix initiate cervical cancer screening at age 25 years and undergo primary human papillomavirus (HPV) testing every 5 years through age 65 years (preferred); if primary HPV testing is not available, then individuals aged 25 to 65 years should be screened with cotesting (HPV testing in combination with cytology) every 5 years or cytology alone every 3 years (acceptable) ( strong recommendation ). The ACS recommends that individuals aged >65 years who have no history of cervical intraepithelial neoplasia grade 2 or more severe disease within the past 25 years, and who have documented adequate negative prior screening in the prior 10 years, discontinue all cervical cancer screening ( qualified recommendation ). These new screening recommendations differ in 4 important respects compared with the 2012 recommendations: 1) The preferred screening strategy is primary HPV testing every 5 years, with cotesting and cytology alone acceptable where access to US Food and Drug Administration‐approved primary HPV testing is not yet available; 2) the recommended age to start screening is 25 years rather than 21 years; 3) primary HPV testing, as well as cotesting or cytology alone when primary testing is not available, is recommended starting at age 25 years rather than age 30 years; and 4) the guideline is transitional, ie, options for screening with cotesting or cytology alone are provided but should be phased out once full access to primary HPV testing for cervical cancer screening is available without barriers. Evidence related to other relevant issues was reviewed, and no changes were made to recommendations for screening intervals, age or criteria for screening cessation, screening based on vaccination status, or screening after hysterectomy. Follow‐up for individuals who screen positive for HPV and/or cytology should be in accordance with the 2019 American Society for Colposcopy and Cervical Pathology risk‐based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors.

15 March 2019 in CA: A Cancer Journal for Clinicians
Verified
Journal Article
Open access
PDF file
RSRobert A. Smith
Robert A. Smith
KAKimberly S. Andrews
Kimberly S. Andrews
DBDurado Brooks
Durado Brooks
SFStacey A. Fedewa
Stacey A. Fedewa
DMDeana Manassaram‐Baptiste
Deana Manassaram‐Baptiste
RWRichard C. Wender
Richard C. Wender
Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, the current American Cancer Society cancer screening guidelines are summarized, and the most current data from the National Health Interview Survey are provided on the utilization of cancer screening for men and women and on the adherence of men and women to multiple recommended screening tests.

11 January 2013 in CA: A Cancer Journal for Clinicians
Verified
Journal Article
Open access
PDF file
RWRichard Wender
Richard Wender
EFElizabeth T. H. Fontham
Elizabeth T. H. Fontham
EBErmilo Barrera
Ermilo Barrera
GCGraham A Colditz
Graham A Colditz
TCTimothy Robert Church
Timothy Robert Church
RSRobert A. Smith
Robert A. Smith
Answer questions and earn CME/CNE Findings from the National Cancer Institute's National Lung Screening Trial established that lung cancer mortality in specific high‐risk groups can be reduced by annual screening with low‐dose computed tomography. These findings indicate that the adoption of lung cancer screening could save many lives. Based on the results of the National Lung Screening Trial, the American Cancer Society is issuing an initial guideline for lung cancer screening. This guideline recommends that clinicians with access to high‐volume, high‐quality lung cancer screening and treatment centers should initiate a discussion about screening with apparently healthy patients aged 55 years to 74 years who have at least a 30–pack‐year smoking history and who currently smoke or have quit within the past 15 years. A process of informed and shared decision‐making with a clinician related to the potential benefits, limitations, and harms associated with screening for lung cancer with low‐dose computed tomography should occur before any decision is made to initiate lung cancer screening. Smoking cessation counseling remains a high priority for clinical attention in discussions with current smokers, who should be informed of their continuing risk of lung cancer. Screening should not be viewed as an alternative to smoking cessation. CA Cancer J Clin 2013;. © 2013 American Cancer Society.