> Cancer incidence rates are primarily the product of genetics and environment

I'm sorry, but that's not how it works.

For example only 1 in 4 breast cancers are attributed globally to risk factors (i.e genetics or environment)? [1]

Since you're bringing it up, I know a things or two about cancer, my father worked in health care, in pulmonary oncology, my mother worked in health care too, in infective diseases, most of my family is tied to Italian public health care, my aunts and uncles worked for it, our family best friends worked there, one of their children and one of my best friends is now a geneticist and is researching rare disease (some types of cancers among the others).

If it was simply about environment and genetics, looking at the numbers, one would assume that in Africa or India they have a very resilient genetic pool and the best environment in the World and in USA they've got some serious problem [2] [3].

Of course that's not the entire story, in those places people don't develop cancer because they die for many other (curable) diseases before cancer gets them.

So what makes survival rates so high in the US?

Well, this Forbes article [4] explains it quite well: overtreating.

But at what price? (not talking about raw monetary value here)

Cancer insurgence is tightly related to aging [5], I've brought up the example of Italy because it's the second oldest population in the World on average after Japan.

And we know that the best cure for cancer is (still) avoiding it.

We have a system here that tries to prevent cancer: women are called in for regular check ups for a number of diseases (including breast cancer), men are checked regularly for prostatic cancer when they are 40 or older and its for free.

Companies, by law, have to send their employees to regular check ups every five years.

I have high blood pressure, I have to attend mandatory check ups every year, because I am more at risk than the others.

It's all paid by the Company.

Would you prefer to develop breast cancer and have a 90% chance of survival or not develop it at all?

Breast cancer is by far the most common type of cancer for women [6] and it has high levels of survival rates in all the western World [7].

What's particularly controversial about the way US counts average survival rates is that they also count breast cancer in situ, which is not a try cancer, but it's used
to inflate breast cancer statistics [8]

One statistics is particularly interesting, despite the fact that since the 90s sales of cigarettes per adult per day dropped
dramatically and are among the lowest in the west [9] the share of cancer deaths attributed to tobacco is still pretty (alarmingly) high [10].

What's really important in cancer prevention and cure is that globally the chances of going back to an average life expectancy is rising, not
only the survival rate after 5 years. In Italy 25% of cancer patients can expect to go back to a normal life, I haven't found the numbers
relative to USA.

[1] https://ourworldindata.org/grapher/share-of-cancer-deaths-at...

[2] https://ourworldindata.org/grapher/share-of-population-with-...

[3] https://ourworldindata.org/grapher/cancer-death-rates?tab=ma...

[4] https://www.forbes.com/sites/quora/2017/06/13/why-the-us-has...

[5] https://ourworldindata.org/grapher/share-of-population-with-...

[6] https://ourworldindata.org/grapher/share-of-population-with-...

[7] https://ourworldindata.org/grapher/five-year-survival-rates-...

[8] https://en.wikipedia.org/wiki/List_of_cancer_mortality_rates...

[9] https://ourworldindata.org/grapher/sales-of-cigarettes-per-a...

[10] https://ourworldindata.org/grapher/share-of-cancer-deaths-at...