Cancer Falls Overall in US, But HPV Cancers Increase

Zosia Chustecka

January 08, 2013

Overall cancer death rates continue to fall in the United States, according to the Annual Report to the Nation on the Status of Cancer, which was published online January 7 in the Journal of the National Cancer Institute.

Incidence rates for many different cancer types are also falling.

The report highlights cancers associated with human papillomavirus (HPV), and the potential for prevention by HPV vaccination. It was coauthored by researchers from the American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute, and the North American Association of Central Cancer Registries.

From 2000 to 2009, overall deaths rates from cancer fell, in both men and women, for all major racial and ethnic groups and for all of the most common cancer sites, including lung, colon and rectum, female breast, and prostate.

The downward trend started in the early 1990, the report notes. From 2000 to 2009, overall cancer death rates decreased by 1.8% per year in men and by 1.4% per year in women.

However, deaths rates increased for certain other cancers, including liver, pancreas, and uterus. In men only, they also increased for melanoma.

During the same period, the rates of overall cancer incidence decreased in men and remained stable in women, the report notes.

A feature section in the report highlights the fact that incidence rates are increasing for oropharyngeal and anal cancers associated with HPV, whereas coverage levels with HPV vaccination remain low. These HPV findings will be reported by Medscape Medical News in a separate article.

Reason to Cheer, But More Work Needed

The continuing drop in cancer mortality over the past 2 decades is reason to cheer. Dr. John Seffrin

"The continuing drop in cancer mortality over the past 2 decades is reason to cheer," said John Seffrin, PhD, chief executive officer of the American Cancer Society.

However, he emphasized the need for more work, as did several other experts. All of them highlighted HPV vaccination as a way of preventing cancer.

"The challenge we now face is how to continue these gains in the face of new obstacles, like obesity and HPV infections," Dr. Seffrin said in a statement. "We must face these hurdles head on, without distraction and without delay, by expanding access to proven strategies to prevent and control cancer," he added.

"We still have much work to do, particularly when it comes to preventing cancer," explained Thomas Frieden MD, director of the CDC.

Edward Benz Jr, MD, president of the Dana-Farber Cancer Institute in Boston, Massachusetts, said the report is "encouraging," but added that the rates of deaths and incidence need to fall even more.

"Cancer rates are declining, continuing a trend that started some years ago," Dr. Benz said in a statement. "People are surviving more and we are getting better at preventing some cancers."

"But we're not taking advantage of all the ways to detect cancers at an early stage, when they can be the most curable," he added. He highlighted HPV vaccination as a prevention strategy that could have a big impact on incidence and death rates. "Many of the things that are still a problem in these statistics can be changed," he explained.

Many Cancer Types Falling, But Not All

The death and incidence rates fell for many cancer types from 2000 to 2009, but not all types.

For men, deaths rates from cancer decreased for 10 of the 17 most common cancers: lung, prostate, colon and rectum, leukemia, non-Hodgkin's lymphoma, kidney, stomach, melanoma, oral cavity and pharynx, and larynx. However, deaths rates increased for melanoma of the skin and for pancreatic and liver cancers.

During the same period, the incidence rates decreased for 5 of the most common cancers in men: prostate, lung, colon and rectum, stomach, and larynx. However, incidence rates increased for 6 others: kidney, pancreas, liver, thyroid, melanoma of the skin, and myeloma.

For women, death rates decreased for 15 of 18 of the most common cancers in women: lung, breast, colon and rectum, ovary, leukemia, non-Hodgkin's lymphoma, brain and other nervous system cancers, myeloma, kidney, stomach, cervix, bladder, esophagus, oral cavity and pharynx, and gall bladder. However, death rates increased for cancers of the pancreas, liver, and uterus.

At the same time, incidence rates in women decreased for 7 common cancers: lung, colon and rectum, bladder, cervix, oral cavity and pharynx, ovary, and stomach. They increased for 7 others: thyroid, melanoma of the skin, kidney, pancreas, leukemia, liver, and uterus.

Incidence rates were stable for several common cancers, including breast cancer in women and non-Hodgkin's lymphoma in both men and women, the report notes.

J Natl Cancer Inst. Published online January 7, 2013. Abstract