US Cancer Death Rate Down, But Number of Deaths Rising

Roxanne Nelson

July 03, 2015

Death rates from cancer in the United States have been declining since the early 1990s, and the decline is predicted to continue until 2020. But on the downside, the actual number of cancer deaths is increasing, owing to an aging population and other demographic changes, according to a report from the Centers for Disease Control and Prevention (CDC).

The CDC predicts that the total number of cancer deaths from 2007 to 2020 will increase by more than 10% in men and in black women, and will begin to stabilize in white women, increasing by less than 5% during this time period.

The report, published in the July 2 issue of Preventing Chronic Disease, reveals that the number of cancer deaths increased 45.5% in white males, 56.0% in white females, 52.8% in black males, and 98.2% in black females.

"These data remind us that cancer statistics can be examined in many ways," said lead author Hannah Weir, PhD, from the Division of Cancer Prevention and Control at the CDC. "The overall cancer death rate continues to decrease in men and women of both races, with the exception of melanoma."

Aging and Minority Populations

In the United States, the population is expected to grow by 10% from 2010 to 2020, and the largest increases are expected in minority populations and in people older than 65 years (13% to 16%). Thus, the increasing number of cancer deaths is primarily related to demographic changes in the population.

"From 1975 to 2009, the number of cancer deaths increased in white and black Americans primarily because of an aging white population and a growing black population," Dr Weir told Medscape Medical News. "Over the past several decades, there has been proportionately greater growth in the black population than in the white population. Over this same time period, gains in life expectancy have been greater in the white population than in the black population."

"However, in the past decade, life expectancy has increased in both black men and women and, as a result, we expect to see more cancer deaths attributed to a growing and aging black population," she added.

For each specific group, the number of cancer deaths attributed to risk declined, whereas the number of cancer deaths attributed to population growth and aging increased.

Table. Change in Cancer Deaths Attributed to Risk, Population Growth, and Population Aging

Group Risk, % Growth, % Aging, %
White males −21.5 26.8 40.1
White females −7.6 27.6 36.0
Black males −21.3 53.7 20.4
Black females −7.1 60.8 44.5

 

Cancer Is Not Inevitable

"It is encouraging that the overall risk to the population of dying from cancer, as measured by the age-standardized death rate, continues to decrease," said Dr Weir. "However, the actual number of cancer deaths continues to increase because the US population is both growing and aging. It is great that people are living longer, but cancer is not inevitable as people age and many cancer deaths can be prevented."

For example, clinicians can check that patients are up to date with recommended cancer screening tests and can assist patients in preventing and managing chronic conditions that substantially increase the risk for cancer, like diabetes and obesity.

"In addition, clinicians can counsel patients on methods to reduce their cancer risk, like smoking cessation, increased physical activity, reduced alcohol consumption, and protection from harmful UV radiation," she explained. "Increased efforts to promote cancer prevention and improve survival are needed to counter the impact of a growing and aging population on the cancer burden and to meet melanoma target death rates."

Healthy People 2020

A decline in the death rate means that the overall risk for cancer-related mortality has decreased in the population overall. But at the same time, the number of cancer deaths has continued to increase. The Healthy People 2020 initiative has called for a 10% to 15% reduction in death rates from 2007 to 2020 for certain cancers.

To determine if Healthy People 2020 cancer mortality targets are likely to be met, Dr Weir and her colleagues at the CDC used mortality data and population estimates and projections to assess how changes in population risk, growth, and aging affected (or will affect) the rate of cancer deaths from 1975 to 2020. This was done for all types of cancer, as well as for the top 23 cancers, by sex and race.

From the analyses, the CDC predicts that cancer deaths will increase 15.2% in men (−23.0% attributable to risk, 38.2% attributable to demographics) and begin to stabilize (8.1%) in women (−19.5% attributable to risk, 27.6% attributable to demographics).

These results, they note, vary by cancer type, sex, and race.

Specifically, morality is predicted to increase for cancers of the corpus and uterus in black women, for cancers of the liver and intrahepatic bile duct in men and women (both races), and for thyroid cancer in women (both races).

But mortality is predicted to decline for colorectal cancer and non-Hodgkin's lymphoma in white women, for esophageal cancer in black men and women, for Hodgkin's lymphoma in white men and women, for laryngeal cancer in black men, and for cancers of the oral cavity and pharynx in black women.

The CDC report predicts that the Healthy People 2020 targets will be met for prostate cancer in 2010, and for other cancers combined (female breast, cervix uteri, colon and rectum, lung and bronchus, oral cavity and pharynx, and prostate) in 2015, except for melanoma.

The incidence rates for melanoma have been rising since 1975 in all age groups; whereas mortality rates overall have not changed, they have increased in older adults. Death from melanoma is predicted to increase until 2020, and death rates and risk are predicted to fall short of the Healthy People 2020 target of a 10% reduction from 2007 to 2020.

The authors have disclosed no relevant financial relationships.

Prev Chronic Dis. 2015;12:E104. Abstract

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