Continuous Decline in US Cancer Death Rate: ACS Report

Nick Mulcahy

January 08, 2016

The continuous decline in cancer death rates in the United States over the past 2 decades has resulted in an overall drop of 23%, and more than 1.7 million cancer deaths averted, according to the latest annual report on cancer incidence, mortality, and survival from the American Cancer Society (ACS).

"This is overwhelmingly a good thing," said Otis W. Brawley, MD, the chief medical officer of the ACS, in a video released by the organization. There are three principal reasons for the steady decline, he said: reduction in smoking and the implementation of tobacco control, improvements in treatment, and the success of "wise screening."

Despite these positive developments, cancer is the leading cause of death for "much of the US population," according to the report authors, led by Rebecca L. Siegel, MPH, from the ACS. As of 2012, cancer was leading cause of death in 22 states in the country.

The report, which tabulates cancer statistics from 1991 to 2012, was published online January 7 in CA: A Cancer Journal for Clinicians.

The annual study also raises a red flag about the increasing incidence and death rates for several cancer types, including liver and pancreas, which are two of the most deadly cancers.

"We're gratified to see cancer death rates continuing to drop. But the fact that cancer is nonetheless becoming the top cause of death in many populations is a strong reminder that the fight is not over," said Dr Brawley in a press statement.

The report also provides a new estimate of the lifetime probability of developing invasive cancer for Americans: 42% for men and 38% for women.

The American Society of Clinical Oncology (ASCO) commended the ACS for providing an annual update on cancer in the United States and saluted the improvement in treatments and prevention efforts.

"This 23% decline in cancer death rates is the result of decades of advancing our understanding and treatment of cancer. As a result of our nation's investment in cancer research, we have made tremendous progress in prevention, chemotherapy, surgery, radiation, immunotherapy, and molecularly targeted treatments," said ASCO in a press statement.

The report also estimates cancer statistics for the current year, and projects that there will be 1,685,210 new cancer cases and 595,690 cancer deaths in the United States in 2016.

In terms of mortality, over the past decade, the rate dropped by 1.8% per year in men and 1.4% per year in women. This good news has been driven by continued decreases in death rates for the four major cancer sites — lung, breast, prostate, and colon/rectum — say the authors.

During the past 2 decades, death rates have dropped from a peak of 215.1 per 100,000 in 1991 to 166.4 in 2012. The decline is larger in men (28% since 1990) than in women (19% since 1991).

The report provides encouraging news about lung cancer deaths.

Those death rates declined 38% from 1990 to 2012 in males and 13% from 2002 to 2012 in females "due to reduced tobacco use as a result of increased awareness of the health hazards of smoking and the implementation of comprehensive tobacco control," write the authors.

In children and adolescents, brain cancer has surpassed leukemia as the leading cause of cancer death because of the "dramatic therapeutic advances against leukemia," they report.

Cancer is the leading cause of death in adults 40 to 79 years of age, and in both Hispanics and Asian/Pacific Islanders (the two groups constitute about one-quarter of the American population). Furthermore, cancer is the leading cause of death in 21 of the 50 states — Alaska, Arizona, Colorado, Delaware, Florida, Georgia, Idaho, Kansas, Maine, Massachusetts, Minnesota, Montana, Nebraska, New Hampshire, New Mexico, North Carolina, Oregon, South Carolina, Vermont, Virginia, and Washington.

Heart disease remains the top cause of death overall in the United States, but cancer is a close second, the authors report. In 2012, there were 599,711 (24%) deaths from heart disease, compared with 582,623 (23%) deaths from cancer.

The report also reflects a recent change in cancer screening in the United States: the erosion of prostate-specific antigen (PSA) testing. This phenomenon is tied to the overall cancer incidence declining by 3.1% per year in men from 2009 to 2012; about half of that drop is related to declines in prostate cancer diagnoses as PSA testing decreases, say the authors.

During that same — from 2009 to 2012 — the overall incidence of cancer was stable in women.

The report's incidence data come from the National Cancer Institute (Surveillance, Epidemiology, and End Results [SEER] Program), the Centers for Disease Control and Prevention (National Program of Cancer Registries), and the North American Association of Central Cancer Registries. Mortality data come from the National Center for Health Statistics.

CA Cancer J Clin. Published online January 7, 2016. Abstract


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