NSCLC and Melanoma Lead Continuing Fall in US Cancer Death Rates

Pam Harrison

July 14, 2021

Cancer death rates in the United States continue to decline overall for many common cancers. This decline is particularly prounounced for non–small cell lung cancer (NSCLC) and melanoma, according to the latest statistics in the "Annual Report to the Nation on the Status of Cancer."

The overall incidence of many cancers continues to increase among women and children as well as among adolescents and young adults, the report indicates.

The report was published online July 8 in the Journal of the National Cancer Institute.

For the most recent interval (2014 to 2018), there was a decrease in death rates for 11 of the 19 most common cancers among men and for 14 of 20 of the most common cancers among women, lead author Farhad Islami, MD, PhD, American Cancer Society, Atlanta, Georgia, and colleagues report.

Expressed as an average annual percent change, overall death rates decreased by 2.2% among men and by 1.7% among women over the study period.

"The continued decline in cancer death rates should be gratifying to the cancer research community, as evidence that scientific advances over several decades are making a real difference in outcomes at the population level," Normal Sharpless, MD, director, National Cancer Institute, said in a statement.

"I believe we could achieve even further improvements if we address obesity, which has the potential to overtake tobacco use to become the leading modifiable factors associated with cancer," he added.

Stable Incidence Rates

Incidence data were collected for all cancers diagnosed from 2001 through 2017.

"During the most recent 5 years (2013–2017), incidence rates were stable in both sexes combined and among males but increased slightly among females," the authors note.

Over the same 5 years, cancer incidence rates remained stable among White men and Black women. They declined among Black and Hispanic men as well as among some other minority ethnic groups.

Interestingly, the overall cancer incidence rate was similar between White and Black patients, the authors add.

Incidence trends for the three most common cancers among men — prostate cancer, lung cancer, and colorectal cancer (CRC) — were similar for most racial and ethnic groups.

Among women, the incidence of breast and uterine cancer increased in every racial and ethnic group between 2013 and 2017. Incidence rates of CRC and lung cancer continued to drop in most of the same groups.

Cancer Death Rates Declining

Cancer death rates decreased by 1.9% per year on average between 2012 and 2018 in both sexes, with rates of decline accelerating over recent years. For example, between 2001 and 2015, cancer death rates in men declined by 1.8% per year, and between 2015 and 2018, it declined by 2.3% per year.

Similarly, among women, cancer death rates declined by 1.4% from 2001 to 2015 and by 2.1% from 2015 to 2018.

Overall, cancer death rates declined in every racial and ethnic group. The overall cancer death rate remained highest for Black patients.

"The 3 most common cancer deaths among males were lung, prostate, and colorectal cancer in most racial/ethnic groups," Islami and colleagues observe. Among women, the three most common causes of cancer deaths were from lung cancer, breast cancer, and CRC in most racial and ethnic groups. Between 2014 and 2018, the largest increase in death from cancer among women was from uterine cancer.

Largest Decreases Seen in NSCLC and Melanoma

The largest falls in cancer deaths rates were for NSCLC and melanoma.

Across the full study interval between 2001 and 2018, the decline in death from lung cancer steadily increased from 2% between 2001 and 2005; 2.9% between 2005 and 2012; 4% between 2012 and 2015; and 5.7% between 2015 and 2018.

This held true for death from melanoma. A decline of 5.7% per year since 2013 was seen among men, and a 4.4% decline per year was seen among women.

Between 2009 and 2014, there was a 3.1% increase per year in the 2-year relative survival rate for patients diagnosed with distant-stage melanoma. The pattern was similar among men and women. "In contrast, earlier declines decelerated for colorectal and female breast cancers and stabilized for prostate cancer in recent years," the authors report.

"The declines in lung cancer and melanoma death rates are the result of progress across the entire cancer continuum — from reduced smoking rates to prevent cancer to discoveries such as targeted drug therapies and immune checkpoint inhibitors," Karen Knudsen, PhD, chief executive officer, American Cancer Society, said in a statement.

"While we celebrate the progress, we must remain committed to research, patient support and advocacy to make even greater progress to improve the lives of cancer patients and their families," she added.

The authors are solely funded through the American Cancer Society.

J Natl Cancer Inst. Published online July 8, 2021. Abstract

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