Cancer Statistics: Public Health Improvements and Future Thoughts

Maurie Markman, MD


March 07, 2023

This transcript has been edited for clarity.

Hello. I'm Dr Maurie Markman from Cancer Treatment Centers of America. I'd like to briefly discuss a very important paper that recently appeared in CA: A Cancer Journal for Clinicians. This has been widely reported in the popular press, but I think it's important for the oncology community and the medical community to be aware of some of the details of this analysis. The paper is titled, "Cancer Statistics, 2023."

This manuscript describes some very important events as they relate to cancer incidence, and I want to summarize three of the findings in this paper. First, and perhaps most important, the analysis looked at cancer death rates from 1991 to 2020 and noted that, over this period, there has been a 33% reduction in the risk for cancer deaths that would have been predicted.

That means changing the lives of 3.8 million individuals who would have been projected to die of cancer over this period. Let me say that again: 3.8 million people who might have died due to cancer did not die over this period of time because of multiple efforts, including use of screening, treatments, reduction in smoking, and human papillomavirus (HPV) vaccination.

This is, I think, an incredible public health accomplishment, which obviously needs to be lauded. But we need to continue to work on this to make sure we don't go in the wrong direction in the future and that we continue to reduce the risk for cancer deaths.

The second very important observation was one that I particularly noticed because of my interest in gynecologic cancers. Looking at the years 2012-2019, and specifically among women in their early 20s — the first group of women who had HPV vaccination in whom we might have seen a reduction in cancer incidence because of vaccination — a 65% drop in cervical cancer incidence was documented among this population compared with what would have been predictably seen without HPV vaccination.

This is an extraordinary public health advance. This obviously needs to be both emphasized and focused on in the future. We need to vaccinate both young men and young women in their adolescent years. This is going to continue to reduce cervical cancer and all other HPV-related events.

Finally, on the flip side, this study identified an increase in prostate cancer incidence of approximately 3% annually from 2014 to 2019. This is perhaps due to the recommendations that have come through in the previous years indicating that we should be doing less prostate cancer screening. Now, those recommendations, when they came about from various groups, were obviously debated and some were heavily criticized.

I would suggest, and others I'm sure will as well, that on the basis of these data — an increase in prostate cancer — we need to go back and look at some of those recommendations. The data leading to those recommendations were obviously well considered, but perhaps they were overly aggressive in reducing recommendations for prostate cancer screening, and maybe they need to be revised.

This is a very important, provocative paper. There are hard data that are very positive, but there are also some questionable data related to what we're currently doing.

For those of you who are interested in cancer epidemiology — and quite frankly, any doctor who deals with patients with cancer, or family members who are concerned about what we are doing and what we are accomplishing — this is a great paper and I would encourage you to look at it.

Thank you for your attention.

Maurie Markman, MD, is president of medicine and science at Cancer Treatment Centers of America in Philadelphia. He has more than 20 years of experience in cancer treatment and gynecologic oncology research.

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