Cancer Mortality Rate Dips

An annual report from the American Cancer Society shows a record drop

THE MORTALITY RATE from cancer in the United States declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest singleyear drop ever recorded, according to the American Cancer Society. The American Cancer Society’s annual report, “Cancer Statistics, 2020” was published in the January/February issue of the society’s peer-reviewed journal CA: A Cancer Journal for Clinicians. The report estimates the number of new cancer cases and deaths expected in the U.S. each year.

The 26-year decline in overall cancer mortality is due to long-term decreased mortality rates in the four most common cancer types: lung, colorectal, breast, and prostate. The decline in deaths from lung cancer led the record drop. Declines in smoking and advances in early detection and treatment have improved the progress in reducing lung cancer mortality, whereas progress in reducing colorectal, breast, and prostate cancers has slowed, according to the report. Yet, lung cancer remains the number one mortality risk–almost one-quarter of all cancer deaths are due to lung cancer, more than breast, prostate, and colorectal cancers combined.

The following rates were reported for lung, colorectal, breast, and prostate cancers:

• Lung cancer mortality rates declined by 51% from 1990 to 2017 among men and 26% from 2002 to 2017 among women. From 2013 to 2017, the rates of new lung cancer cases dropped by 5% per year in men and 4% per year in women.
• Breast cancer mortality rates declined 40% from 1989 to 2017.
• Prostate cancer mortality rates declined 52% from 1993 to 2017. • Colorectal cancer mortality rates declined 53% from 1980 to 2017 among men and by 57% from 1969 to 2017 among women.

Notably, the report also found that recent mortality declines were dramatic for melanoma of the skin in the wake of the FDA’s 2011 approval of new immunotherapy drugs for metastatic cancer. Mortality for melanoma declined 7% annually during 2013-2017 in people ages 20 to 64, and 1% per year in people ages 50 to 64, and 5% to 6% in people aged 65 and older. Progress in the 65+ age group was particularly striking, according to the report, because rates in this age group were increasing prior to 2013.

The decline in the death rate for all cancers over the past 26 years has been steady. Overall cancer death rates dropped by an average of 1.5% per year between 2008 and 2017. A total of 1,806,590 new cancer cases and 606,520 deaths are expected in the U.S. in 2020, which is about 4,950 new cases and more than 1,600 deaths each day.

Other Highlights
The report also included a section on cancer in children and adolescents. Cancer is the second most common cause of death in children aged 1 to 14 in the U.S., surpassed only by accidents. Leukemia is the leading cause of cancer death in both males and females aged 15-29 years. Adolescents aged 15-19 have a unique mix of cancer types including childhood cancers (such as acute lymphocytic leukemia), adult cancers (thyroid cancer and melanoma skin cancer), and a higher risk of lymphoma. Hodgkin lymphoma accounts for 13% of cancer cases in adolescents compared to 9% in ages 20-29 years and 3% in ages 30-39. Cervical cancer is the second-leading cause of cancer death among women ages 20-39 years. The overall cancer incidence rate in children and adolescents has been increasing slightly, by 0.7% per year, since 1975 while death rates have declined continuously from 6.3 per 100,000 population in children and 7.1 in adolescents in 1970 to 2.0 and 2.7, respectively, in 2017, for overall cancer mortality reductions of 68% in children and 63% in adolescents.

Other highlights include:
• The overall rate of new cancer cases in men stayed about the same through 2016 after dropping significantly from 2007 to 2014, due to slowing declines for colorectal cancer and stabilizing rates for prostate cancer. Researchers attribute a sharp drop in prostate cancer diagnoses from 2007 to 2014 to decreased PSA following U.S. Preventive Services Task Force recommendations against routine use of the test because of growing concerns about overdiagnosis and overtreatment.
• The overall rate of new cancer cases in women has stayed about the same over the past few decades. While lung cancer cases have continued to decline, the drop in colorectal cancer cases has slowed and other common cancers in women have increased or stayed the same.
• Rates of new cases continue to increase for cancers of the kidney, pancreas, liver, and oral cavity and pharynx (among non-Hispanic whites) and melanoma skin cancer. Liver cancer is increasing fastest, by 2% to 3% annually during 2007 through 2016, although the pace has slowed from previous years.
• The 5-year relative survival rate for all cancers combined that were diagnosed during 2009 through 2015 was 67% overall.