Cancer death rates continue to decline, but ‘more work ahead’ toward prevention
Cancer death rates declined between 2001 and 2017 in the United States for all cancer sites combined, according to the Annual Report to the Nation on the Status of Cancer published in Cancer.
Rates declined among all major racial and ethnic groups, as well as among men, women, adolescents, young adults and children.
The report also showed overall cancer incidence rates leveled off among men and increased slightly for women between 2012 and 2016.
“The United States continues to make significant progress in cancer prevention, early detection and treatment,” Robert R. Redfield, MD, director of the CDC, said in a press release. “[Although] we are encouraged that overall cancer death rates have decreased, there is still much more we can do to prevent new cancers and support communities, families and cancer survivors in this ongoing battle.”
The American Cancer Society, CDC, NCI and North American Association of Central Cancer Registries collaborated to compile the report, which provided updates on trends in cancer incidence and death rates using data on new cancer diagnoses between 2001 and 2016 and cancer deaths between 2001 and 2017. Researchers also studied trends for the leading cancer types by sex, racial or ethnic group, and age during the past 5 years.
Results showed cancer incidence rates decreased by an average of 0.6% annually between 2012 and 2016.
These trends, however, differed by sex, racial or ethnic group and cancer type.
Cancer incidence rates remained stable among men overall and non-Hispanic white men during the 5-year period but decreased among black, Hispanic, Asian/Pacific Islander and American Indian/Alaska Native men. Incidence rates among men increased for five of the 17 most common cancers, including liver cancer (average annual percent change [AAPC], 2.5%), melanoma (2.2%), kidney cancer (1.5%), oral cavity and pharyngeal cancer (1.2%) and pancreatic cancer (1.1%). Rates remained stable for seven cancers — including prostate — and decreased for five others, including lung (–2.6%), laryngeal (–2.3%), bladder (–1.6%), colorectal (–1.1%), and cancers of the brain and other nervous systems (–0.3%).
Among women of all racial and ethnic groups, cancer incidence rates increased by 0.2% annually between 2012 and 2016, driven by increases in liver cancer (AAPC, 3.7%), melanoma (1.9%), uterine cancer (1.3%), myeloma (1.2%), pancreatic cancer (1%), kidney cancer (0.6%), breast cancer (0.5%) and oral cavity and pharyngeal cancer (0.5%). Incidence rates remained stable for six other common cancers, including colorectal, and decreased for four cancers: ovarian cancer (–1.6%), lung cancer (–1.1%), bladder cancer (–0.9%) and brain and other nervous system cancers (–0.5%).
Despite the increased incidence rates of some malignancies, overall cancer deaths decreased an average of 1.5% annually between 2013 and 2017, including by 1.8% among men and by 1.4% among women.
Among men, death rates decreased for lung, colorectal and nine of the other 19 most common cancers while remaining stable for four cancers, including prostate, and increasing for four others (oral cavity/pharyngeal, soft tissue, pancreatic and brain/other nervous system).
Among women, death rates decreased for 14 of the 20 most common cancers. These included the three most common cancers — breast, lung and colorectal. Death rates among women increased for cancers of the liver, uterus, brain/nervous system, soft tissue and pancreas and remained stable for oral cavity/pharyngeal cancer.
For melanoma, researchers observed a 6.1% annual decrease in death rates among men and a 6.3% annual decrease among women. This represented the largest decline in death rates of all malignancies. Lung cancer death rates decreased by 4.8% annually among men and by 3.7% annually among women.
Among children aged younger than 15 years, cancer incidence rates increased an average of 0.8% annually between 2012 and 2016. Cancer death rates, however, decreased an average of 1.4% annually between 2013 and 2017.
Cancer incidence rates among adolescents and young adults aged 15 to 39 years increased an average of 0.9% annually between 2012 and 2016. Death rates decreased an average of 1% annually between 2013 and 2017.
A companion report showed targets for reducing death rates set under the federal government’s Healthy People 2020 initiative were met overall and for most sociodemographic groups, but not among men, blacks or residents of rural areas.
The report evaluated progress toward Healthy People objectives related to four common cancers — lung, colorectal, prostate and female breast.
It showed death rates decreased by 15% overall between 2007 and 2017, with declines that ranged from 4% in rural areas to 22% in metropolitan areas.
Targets for breast cancer screening (81.1%) and colorectal cancer screening (70.5%) had not yet been met overall or in any sociodemographic group, except for among those with advanced educational degrees. Although breast cancer screening rates rose slightly from 2008 to 2015 among Hispanic women, they declined among other groups — especially among women residing in rural areas, Asian women and women with public or no health insurance.
Targets also were not met for overall cigarette smoking, recent smoking cessation, excessive alcohol use and obesity, although they have been met for secondhand smoke exposure and physical activity.
“Thanks to advances brought about by basic research, we are making remarkable progress against cancer,” Norman E. “Ned” Sharpless, MD, director of the NCI, said in a press release. “This report provides further evidence that cancer death rates continue to decline. But we must not be complacent. The cancer incidence data — especially the increase in cancer among women — is a clear reminder that there is more work ahead.” – by John DeRosier
Disclosures: The researchers report no relevant financial disclosures.