Cancer death rates ‘must decline faster’ to achieve Moonshot goal
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Key takeaways:
- An NCI-led analysis showed cancer mortality-rate declines have accelerated, but the pace is not fast enough to achieve the goal of a 50% decrease by 2047.
- Lifestyle modifications could help reduce death rates.
Cancer Moonshot’s goal of reducing the cancer death rate by at least 50% over the next 25 years will depend upon greater access to and utilization of cancer prevention interventions, according to a study presented at an NCI press briefing.
The briefing, held during American Association for Cancer Research Annual Meeting, included a presentation of data on cancer incidence and mortality from an NCI-led study published in Cancer Discovery. The data showed an acceleration in cancer death rate declines, from 1.4% per year between 2000 and 2015 to 2.3% per year between 2016 and 2019, according to Meredith Shiels, PhD, MHS, senior investigator for NCI’s division of cancer epidemiology and genetics.
“If this progress continues at the same rate between 2022 and 2047, we project a 44% further decline in cancer death rates,” Shiels said. “This would be a tremendous amount of progress over this period, but it would fall short of the 50% decline goal outlined in the Cancer Moonshot.”
Improvements and setbacks
The study — conducted by Shiels and her colleagues at NCI’s division of cancer epidemiology and genetics, the Center for Cancer Research and other collaborators — assessed data from NCI’s SEER database CDC’s National Center for Health Statistics. The investigators evaluated patterns in age-standardized cancer incidence, survival and death rates from 2000 to 2019 for all cancers combined, as well as the six cancers that together comprised 57% of the 600,000 cancer deaths in 2019. These included lung, colorectal, pancreatic, breast, prostate and liver cancer.
The objective was to evaluate the likelihood of achieving Cancer Moonshot’s goal based on recent cancer mortality trends, Shiels said.
“We estimated what cancer death rates could be in 2047 if current patterns continue into the future,” Shiels said. “We focused on the six leading causes of cancer death in the United States and highlighted the most promising and realistic opportunities to accelerate progress.”
The researchers found the reduction in the overall cancer death rate has been driven largely by substantial decreases in deaths due to lung cancer, which declined by 4.7% between 2014 and 2019; colorectal cancer, which decreased by 2% between 2010 and 2019; and breast cancer, which decreased by 1.2% between 2013 and 2019.
Mortality rate patterns for several other cancers have lagged in comparison.
Although prostate cancer death rates declined by 3.4% per year between 2000 and 2013, progress slowed between 2013 and 2019, with only a 0.6% decrease per year. Pancreatic cancer mortality rates increased by 0.2% per year between 2006 and 2019, whereas liver cancer mortality rates, which had been on the rise for decades, declined by 0.5% between 2016 and 2019.
“Cancer death rates must decline faster to reach our goal,” Shiels said. “We need to get to an annual average decline of 2.7% per year to reach the 50% goal.”
Opportunities for improvement
The study will provide direction and focus for NCI officials as they aim to achieve the goal of President Joe Biden and first lady Jill Biden’s Cancer Moonshot, NCI Director Monica M. Bertagnolli, MD, FACS, FASCO, said during the briefing.
“Beyond that, it sheds light on what it would mean to end cancer as we know it in one important milestone,” she said.
Bertagnolli discussed key approaches the NCI has identified, including smoking cessation programs, to help make Biden’s vision a reality.
“We know that up to 30% of all cancer deaths are related to smoking,” she said. “So, we are doubling down on a concerted effort in that area, through making cigarette smoking less attractive. Even more importantly, we’re making a concerted effort toward getting evidence-based smoking cessation tools to every American who wants them.”
Lifestyle modifications such as maintaining a normal weight, healthy diet and exercise, and sun protection are also important toward substantially reducing cancer mortality rates, Bertagnolli said. She also stressed the importance of efforts to eliminate viral causes of cancer, such as HPV and hepatitis C.
“We can eliminate cervical cancer in the United States by getting everyone vaccinated who should be vaccinated,” she said. “We also have three other really nasty cancers that shouldn’t be in our society. Eliminating chronic infection from hepatitis C prevents liver cancers, which are very difficult to treat once they’ve already arrived.”
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