The death rate from cancer in the United States declined by 29 percent between 1991 and 2017, with the largest drop ever seen in a single year — 2.2 percent — occurring between 2016 and 2017, according to the American Cancer Society (ACS) report "Cancer Facts & Figures 2020."
Mortality rates have been on a steady decline for over two decades, but the large single-year drop surprised scientists. Researchers attribute the majority of the 2.2 percent plunge to a reduction in lung cancer–related deaths. Lung cancer is still the leading cause of cancer death and the second leading cause of death in the United States.
Fewer people smoking, combined with new treatments like immunotherapy, video-assisted surgery, and stereotactic ablative radiotherapy, have likely driven the drop in lung cancer deaths, say experts. “It was like a perfect storm, but a good storm,” said Rebecca Siegel, MPH, the scientific director of surveillance research at the ACS, of the decline.
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Among other good news noted in the report:
- There's been a dip in melanoma skin cancer–related deaths for younger generations, ascribed to two new immunotherapies: Yervoy (ipilimumab) and Zelboraf (vemurafenib), approved by the FDA in 2011.
- Improved survival rates for some types of leukemia and lymphoma have been attributed to the availability of targeted therapies. For example, the five-year relative survival rate for chronic myeloid leukemia increased from 22 percent in the mid-1970s to 70 percent for those diagnosed during 2009 through 2015.
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Statistics Highlight Some Changeable Risk Factors and Access to Care
Not all the news was positive, however. Deaths due to cervical cancer are completely preventable, thanks to screening, for example. But, year after year, the second most common cause of death in women in their twenties and thirties is cervical cancer. “There were 10 deaths a week in 2017,” said Siegel.
The disparity in cervical cancer incidence and mortality varies from state to state, too. This may be a result of unequal use of the HPV vaccine and differences in Medicaid expansion throughout the states. Research suggests that screening rates are higher among urban respondents, younger women, and those with insurance.
Among other areas highlighted as having room for improvement:
- Although prostate cancer death rates declined 52 percent from 1993 to 2017, reductions in prostate cancer cases have halted. Diagnoses for this cancer also declined, most likely because of a reduction in the use of Prostate-specific antigen (PSA) testing, which the U.S Preventive Services Task Force recommended out of concern for overdiagnosis and overtreatment.
- Over the past decade, the report found a slight rise in female breast cancer incidence, attributed to a decline in fertility rates and an increase in obesity. Breast cancer accounts for 30 percent of female cancers.
- Obesity was cited as the cause for an increase in kidney, pancreatic, and liver cancer. The majority of liver cancer cases are preventable because most of the risk factors, including obesity, excess alcohol consumption, smoking, and the hepatitis B and hepatitis C viruses, are modifiable.
- Survival rates were lower for black patients than for white patients for every cancer type except for kidney and pancreatic cancers.
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Colorectal Cancer and Cancers in Adolescents and Young Adults in the Spotlight
An estimated 1,806,590 new cancer diagnoses and 606,520 cancer deaths in the United States will occur this year, with about 4,950 new cases and more than 1,600 deaths each day.
Researchers are continuing to look more closely at individual cancers to understand the reasons behind slower declines, specifically in cases of colorectal cancer and the incidence of certain cancers in adolescents and young adults (AYAs), ages 15 to 39 years old, including acute lymphocytic leukemia (ALL), thyroid cancer, melanoma, and lymphoma.
Over the coming year, there are 89,500 new cancer cases and 9,270 cancer deaths projected among AYAs.
The American Cancer Society is expected to issue two reports in the coming months specifically targeted to colorectal cancer and AYAs.
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