In the Journals Plus

US cancer deaths continue to decline

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May 22, 2018

Ned Sharpless

Cancer deaths continue to decline among men, women and children in the United States, according to the Annual Report to the Nation on the Status of Cancer.

Deaths due to malignancy also have decreased among all major racial and ethnic groups, according to the report, a collaboration between the CDC, NCI, American Cancer Society and North American Association of Central Cancer Registries.

Cancer incidence from 1999 to 2014 declined among men and remained stable among women, the report showed.

A companion study revealed an increase in late-stage prostate cancer incidence and stabilization of prostate cancer mortality, which had been declining for decades.

“This year’s report is an encouraging indicator of progress we’re making in cancer research. As overall death rates continue to decline for all major racial and ethnic groups in the United States, it’s clear that interventions are having an impact,” NCI Director Ned Sharpless, MD, said in a press release. “The report also highlights areas where more work is needed. With steadfast commitment to patients and their families, we will be able to lower the mortality rates faster and improve the lives of those affected by cancer.”

The report includes data about cancer incidence and mortality from 1999 through 2015.

During that period, overall cancer death rates decreased by 1.8% per year among men and by 1.4% per year among women.

Photo of Paolo Boffetta
Paolo Boffetta

“These findings are not really surprising because they confirm trends that have been going on for several years,” Paolo Boffetta, MD, MPH, associate director of global cancer and professor at Icahn School of Medicine at Mount Sinai, told HemOnc Today. “However, because cancer incidence used to increase among women — mainly driven by lung cancer — the fact that the increase has now stopped is good news.”

Incidence rates for seven of the 17 most common cancer types among men and seven of the 18 most common cancers among women declined from 2010 to 2014.

Death rates for 11 of the 18 most common cancer types among men and 14 of the 20 most common cancers among women declined from 2011 to 2015. However, death rates for cancers at certain sites increased. These included cancers of the liver, pancreas, brain and other nervous system among men and women; nonmelanoma skin cancer and cancers of the oral cavity, pharynx and soft tissue among men; and cancers of the uterus among women.

“New therapies have certainly contributed, in particular for cancers with good prognosis (eg, breast, prostate cancer),” Boffetta said. “For many cancers with high mortality (eg, liver and pancreas cancer) therapeutic progress have been limited. Progress in some areas such as immunotherapy, however, might have an impact on many cancers.”

For all cancer types combined, men had greater cancer incidence and higher death rates than women across every racial and ethnic group. However, black men and white women had the highest incidence rates compared with other racial groups, and black men and women had the highest death rates compared with other racial groups.

Otis W. Brawley

“There continue to be significant declines in the cancer death rate, with significant differences in rate by sex, race and ethnicity,” Otis W. Brawley, MD, chief medical officer for American Cancer Society and a HemOnc Today Editorial Board member, said in the release. “We need to continue working to understand the reasons for the disparities and how to most efficiently continue supporting and, if possible, accelerate these declines.”

In a companion study, Serban Negoita, MD, DrPH, chief of the data quality, analysis and interpretation branch at NCI, and colleagues looked at trends in prostate cancer.

Between 2007 and 2014, overall prostate cancer incidence rates declined an average of 6.5% per year. However, incidence of distant-stage disease increased from a low of 7.8 cases per 100,000 in 2010 to 9.2 cases per 100,000 in 2014.

“The slight increase in late-stage prostate cancer incidence comes following a time when changes were made to PSA screening guidelines, which resulted in fewer men being screened,” Bobby Liaw, MD, assistant professor of medicine, hematology and medical oncology at The Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai, said in a statement. “However, as screening guidelines have again changed recently, allowing physicians to individualize the decision to screen men based on their personal and familial risks, going forward we expect to see prostate cancer cases being caught at earlier stages, hopefully leading to a reciprocal decrease in new incident cases of advanced-stage disease.”

The report also showed that prostate cancer mortality — which declined steadily from 1993 to 2013 — stabilized between 2013 and 2015.

“This flattening out of prostate cancer mortality [likely is] a reflection of all the new treatments that have come out recently,” Liaw said. “This tells me that all of our efforts to better understand this disease in the overall population of prostate cancer patents has been worthwhile.” – by Cassie Homer

Disclosures: Boffetta, Brawley, Liaw, Negoita and Sharpless report no relevant financial disclosures. Some researchers report employment at American Cancer Society, which receives funding from Merck.

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