Overall cancer death rates continue to decrease in men, women, and children for all major racial and ethnic groups, according to the Annual Report to the Nation on the Status of Cancer, 1975-2014, released today. Credited for the decline are reduced tobacco use (a well-established cause of 16 cancer types), improved early detection, and more effective treatments.
The report finds that death rates during the period 2010-2014 decreased for 11 of the 16 most common types of cancer in men, and for 13 of the 18 most common types of cancer in women, including lung, colorectal, female breast, and prostate cancers. Meanwhile, death rates increased for cancers of the liver, pancreas, and brain in men, and for liver and uterine cancer in women.
The report finds overall cancer incidence rates, or rates of new cancers, decreased in men, but stabilized in women during the period 1999-2013.
The American Cancer Society, Centers for Disease Control and Prevention (CDC), National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) have collaborated annually since 1998 to provide updates on cancer incidence and mortality patterns in the U.S. This most recent report appears early online in the Journal of the National Cancer Institute
This year’s special topic: survival
Each Annual Report to the Nation features an in-depth analysis of a selected topic. This year’s focus is on survival by stage, race/ethnicity, and state of residence for common cancers. It finds that several but not all cancer types showed a significant improvement over time for both early- and late-stage disease, and varied significantly by race/ethnicity and state.
“While trends in death rates are the most commonly used measure to assess progress against cancer, survival trends are also an important measure to evaluate progress in improvement of cancer outcomes,” said the Society’s Ahmedin Jemal, DVM, PhD., lead author of the study. “We last included a special section on cancer survival in 2004, and as we found then, survival improved over time for almost all cancers at every stage of diagnosis. But survival remains very low for some types of cancer and for most types of cancers diagnosed at an advanced stage.”
- Compared to cases diagnosed in 1975-1977, five-year survival for cancers diagnosed in 2006-2012 increased significantly for all but two types of cancer: cervix and uterus.
- The greatest absolute increases in survival (25 percent or greater) were seen in prostate and kidney cancers as well as non-Hodgkin lymphoma, myeloma, and leukemia.
- Cancers with the lowest five-year relative survival for cases diagnosed in 2006-2012 were pancreas (8.5 percent), liver (18.1 percent), lung (18.7 percent), esophagus (20.5 percent), stomach (31.1 percent) and brain (35 percent).
- Cancers with the highest five-year relative survival for cases diagnosed in 2006-2012 were prostate (99.3 percent), thyroid (98.3 percent), melanoma (93.2 percent) and female breast (90.8 percent).
“While this report found that five-year survival for most types of cancer improved among both blacks and whites over the past several decades, racial disparities for many common cancers have persisted, and they may have increased for prostate cancer and female breast cancer,” said Lynne T. Penberthy, MD, MPH, associate director of NCI’s Surveillance Research Program. “We still have a lot of work to do to understand the causes of these differences, but certainly differences in the kinds and timing of recommended treatments are likely to play a role.”
“This report found that tobacco-related cancers have low survival rates, which underscores the importance of continuing to do what we know works to significantly reduce tobacco use,” said Lisa C. Richardson, MD, MPH, director of CDC’s Division of Cancer Prevention and Control.
The authors say devoting increased resources and enacting laws and regulations to strengthen tobacco control policies at both state and federal levels — such as tobacco product pricing strategies, plain packaging, statewide comprehensive smoke-free laws, and reducing nicotine content in tobacco products to nonaddictive — could greatly reduce morbidity and mortality from smoking-related cancers and other smoking-related diseases.
“In addition, every state in the nation has an adult obesity prevalence of 20 percent or more. With obesity as a risk factor for cancer, we need to continue to support communities and families in prevention approaches that can help reverse the nation’s obesity epidemic. We need to come together to create interventions aimed at increasing the uptake of recommended, effective cancer screening tests, and access to timely cancer care,” said Dr. Richardson.
The authors say additional resources are required to create neighborhoods that encourage physical activity and healthy eating habits, and to identify new approaches to prevent and reverse the obesity epidemic.
Study of risk factors needed
The authors say more attention and resources are needed to identify major risk factors for common cancers, such as colorectal, breast, and prostate. Also needed, they say, are concerted efforts to understand the increasing incidence trends in uterine, female breast, and pancreatic cancer.
“The continued drops in overall cancer death rates in the United States are welcome news, reflecting improvements in prevention, early detection, and treatment,” said Betsy A. Kohler, MPH, CTR, executive director of NAACCR. “But this report also shows us that progress has been limited for several cancers, which should compel us to renew our commitment to efforts to discover new strategies for prevention, early detection, and treatment, and to apply proven interventions broadly and equitably.”