The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported. The news comes from
Cancer Statistics, 2020, the latest edition of the American Cancer Society’s annual report on cancer rates and trends.
The steady 26-year decline in overall cancer mortality is driven by long-term drops in death rates for the four major cancers – lung, colorectal, breast, and prostate. The pace of mortality reductions for lung cancer – still the leading cause of cancer death – accelerated in recent years (from 2% per year to 4% overall), spurring the record one-year drop in overall cancer mortality. In contrast, progress slowed for colorectal, breast, and prostate cancers.
The article appears early online in CA: A Cancer Journal for Clinicians, and is accompanied by a consumer version, Cancer Facts & Figures 2020, available on cancer.org. The annual report estimates the numbers of new cancer cases and deaths expected in the U.S. each year. These estimates are among the most widely quoted cancer statistics in the world.
Tune in to
NBC Nightly News with Lester Holt this evening (Jan. 8) to hear our Chief Medical Officer
Bill Cance discuss these new statistics.
More than 2.9 million deaths avoided since 1991, when rates were at their highest
Overall cancer death rates dropped by an average of 1.5% per year during the most recent decade of data (2008-2017), continuing a trend that began in the early 1990s and resulting in the 29% drop in cancer mortality in that time. The drop translates to approximately 2.9 million fewer cancer deaths than would have occurred had mortality rates remained at their peak. Continuing declines in cancer mortality contrast with a stable trend for all other causes of death combined, reflecting a slowing decline for heart disease, stabilizing rates for cerebrovascular disease, and an increasing trend for accidents and Alzheimer disease.
Lung cancer death rates have dropped by 51% (since 1990) in men and by 26% (since 2002) in women, with the most rapid progress in recent years. For example, reductions in mortality accelerated from 3% per year during 2008-2013 to 5% per year during 2013-2017 in men and from 2% to almost 4% in women. However, lung cancer still accounts for almost one-quarter of all cancer deaths, more than breast, prostate, and colorectal cancers combined.
The most rapid declines in mortality occurred for melanoma of the skin, on the heels of breakthrough treatments approved in 2011 that pushed one-year survival for patients diagnosed with metastatic disease from 42% during 2008-2010 to 55% during 2013-2015. This progress is likewise reflected in the overall melanoma death rate, which dropped by 7% per year during 2013-2017 in people ages 20 to 64, compared to declines during 2006-2010 (prior to FDA approval of ipilimumab and vemurafenib) of 2%-3% per year in those ages 20 to 49 and 1% per year in those ages 50 to 64. Even more striking are the mortality declines of 5% to 6% in individuals 65 and older, among whom rates were previously increasing.
“The news this year is mixed,” said
Rebecca Siegel, MPH, lead author of the report. “The exciting gains in reducing mortality for melanoma and lung cancer are tempered by slowing progress for colorectal, breast, and prostate cancers, which are amenable to early detection. It’s a reminder that increasing our investment in the equitable application of existing cancer control interventions, as well as basic and clinical research to further advance treatment, would undoubtedly accelerate progress against cancer.”
Highlights from the report:
- The death rate for breast cancer dropped by 40% from 1989 to 2017.
- The death rate for prostate cancer dropped by 52% from 1993 to 2017.
- The death rate for colorectal cancer dropped by 53% from 1980 to 2017 among males and by 57% from 1969 to 2017 among females.
- Decades-long rapid increases in liver cancer mortality appear to be abating in both men and women.
- Cervical cancer, which is almost completely preventable, caused 10 premature deaths per week in women ages 20-39 in 2017.
- In 2020, 1,806,590 new cancer cases and 606,520 cancer deaths are projected to occur in the United States. (Estimates should not be compared year-to year. They are based on computer models of cancer trends and population and may vary considerably.)
- Progress for hematopoietic and lymphoid malignancies (leukemias and lymphomas) has been especially rapid due to improvements in treatment protocols, including the development of targeted therapies. The 5-year relative survival rate for chronic myeloid leukemia increased from 22% in the mid-1970s to 70% for those diagnosed during 2009 through 2015, and most patients treated with tyrosine kinase inhibitors now experience nearly normal life expectancy.
- The overall cancer incidence rate in men declined rapidly from 2007 to 2014, but stabilized through 2016, reflecting slowing declines for colorectal cancer and stabilizing rates for prostate cancer.
- The overall cancer incidence rate in women has remained generally stable over the past few decades because lung cancer declines have been offset by a tapering decline for colorectal cancer and increasing or stable rates for other common cancers in women.
- The slight rise in breast cancer incidence rates (by approximately 0.3% per year) since 2004 has been attributed at least in part to continued declines in the fertility rate and increased obesity, factors that may also contribute to increasing incidence for uterine cancer (1.3% per year from 2007-2016).
- Lung cancer incidence continues to decline twice as fast in men as in women, reflecting historical differences in tobacco uptake and cessation.
- In contrast, colorectal cancer incidence patterns are generally similar in men and women, with the rapid declines noted during the 2000s in the wake of widespread colonoscopy uptake appearing to taper in more recent years.
- Incidence continues to increase for cancers of the kidney, pancreas, liver, and oral cavity and pharynx (among non-Hispanic whites) and melanoma of the skin. Liver cancer is increasing most rapidly, by 2% to 3% annually during 2007 through 2016, although the pace has slowed from previous years.
- The 5-year relative survival rate for all cancers combined diagnosed during 2009 through 2015 was 67% overall, 68% in whites, and 62% in blacks.
- Cancer survival has improved since the mid-1970s for all of the most common cancers except cervical and uterine cancers. Stagnant survival rates for these cancers largely reflect a lack of major treatment advances for patients with recurrent and metastatic disease.
“The accelerated drops in lung cancer mortality as well as in melanoma that we're seeing are likely due at least in part to advances in cancer treatment over the past decade, such as immunotherapy,” said Dr. Cance. “They are a profound reminder of how rapidly this area of research is expanding, and now leading to real hope for cancer patients.”
Special section in Cancer Facts & Figures: Cancer in adolescents and young adults
Each year, ACS researchers include a special section in
Cancer Facts & Figures highlighting an issue of cancer research or care. This year, the topic is cancer in adolescents and young adults (AYAs). As more research focuses on these patients, we are learning more about how cancers in this age group develop and are best treated:
- AYAs are more likely to be diagnosed at a late stage because of delays in diagnosis due to the rarity of cancer in this age group, higher uninsured rates, and higher rates of aggressive disease.
- AYA patients have a high risk of long-term and late effects, including infertility, sexual dysfunction, heart problems, and future cancers.
- In 2020, the most commonly diagnosed cancers will be thyroid, testicular, and melanoma skin cancer in ages 20-29 years, and breast, thyroid, and melanoma in ages 30-39 years.
- Leukemia is the leading cause of cancer death in both males and females ages 15-29 years, while brain and breast cancers are the leading causes of death in males and females, respectively, ages 30-39 years. Although cervical cancer is highly preventable through the HPV vaccine and screening, it is the second-leading cause of cancer death among women ages 20-39 years.
- During 2007-2016, the steepest increases in thyroid cancer incidence rates occurred among adolescents, 4.9% per year among males and 4.1% per year among females.
- In adults ages 20-39 years, rates increased for cancers of the colorectum (3%-6% per year), endometrium (3%), kidney (3%), and breast (0.2%-2%), with more rapid increases among those in their 20s.