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New ACS analysis shows large declines in cancer mortality since 1971 Passage of National Cancer Act

It’s been 50 years since President Nixon signed the National Cancer Act, launching the War on Cancer. How did we do? Substantial progress has been made in the war against cancer, according to new analysis from the American Cancer Society.

Appearing online Nov. 11 in JAMA Oncology, the analysis found that as of 2019 mortality rates for all cancers combined dropped by 27% since 1971 and by 32% since 1991, when mortality rates were highest. Mortality rates have dropped since 1971 for 12 of 15 investigated cancer sites, including by as much as 70% for cervical and stomach cancer. However, rates increased in parts of the South and for pancreatic cancer and progress was limited for brain and esophageal cancers.

“The increase in overall cancer mortality in many parts of the southern states suggests unequal dissemination of advances in cancer control like the availability of screening and therapeutic advances,” said Ahmedin Jemal, DVM, PhD, senior vice president of Surveillance and Health Equity Science, “whereas the continuous increase in pancreatic cancer mortality underscores the need for increased investment in the prevention, early detection, and treatment of this highly fatal disease.”

The year 2021 marks the 50th anniversary of the National Cancer Act of 1971, which designated defeating cancer as a national priority. The Act allocated substantial resources to the National Cancer Institute, which has seen a 25-fold annual budget increase since the law was enacted, from 227 million to 6.01 billion.

ACS researchers, led by Tyler Kratzer, epidemiologist, analyzed national cancer mortality data from the National Center for Health Statistics for all cancers and for the top 15 sites in 1971, which accounted for 81% of cancer deaths at the time. Rate ratios and rate differences were calculated to compare mortality in 2019 to 1971 and rate peak years when applicable.

Researchers credit the decline in mortality rates to improvements in prevention, early detection, and treatment. For example, the substantial declines in lung, oral cavity, and bladder cancer mortality largely reflect reductions in smoking due to enhanced public awareness of health consequences, increased cigarette excise taxes, and smoke-free laws, whereas the large declines in female breast and colorectal cancer mortality are mainly due to screening and advances in treatment.

According to the authors, the findings demonstrate considerable progress in reducing cancer burden in the wake of expanded public investment following the passage of the National Cancer Act in 1971. Improving health equity through investment in social determinants of health and implementation research is critical to ensuring continued progress.

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