Overall cancer death rates in the U.S. decline while some cancers continue to climb

The good news is that over the past 25 years, there has been a dramatic 27 percent drop in cancer-related deaths in the U.S., according to the American Cancer Society (ACS) report “Cancer Statistics, 2019, published online January 8, 2019 in CA: A Cancer Journal for Clinicians. The main reason for this decline is attributed to fewer people smoking and thus fewer being diagnosed with lung cancer.

Since 1991, the report has discovered a steady 1.5 percent drop each year in cancer deaths.  This has resulted in about 2.6 million fewer people who have succumbed to cancer in the U.S. during that time. Cancer is still the second leading cause of death after heart disease in the U.S. and accounts for 22 percent of all deaths in the country. Cancer is the leading cause of death in Hispanics and Asian-Americans under age 80.

Reasons for reduction of cancer deaths

As stated earlier, since fewer people are taking up smoking, this is the biggest reason why the death rates from cancer have declined, especially for lung cancer.  Lung cancer deaths dropped a significant 48 percent from 1990 to 2016 among men, and 23 percent from 2002 to 2016 among women and are still continuing to decline. 

Besides fewer people smoking, other contributing factors for the decline in cancer deaths is largely due to better treatment and screening, such as mammography and colonoscopy.  Both of these procedures have had a significant impact on death rates for cancers such as breast and colorectal. Breast cancer, when found at an early stage by mammography, is now considered highly curable.  The rate of deaths from breast cancer fell 40 percent between 1989 and 2016.  Colonoscopies are very effective for finding and identifying precancerous lesions called polyps in the colon which can be removed before they become cancerous. Colorectal cancer death rates fell a stunning 53 percent from 1970 to 2016. 

Prostate cancer is another cancer which has seen a dramatic drop of 51 percent from 1993 to 2016 in prostate cancer death rates.  Thanks to prostate specific antigen (PSA) testing and better treatment, these factors have been primary reasons for lives saved from this cancer.

New frontiers of newer therapies are also on the horizon which will and already have extended the lives of people with certain types of cancer, such as melanoma and lung cancer. These new treatments include targeted therapies and immunotherapies.  Immunotherapies look to be promising in continuing to provide effective treatments for several types of cancer in the coming years.

Some cancers are still increasing

While lung, breast, colorectal and prostate cancers are seeing reductions in death rates, other cancers rates have actually risen.  Cancer incidence rates have raised for melanoma, liver, thyroid, uterus, and pancreas. Some of these cancers have also seen a rise in their death rates. From 2012 to 2016, death rates rose for:

·      Liver cancer in men, by 1.2 percent per year

·      Liver cancer in women, by 2.6 percent per year

·      Pancreatic cancer in men, by 0.3 percent per year

·      Uterine (or endometrial) cancer in women, by 2.1 percent per year

Other cancers rates that are rising include cancer of the brain and within the oral cavity and pharynx.  Oropharyngeal cancers are linked to human papillomavirus (HPV) infection.  Part of the reason for increases seen in liver cancer could be linked to obesity.

The rise in liver cancer is considered to be alarming as it is currently the fastest-growing cancer in the U.S.  Up to 70 percent of liver cancer cases are potentially preventable.  Modifiable factors that appear to be the blame for part of the rise in liver cancer include obesity, alcohol consumption, smoking, and preventing hepatitis B and C virus infection.

Hepatitis C infections are rising due to the rising rates of opioid addiction in the U.S. Treatments for hepatitis C infection are available but for some patients are too expensive.

Endometrial cancer rates in women have been increasing for several years and are believed to be related to the obesity epidemic.  What makes it unclear if obesity is a main factor or not is the fact that there are fewer hysterectomies now than in the past, which changes who gets endometrial cancer or not.

The continual rise in obesity across all ages is a concern when it comes to cancer. Getting a handle on obesity is tricky as much of it revolves around access to affordable, healthy food and where people can go to exercise that is safe.  The coming years will show obesity’s influence on cancer rates.