A new report out today from the American Cancer Society shows that death rates from cancer have experienced a record drop for the second year in a row. The statistics released today show that there was a 2.4% reduction in death rates from the disease from 2017 to 2018, the most recent year where full records are available.
Overall cancer death rates in the U.S. have been reducing continuously since 1991, representing a 31% reduction up to 2018. The drop is likely attributed to several different factors including reductions in smoking, earlier detection, and improvements in treatment, with the four most common types of cancer; breast, lung, colorectal and prostate all experiencing significant declines in mortality in recent years.
Lung cancer is the most common cause of cancer death, accounting for more deaths than breast, prostate, and colorectal cancers combined, but improvements in treatments for lung cancer have been a big driver of reducing cancer mortality overall, with a 5% annual drop in mortality during 2014-2018.
“Lung cancer mortality, shows continued decline and both men and women who are diagnosed with lung cancer are surviving longer and that’s really fantastic news,” said Deborah Schrag, MD, Chief of Population Sciences at Dana-Farber Cancer Institute and Professor of Medicine at Harvard Medical School, noting that lung cancer remains the number 1 cause of death from cancer. “There is more work to be done which includes ensuring that all patients have the opportunity to undergo appropriate diagnostic evaluation to see if they can benefit from targeted therapies or immunotherapy,” Schrag added.
Although not everybody who develops lung cancer has smoked, the large majority of cases are thought to be due to smoking, with efforts still needed to drive down tobacco usage.
“To continue making progress, we cannot let up on tobacco control. The rates of lung cancer incidence in states like Kentucky where tobacco use is more common are more than 3 times higher for men and 4 times higher for women than the rates in states like Utah where tobacco use is less common,” said Schrag.
However, despite the good news from some of the more common cancer types, progress in reducing death rates in some types of cancer is slow.
“Although it is not the most common cancer, pancreas is the #4 most common cause of death. This past year it claimed the lives of Alex Trebek, John Lewis and Ruth Bader Ginsburg. For pancreas cancer, trends are flat and we have neither effective screening, nor treatment,” said Schrag.
The report also describes concerning disparities in cancer survival between Black Americans and white Americans.
“For uterine, cervix, and head and neck cancer, average 5-year survival rates are more than 10% lower for black Americans than they are for white Americans and for breast cancer, the gap is 9% (82% vs 91%),” said Schrag.
The new report also estimates that in the U.S. in 2021, almost 1.9 million new cancer cases will be diagnosed and 608,570 Americans will die from cancer. However, the projections are based on the most recent, complete data from 2017 to 2018 and they don’t take into account the effect of the Covid-19 pandemic on cancer, with many experts predicting a negative effect on cancer outcomes.
“The impact of Covid-19 on cancer diagnoses and outcomes at the population level will be unknown for several years because of the time necessary for data collection, compilation, quality control, and dissemination,” said Rebecca Siegel, MPH, lead author of the report. “We anticipate that disruptions in access to cancer care in 2020 will lead to downstream increases in advanced stage diagnoses that may impede progress in reducing cancer mortality rates in the years to come,” Siegel added.
However, some experts are more positive about the long-term impacts of the Covid-19 pandemic.
“We are hopeful that the long term impact will be minimal, and when we look at the data 5 years from now, the impact of the pandemic will be a small blip. We may still be playing catch up next year, depending upon vaccination distribution, how quickly heath systems can build up to capacity and frankly how trusting people will be to come in for screening. We can recover from this and get back on track with cancer prevention and screening. We are continuing to encourage patients to resume treatment and routine screening as soon as it is safe to do so,” said Schrag.