Cancer deaths in the US have fallen 33% since 1991, in part due to advances in treatment, early detection and less smoking, a new report says

Cancer deaths in the US have fallen 33% since 1991, in part due to advances in treatment, early detection and less smoking, a new report says

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The percentage of people dying from cancer in the United States has steadily declined over the past three decades, according to a new report from the American Cancer Society.

Cancer deaths in the U.S. have fallen 33 percent since 1991, corresponding to an estimated 3.8 million deaths averted, according to the report published Thursday in CA: Cancer Journal for Clinicians. The rate of lives lost to cancer continued to decline in the most recent year for which data is available, between 2019 and 2020, by 1.5%.

The 33 percent drop in cancer deaths is “really great,” said Karen Knudsen, CEO of the American Cancer Society.

The report attributes this steady progress to improvements in cancer treatment, reductions in smoking and increases in early detection.

“New discoveries about prevention, early detection and treatment have led to real, meaningful gains in many of the 200 diseases we call cancer,” Knudsen said.

In their report, researchers from the American Cancer Society also cited HPV vaccinations as being associated with reduced cancer deaths. Infections with HPV or human papillomavirus can cause cervical and other cancers, and vaccination is associated with a reduction in new cases of cervical cancer.

Among women in their early 20s, there was a 65% drop in cervical cancer rates from 2012 to 2019, “which completely follows the time when HPV vaccines came into use,” Dr William said Dahut, the society’s chief scientific officer.

“There are other cancers that are linked to HPV — whether it’s head and neck cancer or anal cancer — so there’s optimism that this will make a difference beyond that,” he said.

The lifetime probability of being diagnosed with invasive cancer is estimated at 40.9% for men and 39.1% for women in the US, according to the new report.

The report also included projections for 2023 that there could be nearly 2 million new cases of cancer—the equivalent of about 5,000 cases a day—and more than 600,000 cancer deaths in the United States this year.

In the early days of the Covid-19 pandemic, many people missed regular medical check-ups, and some doctors have seen an increase in cases of advanced cancer as a result of the pandemic’s delayed examinations and treatment.

The American Cancer Society researchers were unable to track “this reduction in screening that we know we all saw across the country during the pandemic,” Knudsen said. “I think by this time next year, our report will give some initial insight into what the impact of the pandemic has been on cancer incidence and cancer mortality.”

The new report includes data from national programs and registries, including those at the National Cancer Institute, the US Centers for Disease Control and Prevention and the North American Association of Central Cancer Registries.

Data show that cancer death rates in the U.S. have increased for most of the 20th century, largely due to an increase in smoking-related lung cancer deaths. Then, as smoking rates declined and improvements in early detection and treatment of some cancers increased, there was a decline in cancer mortality from its peak in 1991.

Since then, the pace of decline has slowly accelerated.

The new report found that the five-year relative survival rate for all cancers increased from 49% for diagnoses in the mid-1970s to 68% for diagnoses in 2012-18.

The types of cancer that now have the highest survival rates are thyroid at 98%, prostate at 97%, testicular at 95% and melanoma at 94%, according to the report.

Current survival rates are lowest for pancreatic cancer at 12%.

The finding of declining cancer deaths shows “the continuation of the good news,” said Dr. Otis Brawley, a professor of oncology at Johns Hopkins University who was not involved in the study.

“The biggest reason for the decline that began in 1991 was the prevalence of smoking in the United States, which began to decline in 1965,” said Brawley, the former chief medical officer of the American Cancer Society.

“That’s the reason we started a decline in 1991 and that decline continued because the prevalence of people smoking in the United States continued to decline,” he said. “Now, for certain diseases, our ability to treat has improved, and there are some people who don’t die because of treatment.”

Although cancer death rates have been on a steady decline, the new report also highlights that new cases of breast, uterine and prostate cancers are “alarming” and rising in the United States.

Frequency of breast cancer in women have increased by about 0.5 percent annually since the mid-2000s, according to the report.

The incidence of cervical cancer has increased by about 1% per year since the mid-2000s among women 50 and older, and by almost 2% per year since at least the mid-1990s among younger women.

The incidence rate of prostate cancer increased by 3% per year from 2014 to 2019, after two decades of decline.

Knudsen called prostate cancer an “anomaly” because its previous decline in incidence has reversed, appearing to be due to diagnoses of advanced disease.

On Thursday, the American Cancer Society announced the launch of the Impact Initiative, aimed at improving prostate cancer incidence and mortality by funding new research programs and expanding support for patients, among other efforts.

“Unfortunately, prostate cancer remains the number one most commonly diagnosed malignancy among men in this country, with almost 290,000 men expected to be diagnosed with prostate cancer this year,” Knudsen said. Cancer diagnosed when it is confined to the prostate has a five-year survival of “over 99%,” she said, but there is no permanent cure for metastatic prostate cancer.

“Prostate cancer is the second leading cause of cancer death in men in this country,” she said. “What we’re reporting is not only an increase in prostate cancer across all demographics, but a 5% annual increase in the diagnosis of men with more advanced disease. So we’re not catching these cancers early when we have the opportunity to cure men of prostate cancer.

Breast, uterine, and prostate cancers also have a large racial disparity, with communities of color having higher death rates and lower survival rates.

In 2020, the risk of overall cancer death was 12 percent higher among blacks than whites, according to the new report.

“Not every individual or every family is affected equally,” Knudsen said.

For example, “Black men unfortunately have a 70 percent increase in prostate cancer incidence compared to white men and a two- to four-fold increase in prostate cancer mortality compared to any other ethnic and racial group in the United States,” she said .

Data in the new report demonstrate “important and consistent” progress against cancer, Dr. Ernest Houck, vice president for cancer prevention and population sciences at the University of Texas MD Anderson Cancer Center, said in an email.

“Cancer is preventable in many cases and detected early with better outcomes in many others. When necessary, treatments are improved both in terms of their efficacy and safety. This is great news,” Hawke wrote.

“However, it is past time to take health inequalities seriously and make them a much bigger national priority. The inequities in cancer risks, cancer care and cancer outcomes are intolerable, and we must not settle for these regular reminders of avoidable injustices,” he said. “With deliberate and dedicated effort, I believe we can close these disparities and make even greater progress to end cancer.”

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