Cancer Deaths Continue to Decline, But Not for All Malignancies

Between 2014 and 2018, there was an overall decline in cancer deaths in men, women, and children of all racial and ethnic groups in the United States, according to the National Cancer Institute Annual Report to the Nation.¹

Melanoma death rates in particular have seen a rapid decline between 2001 and 2018. However, for prostate, colorectal, and female breast cancers, previous trends of declining death rates of slowed or disappeared. Additionally, the overall incidences of cancer in women, children, adolescents, and young adults continue to climb.²

“The declines in lung cancer and melanoma death rates are the result of progress across the entire cancer continuum — from reduced smoking rates to prevent cancer to discoveries such as targeted drug therapies and immune checkpoint inhibitors,” said Karen E. Knudsen, MBA, PhD, chief executive officer at the American Cancer Society, in a press release. “While we celebrate the progress, we must remain committed to research, patient support, and advocacy to make even greater progress to improve the lives of cancer patients and their families.”¹

All trends covered in the report cover the period prior to the COVID-19 pandemic. Data was collected using registries that participate in the CDC’s National Program of Cancer registries and/or the NCI’s Surveillance, Epidemiology, and End Results (SEER) program.²

Of the 19 most common cancers in men, death rates decreased for 11 of them. Of the 20 most common cancers in women, death rates decreased for 14 of them. There was an increase in 5 cancers for each sex, according to the report. Population data was extrapolated using the US’s Census Bureau’s Population Estimates Program.² 

The overall cancer incidence rate per 100,000 people between 2013-2017 was 487.4 for men and 422.4 for women. The rate of cancer deaths per 100,000 people between 2014-2018 was 185.5 among men and 133.5 among women. During that same time period, death rates accelerated for lung cancer and melanoma, slowed down for colorectal and female breast cancer, and leveled off for prostate cancer.²

For men, between 2013-2017, incidence rates increased in melanoma, kidney, renal pelvis, pancreas, oral cavity and pharynx, and testis. Incidence rates remained stable for liver, myeloma, prostate, esophagus, leukemia, non-Hodgkin lymphoma (NHL), and thyroid cancer. Incidence rates decreased in lung, larynx, urinary bladder, stomach, colon and rectum, and brain cancer. Lung and colorectal cancer saw greater declines in Black men. Incidences of bladder cancer declined in white, API, and Hispanic males were stable among Black males and increased among American Indian/Alaskan Native (AI/AN) males.² 

For women during the same time period, incidences increased in liver, melanoma, kidney, myeloma, corpus, not otherwise specified uterus, pancreas, breast, and oral cavity, and pharynx cancer. Incidences were stable in cervix, leukemia, stomach cancers, as well as in NHL. Incidences decreased in thyroid, ovary, lung, colorectum, bladder, brain, and ONS. Lung cancer rates were stable among White, Black, and Hispanic women but were stable among API and AI/AN women. Colorectal and lung cancer declines were greater among Black women than in women of other ethnic groups.²

Between 2014-2018, the cancer death rate decreased 1.9% per year (95% CI = 1.6% to 2.3%) on average for both genders. Cancer death rates decreased more for men, 2.2% (95% CI = 1.9% to 2.5%), than for women at 1.7% (95% CI = 1.4% to 2.1%). The rate of death decreased for every racial and ethnic group, ranging from 0.7% in AI/AN individuals to 2.1% in API individuals. The overall cancer death rate was highest among Black people at 182.5 deaths per 100,000 people, followed by AI/AN people at 163.2 deaths, then white 160.2 people, Hispanic, 110.8, and API persons at 98 deaths.²

For children, the incidence rate was 16.8 cases per 100,000 cases, with the highest rate among White children at 17.8. Incidence rates increased between 2013 and 2017 for all racial and ethnic groups with the exception of AI/AN children, whose rates were stable. Leukemia was the most common cancer type at 5.2 cases per 100,000 people, brain at 3.8 cases and lymphoma at 1.6 cases. For children, the cancer death rate was 2.1 deaths per 100,000 standard population, with the highest death rate among AI/AN children at 2.6 deaths per 100,000 standard population. The most common cancer deaths were from brain cancer. Despite rising incidence rates, the overall cancer death rate decreased. Between 2014 and 2018.²

“It is encouraging to see a continued decline in death rates for many of the common cancers,” said Karen Hacker, MD, MPH, director of CDC’s National Center for Chronic Disease Prevention and Health Promotion in a press release. “To dismantle existing health disparities and give everyone the opportunity to be as healthy as possible, we must continue to find innovative ways to reach people across the cancer care continuum — from screening and early detection to treatment and support for survivors.”¹

According to study authors, the decline in smoking has led to a decline in the incidences of lung cancer. Additionally, the rising rates of obesity have led to an increase in kidney cancer.

“The continued decline in cancer death rates should be gratifying to the cancer research community, as evidence that scientific advances over several decades are making a real difference in outcomes at the population level,” said Norman E. Sharpless, MD, director of the National Cancer Institute, part of the National Institutes of Health in a press release. “I believe we could achieve even further improvements if we address obesity, which has the potential to overtake tobacco use to become the leading modifiable factor associated with cancer.” ¹

Social factors also need to be addressed in order to continue the decline in cancer rates, according to experts.

“When evaluating health disparities, it is critical to acknowledge the social factors that influence the health of the communities and access to health care,” said Betsy A. Kohler, MPH, NAACCR executive director in a press release. “Social and economic indicators, particularly based on small area assessments, are increasingly important to understanding the burden of cancer.”¹

_REFERENCES:

_{1.Annual Report to the Nation: Rapid decrease in lung cancer and melanoma deaths lead overall continued decline in cancer death rate. News release. NCI. July 8, 2021. Accessed July 27, 2021. https://bit.ly/3f8bgIa.}

_{2.Islami F, Ward E, Sung H, et al. Annual report to the nation on the status of cancer, Part 1: National Cancer Statistics. J Natl Cancer Inst. 2021; djab13. doi: 10.1093/jnci/djab131}