Death By Cancer Shows Decline in the 2020 Annual Report to the Nation on the Status of Cancer

From 2001 to 2017, the cancer death rates continued to decline in the United States, and these decreases were observed in all major racial and ethnic groups, as well as in males, females, adolescents, young adults, and children. However, the rates of cancer incidence for all cancers slightly increased in females from 2012 to 2016, according to the Annual Report to the Nation on the Status of Cancer, which was published inCancer.¹

The cancer incidence rate declined 0.6% on average per year between 2012 to 2016, although trends differed by sex. Incidence rates remained stable in males (P=.14), while it was slightly increased in females at 0.2% (P=.007). Overall cancer death rates on average decreased 1.5% between 2001 and 2017, but investigators noted the rate decreased more rapidly among males at 1.8% compared with females at 1.4% per year during this time period as well.²

Status of Cancer by Gender

“The United States continues to make significant progress in cancer prevention, early detection, and treatment,” Robert R. Redfield, MD, director, Centers for Disease Control and Prevention (CDC), said in a statement.¹“While we are more encouraged that overall cancer death rates have decreased, there is still much more we can do to prevent new cancers and support communities, families, and cancer survivors in this ongoing battle.”

Among males, the stability of this trend was largely due to a balance of incidence rates in 7 of the most common cancer types, which included multiple myeloma, thyroid, leukemia, esophagus, non-Hodgkin lymphoma (NHL), stomach, and prostate. A decrease in the cancer incidence rate was observed for lung and bronchus, larynx, urinary bladder, colon and rectum, and brain and other nervous system cancers.²

Investigators also noted that the incidence of cancer rate was increased in males for 5 cancers, which included liver and intrahepatic bile duct, melanoma of the skin, kidney and renal pelvis, oral cavity and pharynx, and pancreatic cancers. Trends in 3 of the most common cancer types were recorded by racial/ethnic groups. The incidence of prostate cancer decreased among Hispanic males. Lung and CRC incidence rates decreased in Caucasian, African American, Asian Pacific/Islander, and Hispanic groups compared with the American Indian/Alaska Native group, which remained stable.

Incidence rates were increased for 8 of the most common cancer types in females, which included liver, melanoma, corpus and uterus, multiple myeloma, pancreas, kidney, breast, and oral cavity and pharynx, which led to the slight increase in the overall incidence rate. Only 4 cancers decreased in terms of incidence, including ovary, lung, bladder, and brain and other nervous system, and 6 cancers remained stable in females, those being cervix, stomach, leukemia, NHL, thyroid, and colorectum.

Breast cancer incidence rates increased across racial and ethnic groups for females whereas the incidence of lung cancer decreased among Caucasian, African American, and Hispanic females. Lung cancer incidence rates remained stable in Asian Pacific/Islander and American Indian/Alaska Native groups. Colorectal cancer incidence was decreased among Caucasian, Asian Pacific/Islander and American Indian/Alaska Native females and remained stable among African American and Hispanic females.

Death rates declined for 11 of the 19 most common cancers among males, while the rate remained stable in 4 of these cancers and increased in 4. In particular, the rate remained stable in prostate cancer and increased in oral cavity and pharynx cancers, soft tissue cancers including heart, brain, and other nervous system, and pancreatic cancer.

The death rates declined for 14 of the 20 most common cancers among females, including lung and bronchus cancer, breast cancer, and colorectal cancer (CRC). The death rates increased, however, for cancers of the uterus, liver, brain, and other nervous system. Oral cavity and pharynx cancer death rates remained stable in females.

The 3 most common cancer deaths in males included lung, prostate, and CRC overall, except for Asian Pacific/Islander males. Among this group of males, lung cancer was the most common cancer, followed by liver, colorectum, and prostate. Lung cancer death rates decreased the most among African American and Hispanic males, while prostate cancer decreased the most among African American, Asian Pacific/Islander, and American Indian/Alaska Native groups. CRC death rates remained stable among American Indian/Alaska Native males, but this decreased in all other racial/ethnic groups. Liver cancer death rates increased among Caucasian, American Indian/Alaska Native, and Hispanic males compared with stabilization of the rates in African American males and a decrease among Asian Pacific/Indian males.

The 3 most common cancer deaths were lung, breast, and CRC among females, with the exception of Hispanic females, in which breast and lung cancers were the most common, respectively. Lung cancer death rates decreased across all racial/ethnic groups. Breast and CRC death rates decreased among Caucasian, African American, Asian Pacific/Islander, and Hispanic females, while the rate remained stable among American Indian/Alaska Native females. Pancreas cancer death rates increased among Caucasian females, decreased among African American females, and remained stable in other racial/ethnic groups. Uterine cancer death rates increased among Caucasian, African American, Asian Pacific/Islander, and Hispanic females, but the rate could not be calculated for the American Indian/Alaska Native group.

Investigators also noted a shift in trends for melanoma and lung cancer. The death rates of melanoma decreased by 7.6% in males per year from 2014 to 2017, and the rates decreased by 6.3% in females per year during this time period. However, between 2001 to 2016, the death rate of melanoma had increased by 2.2% in males and 1.9% in females.

Lung cancer, which remains the leading cause of cancer death in the United States and accounts for about one-fourth of all cancer deaths, demonstrated a decrease in rates as well; in males, the lung cancer death rate declined 2.0% per year from 2001 to 2005 compared with 0.5% in females. The rates declined 2.9%, 4.0%, and 5.5% for 2005 to 2012, 2012 to 2015, and 2015 to 2017 in males, respectively. The lung cancer death rates declined 2.0% from 2007 to 2014 and 4.2% from 2015 to 2017 in females.

Cancer Incidence and Death Rates in Children, Adolescents, and Young Adults

Lung cancer incidence rates decreased as well, but these rates declined at a slower rate of 2.6% in males per year from 2007 to 2016 and 1.1% in females from 2006 to 2016.

For the first time, the Annual Report to the Nation reported trends for the most common cancer types among children, adolescents, and young adults. Children are defined as 0 to 14 years old, while adolescents and young adults are aged 15 to 39 years.

Overall cancer incidence rates increased at an average of 0.8% per year from 2012 to 2016 in children. However, there were increasing trends during this 5-year period for the most common cancer types for children, which included leukemia, brain, and other nervous system cancers, and lymphoma. In adolescents and young adults, the overall incidence rate increased at an average of 0.9% per year from 2012 to 2016, and the most common cancer in this group was female breast cancer. The incidence rate was highest among young African American females.

Among children, the overall cancer death rates decreased at an average of 1.4% per year and by 1.0% per year in adolescents and young adults. Death rates remained stable, however, for children with brain and other nervous system cancer between 2001 and 2017. Leukemia death rates declined 2.8% per year in children.

The incidence of the 4 most common cancers for adolescents and young adults increased from 2012 to 2016, which included female breast, thyroid, and testis, while the incidence of lymphoma decreased. Among these patients, female breast cancer remained stable from 2001 to 2010 and increased by 1.2% per year from 2010 to 2016. Thyroid cancer decreased from 5.8% to 1.7% between 2001 to 2010 and 2020 to 2016, respectively.

The death rates among African American adolescents and young adults were twice as high as what was observed in the Caucasian population, as well as more than double what was observed in the Asian Pacific/Islander, American Indian/Alaska Native, and Hispanic populations. Overall, the cancer death rate has declined from 3.0% from 2001 through 2005 to 1.0% from 2005 to 2017. Most notably, the cancer death rates for common sites declined from 2001 to 2010 then stabilized from 2010 to 2017 in adolescents and young adults.

Overall, cancer death rates continue to decline among groups, which reflects changes in the cancer risk factors, screening test use, diagnostic practices, and treatment advances. The American Cancer Society, Centers for Disease Control and Prevention, National Cancer Institute, and the North American Association of Central Cancer Registries collaborated on this annual study to analyze trends in cancer incidence and death rates.A special report, part II of the Annual Report to the Nation, was also published inCancerreporting trends in monitoring cancer risk factors and the promotion of healthy behaviors.

“Many cancers can be prevented or treated effectively if they are found early,” study authors wrote. “Population‐based cancer incidence and mortality data can be used to inform efforts to decrease the cancer burden in the United States and regularly monitor progress toward goals.”

References:

1. Annual report to the nation: Cancer death rates continue to decline [news release]. National Cancer Institute; March 12, 2020. https://bit.ly/38TFnNA. Accessed March 16, 2020.
2. Henley SJ, Ward EM, Scott S, et al. Annual report to the nation on the status of cancer, part I: national cancer statistics [Published Online March 12, 2020].Cancer. doi.org/10.1002/cncr.32802.