Annual Report to the Nation Part1: Rapid decrease in lung cancer and melanoma deaths lead overall continued decline in cancer death rate

According to the latest annual report to the Nation on the Status of Cancer, overall cancer death rates in men and women continue to decline for all racial and ethnic groups in the United States. From 2001 to 2018, the decline in lung cancer death rates accelerated and melanoma death rates dropped significantly in more recent years, reflecting a significant increase in survival for metastatic melanoma. However, the report finds that for several other major cancers, including prostate, colorectal and female breast cancers, previous declining trends in death rates slowed or disappeared.

The report, appearing in JNCI: The Journal of the National Cancer Institute, also finds that the overall incidence of cancer continues to increase in women, children and adolescents, and young adults (AYAs). All trends in this report relate to the period before the COVID-19 pandemic.

The annual report is a joint effort of the American Cancer Society (ACS); the Centers for Disease Control and Prevention (CDC); the National Cancer Institute (NCI), part of the National Institutes of Health; and the North American Association of Central Cancer Registries (NAACCR).

The report shows a decline in the death rate for 11 of the 19 most common cancers in men, and 14 of the 20 most common cancers in women, over the most recent period (2014-2018). While the declining trends in lung cancer and melanoma death rates accelerated over this period, previous declining trends in colorectal and female breast cancer deaths and those for prostate cancer leveled off. Death rates rose for a few cancers such as brain and other nervous system and pancreas in both sexes, oral cavity and pharynx in men, and liver and uterus in women.

“The declines in lung cancer and melanoma death rates are the result of advances across the 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, Ph. .D., general manager of the American Cancer Society. “As we celebrate progress, we must remain committed to research, patient support and advocacy to make even more progress to improve the lives of cancer patients and their families.”

An analysis of long-term trends in cancer death rates in this year’s report also shows that the decline in death rates in both men and women accelerated between 2001 and 2018. In men, a decline of 1.8% per year in 2001-2015 accelerated to a decline of 2.3% per year in 2015-2018. In women, a decline of 1.4% per year from 2001 to 2015 accelerated to a decline of 2.1% per year in 2015-2018. The report found that overall cancer death rates declined in every racial and ethnic group from 2014 to 2018.

“It’s encouraging to see a continued decline in the death rate for many of the common cancers,” said Karen Hacker, MD, MPH, director of CDC’s National Center for Chronic Disease Prevention and Health Promotion. “To eliminate existing health inequalities 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.”

However, an increase in cancer incidence and death rates or a slowdown in previous declining trends for some other cancers, such as colorectal and female breast cancer, are likely due to risk factors such as obesity.

“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 population-level outcomes,” said Norman E. “Ned” Sharpless, MD, director of the National Cancer Institute. Cancer Institute, part of the National Institutes of Health. “I believe we can achieve even further improvements if we tackle obesity, which has the potential to overtake tobacco use to become the main modifiable factor associated with cancer.”

The authors report that death rates for childhood cancers (<15 years) and AYAs (ages 15-39 years) continued to decline, despite an increase in incidence from 2001 to 2017. The overall incidence of childhood cancers and AYAs increased in all racial groups. /ethnic groups except American Indians/Alaska Native children where the numbers remained stable. The most common cancer among AYAs was female breast cancer.

“When evaluating health inequalities, it is critical to recognize the social factors that influence community health and access to health care,” said Betsy A. Kohler, MPH, executive director of NAACCR. “Social and economic indicators, particularly based on assessments of small areas, are becoming increasingly important in understanding the burden of cancer.”

Other key findings include:

Overall cancer incidence rates were higher in males than females in all racial and ethnic groups except the Asian/Pacific Islander population, where rates were similar. In general, cancer incidence rates were slightly lower among black people than among white people. In contrast, overall cancer death rates were higher among black people than among white people. The incidence of liver cancer has increased before, but data shows that the rates have stabilized in both men and women. Two-year relative survival for advanced-stage melanoma cases diagnosed in 2001-2009 was stable, but increased by 3.1% per year for those diagnosed in 2009-2014. Two-year relative survival increased only slightly for early-stage and intermediate-stage melanomas diagnosed in the 2001-2014 period (0.03% and 0.4% per year, respectively).

The authors indicate that these findings could help inform health care providers about the need to increase efforts in cancer prevention, early detection and treatment, and the need for equitable implementation of effective interventions, especially among populations with insufficient resources. resources.

For more information about the report, see: https://seer.cancer.gov/report_to_nation/.

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