Steady reductions in smoking combined with advances in cancer prevention, early detection, and treatment have resulted in a 23 percent drop in the cancer death rate since its peak in 1991, according to the annual Cancer Statistics report from the American Cancer Society.
The drop translates to more than 1.7 million cancer deaths averted through 2012. The findings were published in CA: A Cancer Journal for Clinicians. The report estimates there will be 1,685,210 new cancer cases and 595,690 cancer deaths in the United States in 2016.
Overall cancer incidence is stable in women, and declining by 3.1 percent per year in men, from 2009-2012, with one-half of the drop in men due to recent rapid declines in prostate cancer diagnoses as PSA testing decreases.
Cancer mortality continues to decline. Over the past decade of data, the rate dropped by 1.8 percent per year in men and 1.4 percent per year in women. The decline in cancer death rates over the past two decades is driven by continued decreases in death rates for the four major cancer sites: lung, breast, prostate, and colon/rectum.
Death rates for female breast cancer have declined 36 percent from peak rates in 1989, while deaths from prostate and colorectal cancers have each dropped about 50 percent from their peak, a result of improvements in early detection and treatment. Lung cancer death rates declined 38 percent between 1990 and 2012 among males and 13 percent between 2002 and 2012 among females due to reduced tobacco use.
The report also features an analysis of leading causes of death by state and finds that, even as cancer remains the second leading cause of death nationwide, steep drops in deaths from heart disease have made cancer the leading cause of death in 21 states: Alaska, Arizona, Colorado, Delaware, Florida, Georgia, Idaho, Kansas, Maine, Massachusetts, Minnesota, Montana, Nebraska, New Hampshire, New Mexico, North Carolina, Oregon, South Carolina, Vermont, Virginia and Washington.
In addition, cancer is the leading cause of death among adults ages 40 to 79, and among both Hispanics and Asian/Pacific Islanders, who together make up one-quarter of the U.S. population. Heart disease remains the top cause of death overall in the United States. In 2012, there were 599,711 deaths from heart disease, compared to 582,623 deaths from cancer.
“We’re gratified to see cancer death rates continuing to drop. But the fact that cancer is nonetheless becoming the top cause of death in many populations is a strong reminder that the fight is not over,” said Otis Brawley, chief medical officer of the American Cancer Society.
Other findings from the report include:
• Among children and adolescents, brain cancer has surpassed leukemia as the leading cause of cancer death, a result of more rapid therapeutic advances against leukemia.
• Thyroid cancer continues to be the most rapidly increasing cancer (>5 percent per year in both men and women), partially due to overdiagnosis because of the increased use of advanced imaging techniques.
• Colorectal cancer incidence and death rates declined by about 3 percent per year in both men and women from 2003 through 2012, with momentum gaining in the most recent years. However, rates increased by 1.8 percent per year from 1992 through 2012 in men and women aged younger than 50 years, among whom screening is not recommended for those at average risk.
• In contrast to stable or declining trends for most cancers, incidence rates increased from 2003 to 2012 among both men and women for some leukemia subtypes and for cancers of the tongue, tonsil, small intestine, liver, pancreas, kidney, renal pelvis, and thyroid.
• In addition, incidence rates increased in men for melanoma; myeloma; and cancers of the breast, testis, and oropharynx. Among women, incidence rates increased for cancers of the anus, vulva, and uterine corpus.
• Recent declines in incidence for melanoma and liver cancer among young adults may portend a reduction in the burden of these cancers in future generations.
• Death rates from cancer have dropped from a peak of 215.1 per 100,000 in 1991 to 166.4 in 2012. The decline is larger in men (28 percent since 1990) than in women (19 percent since 1991).
• Breast cancer is the leading cause of cancer death in women aged 20 to 59 years, while lung cancer is the cause of cancer death in women 60 and older. Among men, leukemia is the leading cause of cancer death for those aged 20 to 39 years, whereas lung cancer ranks first among men 40 and older.
Incidence data comes from the NCI Surveillance, Epidemiology, and End Results program, the Centers for Disease Control and Prevention National Program of Cancer Registries, and the North American Association of Central Cancer Registries. Mortality data comes from the National Center for Health Statistics.