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U.S. Cancer Death Rates Hit 26-Year Low

U.S. Cancer Death Rates Hit 26-Year Low

Breakthrough treatments for lung cancer and melanoma spurred the sharpest one-year drop on record.

Deaths from cancer have been on the decline for 26 years, dropping 29 percent between 1991 and 2017, according to a January 2020 report from the American Cancer Society (ACS).

This decline suggests that more than 2.9 million deaths have been prevented since the early 1990s.

Lung cancer remains the leading cause of cancer-related deaths in the United States, but after peaking in 1990, death rates for the disease have dropped 51 percent among men. Death rates among women, which peaked in 2002, have also fallen 26 percent, the ACS found.

Declines in lung cancer death rates have accelerated among men and women in recent years, spurring the largest ever single-year drop in overall cancer mortality of 2.2 percent from 2016 to 2017, the report revealed. 

Meanwhile, major advances in the treatment of melanoma sparked the sharpest drop in cancer deaths. Since the U.S. Food and Drug Administration approved two new drugs (ipilimumab and vemurafenib) back in 2011, one-year survival rates for those with advanced forms of the disease jumped 13 percent from 2010 to 2015.

Meanwhile, the overall melanoma death rate dropped by 7 percent annually among adults ages 20 to 64 years old between 2013 and 2017. Before these drugs were approved, overall melanoma death rates had less dramatic declines. And from 2006 to 2010, the overall death rate among adults older than 65 was actually increasing.

Progress against cancer is mixed
Advances in the early detection and treatment of colorectal, breast and prostate cancers have also helped drive long-term declines in cancer deaths:

  • The death rate for breast cancer dropped by 40 percent since peaking in 1989.
  • The death rate for prostate cancer dropped by 52 percent since peaking in 1993.
  • The death rate for colorectal cancer among men dropped by 53 percent since 1980 and dropped by 57 percent among women since 1969.

But progress against these major forms of the disease has slowed in recent years.

"The exciting gains in reducing mortality for melanoma and lung cancer are tempered by slowing progress for colorectal, breast and prostate cancers, which are amenable to early detection,” said Rebecca Siegel, lead author of the report, in an ACS news release. “It's a reminder that increasing our investment in the equitable application of existing cancer control interventions, as well as basic and clinical research to further advance treatment, would undoubtedly accelerate progress against cancer."

Racial and economic disparities remain
Cancer rates and outcomes vary widely among different racial and ethnic groups, mainly due to socioeconomic factors that can affect people’s access to high-quality medical care that can help detect cancer early when it’s more treatable—or prevent the disease from occurring in the first place.

Still, the racial gap in cancer deaths continues to shrink. Overall, the discrepancy in cancer death rates between blacks and whites has fallen from a peak of 33 percent in 1993 to 13 percent in 2017. The ACS attributes this progress to lower prevalence of smoking among black teens and declines in smoking-related cancers.

Some cancers still on the rise
Despite a drop in the overall number of new colorectal cancer cases, the number of adults younger than 55 years old being diagnosed with the disease rose 2 percent annually since the mid-1990s, the ACS reveals.

Other cancer diagnosis rates still rising:

  • Liver cancer rates increased by 2 to 3 percent annually between 2007 and 2016.
  • Breast cancer rates increased by approximately 0.3 percent annually since 2004.  
  • Uterine cancer rates increased by 1.3 percent annually between 2007 and 2016.

Prevention is key
In 2020, the ACS estimates that there will be 1,806,590 new cancer diagnoses in the U.S.—or nearly 5,000 new cases each day. The group also projects that 606,520 people will die from the disease.

One bright spot: many of these cancers are highly preventable. For example, the researchers noted that most liver cancer risk factors—such as obesity, heavy drinking and smoking—are controllable.

There are several ways you can help reduce your risk for certain forms of cancer, including:

Kick bad habits. Not smoking, exercising regularly, limiting your alcohol intake (or not drinking at all) and maintaining a healthy weight could help. For cancer prevention, the ACS recommends cutting back on the amount of red and processed meats you consume, opt for whole grains instead of refined grains and eat at least two and a half cups of fruits and vegetables each day. About 19 percent of all cancer deaths are caused by smoking while 4 percent are linked to alcohol consumption and 2.2 percent are associated with sedentary lifestyles, the ACS reports. Obesity is associated with an increased risk for 13 types of cancer, which accounted for about 40 percent of all cancers diagnosed in the U.S. in 2014, according to the Centers for Disease Control and Prevention (CDC).

Prevent and treat infections. Other cancers caused by viruses, including human papillomavirus (HPV), hepatitis B virus (HBV) and hepatitis C virus (HCV)—as well as bacteria, including Helicobacter pylori (H. pylori)—could also be prevented through vaccination or by avoiding or treating these infections.

Apply sunscreen. It’s estimated that the vast majority of melanomas are caused by exposure to UV radiation, which is preventable, according to the U.S. Department of Health and Human Services. The ACS also points out that nearly 5 percent of cancer cases and 1.5 percent of cancer deaths are linked to exposure to UV radiation. The group estimates that millions of skin cancers diagnosed each year could be prevented if people protected their skin by routinely applying sunscreen and avoiding indoor tanning facilities. For the prevention of skin cancer, use broad spectrum sunscreen with a sun protection factor (SPF) of at least 30 and reapply every two hours or after swimming or sweating, the American Academy of Dermatology recommends.

Get screened. Certain cancers may be detected early on when treatments are often more successful. Screening tests are recommended for breast, cervical, colorectal and lung cancers. There are also screening tests available to detect prostate cancer, but the risks and benefits of these tests are less clear.

You should weigh the risks and benefits of cancer screenings with your doctor. Together, you can determine when and how often you should be screened for certain forms of cancer based on your values, age, health preferences and individual risk for the disease.

Some doctors perform skin examinations to also screen for skin cancer during routine checkups but it’s also important to perform regular self-checks, the ACS advises. During a skin self-exam, you should use a full length and hand mirror to look at all sides of your body—front and back as well as both sides with your arms raised. Be sure to check your elbows, forearms, underarms, the palms of your hands, the soles of your feet and the skin between your toes.

Ideally, you should perform this skin self-exam once per month and report any worrisome or suspicious changes to your doctor.

Medically reviewed in September 2019. Updated in January 2020.

Sources:
Rebecca L. Siegel, MPH; Kimberly D. Miller, MPH; Ahmedin Jemal, DVM, PhD. “Cancer Statistics, 2020.” CA: A Cancer Journal for Clinicians. 2020;0:1–24.
American Cancer Society. “More than 4 in 10 Cancers and Cancer Deaths Linked to Modifiable Risk Factors.”
U.S. Centers for Disease Control and Prevention. “Cancers Associated with Overweight and Obesity Make up 40 percent of Cancers Diagnosed in the United States.”
U.S. Department of Health and Human Services. “Surgeon General Call to Action to Prevent Skin Cancer: Exec Summary.”

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