Cancer mortality at an all time low finds report

By Dr. Ananya Mandal, MDMay 30 2019

In a new Annual Report to the Nation on the Status of Cancer, researchers have found that death rates due to cancer have declined over among all age groups and both sexes in the United States between 1999 and 2016.

This latest report comes as a joint effort of National Cancer Institute (NCI), National Institutes of Health, Centers for Disease Control and Prevention (CDC), the American Cancer Society (ACS) and the North American Association of Central Cancer Registries (NAACCR). The report was published in the Journal of the National Cancer Institute yesterday (May 30, 2019).

The Annual Report to the Nation on the Status of Cancer shows a continued overall decline in cancer mortality. But for women ages 20-49, the report found an uptick in cancer incidence rates. Our progress continues, but we still have much work to do. #NIH https://t.co/12kkEvijtH

— Francis S. Collins (@NIHDirector) May 30, 2019

The report also adds that there is a decline in the incidence of new cancers among men between 2008 and 2015 after a rise between 1999 and 2008. Among women, the number of new cancers has been stable between 1999 and 2015.

Annual Report to the Nation 2019: National Trends in Cancer Death Rates

Betsy A. Kohler, executive director of NAACCR in a statement said, “We are encouraged by the fact that this year’s report continues to show declining cancer mortality for men, women, and children, as well as other indicators of progress. There are also several findings that highlight the importance of continued research and cancer prevention efforts.”

The report has a special section that focussed on the rates and trends of cancer among population aged between 20 and 49 years. The report finds;

• Between 2011 and 2015, there was a 1.2 times more incidence of new cancers among men than women
• Between 2012 and 2016, there has been a 1.4 times more cancer related deaths among men than women
• Among those aged between 20 and 49, the incidence of new cancers as well as rates of deaths due to cancer were similar in both men and women
• Among those aged 20 to 49 the yearly incidence of invasive cancers between 2011 and 2015 was 115.3 per 100,000 people among men and 203.3 per 100,000 people among women.
• Among men of the age 20 to 49 years, cancer incidence fell an average of 0.7 percent per year and rose an average of 1.3 percent among women
• Between 2012 and 2016, the cancer death rate per year among 20 to 49 year olds was 22.8 per 100,000 people among men and 27.1 per 100,000 people among women
• In this age group of 20 to 49, the commonest cancers in women were breast cancer (incidence 73.2 per 100,000 people), thyroid cancer (incidence 28.4 per 100,000 people), and melanoma of the skin (incidence 14.1 per 100,000 people).
• In this age group of 20 to 49, the commonest cancers in men were colon and rectum (incidence 13.1 per 100,000 people), testes (incidence 10.7 per 100,000 people), and melanoma of the skin (incidence 9.8 per 100,000 people).
• In this age group of 20 to 59, the death rates reduced by 2.3 percent per year among men and 1.7 percent among women between 2012 and 2016.
• There was highest incidence of in situ breast cancer and nonmalignant central nervous system tumors among women and men aged 20 to 49 wrote the researchers adding that it had significant long term impact.
• Total death rates due to cancer declined by 1.8 percent among men and 1.4 percent among women
• Among men death rates rose for 6 cancers including liver cancer, oral cavity and pharynx cancer, and non-melanoma skin cancer
• Among women, there was a decline in death rates due to lung and bronchus, breast, and colorectal and an increase in death rates due to uterus cancer and liver cancer.
• Cancer incidence rates were highest for black men and white women and those from Asian/Pacific Islander men and women had the lowest incidence of cancers. Non-Hispanic men and women had the highest cancer incidence, the report found.

Elizabeth Ward, Ph.D., lead author of the study and a consultant at NAACCR in a statement said, “The greater cancer burden among women than men ages 20 to 49 was a striking finding of this study. The high burden of breast cancer relative to other cancers in this age group reinforces the importance of research on prevention, early detection, and treatment of breast cancer in younger women.”

Douglas R. Lowy, M.D., acting director of NCI in his statement said, “It is important to recognize that cancer mortality rates are declining in the 20-to-49-year-old age group, and that the rates of decline among women in this age group are faster than those in older women.”

The report adds that timely detection and treatment was the key to the reducing numbers. Thyroid cancers for example have stabilized in terms of numbers among women between 2013 and 2015 due to better diagnostics and screening.

They add that there has been a reduction in new cases and deaths due to lung, bladder, and larynx cancers because of decline in tobacco smoking. On the other hand cases of uterus, post-menopausal breast cancers and colon and rectum cancers rose in the last few years due to increasing weight, obesity and physical inactivity.

Skin melanomas on the other hand have also declined due to better awareness regarding sun protection. Between 2014 and 2016 there has been a decline of 8.5 percent per year in skin melanoma deaths in men and a 6.3 percent decline per year among women between 2013 and 2016. J. Leonard Lichtenfeld, M.D., M.A.C.P., interim chief medical officer of ACS, in a statement said, “The declines seen in mortality for melanoma of the skin are likely the result of the introduction of new therapies, including immune checkpoint inhibitors that have improved survival for patients diagnosed with advanced melanoma. This rapid change shows us how important it is to continue working to find effective treatments for all kinds of cancer.”

CDC Director Robert R. Redfield, in a statement said, “Major declines overall in cancer mortality point in the right direction, yet significant differences remain in cancer cases and deaths based on gender, ethnicity, and race. A better understanding of these discrepancies improves cancer diagnosis and recovery for all patients and is vital to our public health mission.”