United States sees unprecedented fall in deaths from cancer

By Sally Robertson, B.Sc.Jan 9 2020

The death rate from cancer in the United States has seen the greatest fall in the year 2016-2017 since rates started to fall in 1992, says the American Cancer Society (ACS).

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According to a new ACS report, the overall drop in the death rate from cancer has mainly been driven by accelerating advances in the treatment of lung cancer.

Lead author of the report, Rebecca Siegel, says: "The big news is that despite slowing progress for other leading causes of death, the cancer death rate is not only continuing to drop but had the largest one-year drop ever from 2016 to 2017."

"This is driven by accelerating progress against lung cancer," she added

The decelerated rate of death from lung cancer drove an overall decline in cancer mortality of 2.2% between 2016 and 2017.

There was also a dramatic decline in death from melanoma, the deadliest form of skin cancer, according to the report.

Experts attribute progress to treatment advances

The U.S. has seen the falls in death rates for lung cancer and melanoma since the U.S. Food and Drug Administration approved new therapies for metastatic disease (cancer that has spread to other parts of the body).

In an op-ed piece published in the journal Cancer Letter, Professor of Oncology and Epidemiology at Johns Hopkins University and former chief medical officer at the ACS, Otis Brawley, highlights the advancements that have been made in lung cancer treatment and the impact that this has had on cancer mortality rates.

"As I look through just-published tables of age-adjusted cancer mortality, I recognize an unprecedented development," he writes. "Immunotherapy is showing such a dramatic impact in the treatment of locally advanced and advanced non–small cell lung cancer that this effect elevates the statistics for all lung cancer and ― this I find astonishing ― you can even see its effect in age-adjusted cancer mortality overall."

Chief medical and scientific officer for the ACS, William Cance, also attributed the decline in mortality from lung cancer and melanoma to the progress in treatment made over the last decade:

"They are a profound reminder of how rapidly this area of research is expanding, and now leading to real hope for cancer patients."

To what extent has the death rate slowed?

Between 2008 and 2013, the lung cancer death rate slowed by 3% per year for men and by 2% per year for women. The rates then slowed again between 2013 and 2017. However, at the same time, declines in death rates from breast and colorectal cancers have slowed.

The news this year is mixed. 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."

Rebecca Siegel, American Cancer Society

Lung cancer leading cause of death in U.S.

Accounting for as much as 27% of all cancer deaths, lung cancer is the leading cause of cancer death in the U.S. and causes more fatalities than breast, prostate, colorectal, and brain cancers combined.

Historically, lung cancer plagued the U.S. for most of the last century. According to the Centers for Disease Control and Prevention (CDC), Americans have been stopping smoking in increasing numbers ever since the Surgeon General Report declared in 1964 that smoking causes lung cancer. However, the death rate from cancer still continued to increase.

Almost three decades after the release of the report, the death rate from cancer finally started to fall in 1992. And compared with 1992, deaths from cancer in 2017 have fallen by 29%, which represents an estimated 2,902,200 fewer cancer deaths, says the ACS.

"This steady progress is largely due to reductions in smoking and subsequent declines in lung cancer mortality, which have accelerated in recent years," writes Siegel and colleagues.

In recent years, many people have taken up vaping, as e-cigarettes have increasingly been marketed as a safer option than conventional cigarettes. A sharp rise in the uptake of vaping and a surge in vaping-related illnesses has sparked concerns amongst public health authorities, and the American Lung Association has warned that "e-cigarettes are not safe."

However, the ACS still advises that vaping is "likely to be significantly less harmful for adults than smoking regular cigarettes."

While the CDC has advised that people who are worried about health risks should avoid vaping, it also advises that anyone who has managed to stop smoking through using e-cigarettes should not go back to traditional cigarettes.