This year’s Annual Report to the Nation on the Status of Cancer highlights trends in cancer incidence and mortality overall and in key patient subgroups.
Cancer mortality rates are declining in men and women across all racial and ethnic groups, with notable declines in lung cancer and metastatic melanoma deaths noted from 2001 to 2018, according to the most recent Annual Report to the Nation on the Status of Cancer.1 That said, several other tumor types that were previously experiencing declining death rates, including prostate, colorectal (CRC), and female breast cancer, have either experienced a slowing or halt of decline entirely.
Among some of the more favorable trends, lung cancer death rates per year were found to have particularly declined for men, dropping 2.0% per year from 2001 to 2005, 2.9% from 2005 to 2012, 4.0% from 2012 to 2015, and 5.7% from 2015 to 2018.2 Mortality rates for kidney cancer have also been on the decline since 2001 in both sexes, although it began declining more rapidly for men in 2015. After a period of stable trends, melanoma death rates began a notable decline in 2013 for male patients (5.7% per year) and in 2012 for female patients (4.4% per year). Additionally, bladder cancer mortality began to fall in 2013 for men (1.3% per year) with a steady decrease for women from 2001 to 2018 (0.6% per year). Liver cancer mortality stabilized for men and decelerated for women from 2013 to 2018.
“The declines in lung cancer and melanoma death rates are the result of progress across the entire cancer continuum—from reduced smoking rates to prevent cancer to discoveries such as targeted drug therapies and immune checkpoint inhibitors,” Karen E. Knudsen, MBA, PhD, chief executive officer of the American Cancer Society, said in a press release. “While we celebrate the progress, we must remain committed to research, patient support, and advocacy to make even greater progress to improve the lives of patients [with cancer] and their families.”
By contrast, while female breast cancer death rates decreased by 2.3% per year on average during 2003 to 2007, it decreased by 1.6% per year for 2007 through 2014 and 1.0% for 2014 to 2018. Similarly, prostate cancer death rates decreased by 3.5% per year on average from 2001 to 2013 and stabilized from 2013 to 2018.
The report, which covers a period prior to the COVID-19 pandemic, also found that overall incidence rates of cancer had decreased overall among women, children, and adolescents and young adults. Overall, the report observed a decrease in death rates for 11 of the 19 most common cancers for men and 14 of the 20 most common cancers for women during 2014 to 2018.
Long-term trends in cancer mortality rates in the annual report indicated that the decline in death rate accelerated for both male and female patients from 2001 to 2018. Male patients experienced a 1.8% decline in mortality per year from 2001 to 2015, which increased to 2.3% per year from 2015 to 2018. Moreover, female patients experienced a decline of 1.4% per year from 2001 to 2015, which increased to 2.1% per year from 2015 to 2018.
Cancer death rates were highest among Black populations (182.5 per 100,000) followed byAmerican Indian/Alaska Native (163.2 per 100,000), White (160.2 per 100,000), Hispanic (110.8 per 100,000), and Asian/Pacific Islanders (98.0 per 100,000). Although prostate cancer deaths were stable among White, Black, and Hispanic men, rates decreased for Asian/Pacific Islanders and American Indian/Alaska Natives. Moreover, CRC death rates declined among all racial and ethnic groups with the exception of American Indian/Alaska Natives who experienced stable rates. In pancreatic cancer—the fourth most common cancer-related death among White and Black men—mortality rates increased for White men but was stable for all other groups.
Mortality rates for lung cancer, breast cancer, and CRC decreased for all female patients across all racial and ethnic groups from 2014 to 2018, with the exception stable rates observed in breast cancer deaths in Asian/Pacific Islanders and American Indian/Alaska Natives and CRC cancer deaths among American Indian/Alaska Natives. While pancreatic cancer death rates slightly increased for women, there was not a statistically significant increase in any one racial or ethnic group. Uterine cancer accounted for the largest increase in death rates for women during the 2014 to 2018 period, wherein increased rates were observed among White, Black, Asian/Pacific Islanders, and Hispanic females.
“It is encouraging to see a continued decline in death rates for many of the common cancers,” Karen Hacker, MD, MPH, director of Centers for Disease Control and Prevention’s National Center for Chronic Disease Prevention and Health Promotion, said in a press release. “To dismantle existing health disparities 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.”
Despite an increase in incidence during 2001 to 2017, cancer mortality rates are continuing to decline among children under the age of 15 and adolescents and young adults who are 15 to 39 years of age. Overall incidences of cancer increased in children and young adults and adolescents across all racial and ethnic groups, with the exception of American Indian/Alaska Natives whose rates remained stable. Among adolescents and young adults, the most common tumor type was female breast cancer.
“When evaluating health disparities, it is critical to acknowledge the social factors that influence the health of the communities and access to health care,” Betsy A. Kohler, MPH, Executive Director of North American Association of Central Cancer Registries, concluded. “Social and economic indicators, particularly based on small area assessments, are increasingly important to understanding the burden of cancer.”