Cancer mortality has declined in the United States for the second consecutive year. This is mainly due to the reduced incidence and mortality of cancer. Non-small cell lung cancer (NSCLC) Men and women, according to a new report from the American Cancer Society.
Research Published online January 12 CA: Cancer Journal for Clinicians.
“Mortality is a better indicator of cancer progression than incidence or survival because it is less susceptible to bias due to changes in detection methods,” said Rebecca Siegel, MPH of the American Cancer Society in Atlanta, Georgia. The author, led by, commented.
“ Overall 31% decrease as of 2018 [since the early 1990s] This represents an estimated 3,188,500 fewer cancer deaths (2,170,700 for men and 1,017,800 for women) than it would occur if mortality was at its peak, “the researchers add.
Importantly, lung cancer accounted for 46% of the overall decrease in cancer mortality over the last five years, with a record one-year decrease of 2.4% between 2017 and 2018.
The authors suggest that the recent rapid decline in lung cancer mortality reflects better treatments for NSCLC. For example, survival after 2 years increased from 34% of patients diagnosed with NSCLC between 2009 and 2010 to 42% of patients diagnosed between 2015 and 2016 — all diagnoses. The absolute increase in survival odds at this stage is 5% to 6%.
In a more solemn note, the author warns that COVID-19 is predicted to adversely affect both the diagnosis and outcome of patients diagnosed with cancer in the near future as before. report Along Medscape Medical News..
“The disruption of access to cancer treatments in 2020 could lead to increased downstream diagnosis of advanced stages and hinder the progress of lower cancer mortality over the next few years, Siegel said in a statement. I expect that there will be. “
New cancer cases
This report estimates new cancer cases and mortality in 2021 in the United States (country and state) based on the latest population-based data on cancer incidence by 2017 and mortality by 2018. Provide a number. “An estimated 608,570 Americans will die of cancer in 2021, which is equivalent to more than 1,600 deaths per day,” Siegel and colleagues report.
The maximum number of deaths is the most common cancers: lung, prostate, and Colorectal cancer In men and lungs, women with breast and colorectal cancers, they add. However, the mortality rate of all three cancers continues to decline.
As of 2018, researchers say lung cancer mortality has decreased by 54% in men and 30% in women over the last few decades.
Mortality from women breast cancer It has decreased by 41% since 1989. 52% Prostate cancer Since 1993; colorectal cancer in men (since 1980) and women (since 1969) has increased by 53% to 59%, respectively.
“But in recent years, the decline in breast and CRC (colorectal cancer) mortality has slowed and stopped in prostate cancer,” the researchers said.
In contrast, the pace of annual decline in lung cancer mortality doubled from 3.1% in 2009-2013 to 5.5% in 2014-2018 in men and from 1.8% to 4.4% in women at the same time interval. ..
Increased incidence on common sites
Despite steady progress in most cancer mortality rates, “mortality rates continue to rise in some common areas,” Siegel and colleagues report.
For example, endometrial cancer mortality has been accelerating at twice the rate of increase since the late 1990s. Mortality from oral and pharyngeal cancers is also increasing — in this cancer, an increase in mortality is parallel to an increase in its incidence.
“”Pancreatic cancer Mortality [in turn] It continued to increase slowly in men … but remained stable in women, despite the incidence. [rates] Both men and women are up about 1% annually. “
On the other hand, the incidence of Cervical cancerAlthough declining overall over decades, it is increasing not only in cervical adenocarcinoma, which is often undetectable by cytology, but also in patients with more distant disease.
“These findings underscore the need for more targeted efforts to increase HPV vaccination in all older people. [26 and younger] And we do a primary HPV test or HPV / cytology joint test every 5 years among women starting at age 25, “the authors emphasize.
More positively, the long-term increase in mortality Liver cancer Recently, they add that they have slowed down among women and are stable among men.
Again, the disparities in both cancer development and outcomes were quite different between racial and ethnic groups. For example, cancer is the leading cause of death for Hispanics, Asian Americans, and Native Alaskan people. The 5-year survival rate for almost all cancers remains higher in whites than in blacks, but the cancer mortality gap between blacks and whites has dropped from a peak of 33% in 1993 to 13%. ..
Geographical disparities in cancer mortality are still predominant. The rates are highest for preventable cancers such as lung and cervical cancer, and mortality rates vary five-fold from state to state.
And while cancer remains the second leading cause of death in children, cancer mortality continues to decline over time in both children and adolescents. This is primarily the result of a dramatic reduction in leukemia mortality in both age groups.
The author of the study does not disclose the relevant financial relationship.
CA: Cancer Journal for Clinicians. Published online on January 12, 2021. Full text
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