U.S. Cancer Death Rates Continue to Fall

28 may 2009-- Some 650,000 people are alive today who wouldn't be were it not for advances in cancer prevention, detection and treatment over the past 15 years, new statistics show.

The American Cancer Society's Cancer Statistics 2009 report finds an encouraging 19.2 percent drop in cancer death rates among men from 1990 to 2005, as well as an 11.4 percent drop in women's cancer death rates during the same time period.

Overall, cancer death rates fell 2 percent per year from 2001 to 2005 in men and 1.6 percent per year from 2002 to 2005 in women. By comparison, between 1993 and 2001, overall death rates in men declined 1.5 percent per year and, between 1994 and 2002, 0.8 percent in women.

"We continue to see a decrease in death rates from cancer in both men and women and this is mainly because of prevention - mostly a reduction in smoking rates; detection which includes screening for colorectal cancer, for breast cancer and for cervical cancer; and also improved treatment," said report author Ahmedin Jemal, strategic director for cancer surveillance at the American Cancer Society.

"To put this in perspective, the number of lives saved is more than the population of Washington, D.C.," said Dr. Louis M. Weiner, director of the Lombardi Comprehensive Cancer Center at Georgetown University. "In my mind, that's a cause for some celebration. However, there are some sobering trends that we have to be aware of. The death rate for cardiovascular disease has dropped much more dramatically over that period than has the death rate from cancer, indicating the difficulty of developing new strategies to reduce the incidence of cancer and also to treat it more effectively. This is a very complex set of diseases. While we have come a long way, we have a lot further to go."

Hopefully, continued reductions in smoking rates, especially among women, should push cancer rates further down in the future, the researchers noted.

Although some 45 million Americans continue to smoke, for a prevalence rate of about 20 percent, "smoking prevalence is going in the right direction," Jemal said. "We're going to see a reduction in lung cancer death rates, although I don't know when it might be. In particular, we will see a reduction in cancer death rates among women that's going to drive [down] the overall cancer death rate."

Better screening could also further fuel the trend. Only 50 percent of Americans over the age of 50 currently get regular screening for colorectal cancer, he said.

Here is a summary of the report's findings:

• In 2009, an estimated 1,479,350 new cases of cancer will be diagnosed in the U.S. (766,130 in men and 713,220 in women) and 562,340 people will die of the disease (292,540 men and 269,800 women). This means 1,500 deaths from cancer every day).
• Between 2001 and 2005, the incidence of cancer in men declined by 1.8 percent per year; from 1998 to 2005 the incidence rate in women dropped 0.6 percent per year. In men, the gains were largely as a result of decreases in the incidence of lung, prostate and colorectal cancer (the three most common cancers). In women, the decline was largely attributable to declines in both breast and colorectal cancer, the two most common tumor types in women.
• Cancer death rates dropped by 11.4 percent for women between 1991 and 2005, with a 37 percent decline in deaths from breast cancer and a 24 percent decrease in deaths from colorectal cancer.
• The three leading cancer killers in men are lung, prostate and colorectal cancer. In women, they are lung (accounting for 26 percent of all cancer deaths), breast and colorectal cancer.
• Men have a 44 percent chance of developing cancer during their lifetime and women a 37 percent chance, although women are more likely to have the disease earlier (before age 60).
• Lung cancer shows the greatest regional variation in cancer incidence, ranging from a low of 39.6 cases per 100,000 in men and 22.4 per 100,000 in women in Utah to 136.2 in men and 76.2 in women in Kentucky. These statistics correlate directly to smoking rates in the two states, with Utah having the lowest prevalence in adult smoking in the country, and Kentucky the highest.
• Blacks still assume a disproportionate share of the cancer burden, with black men being 18 percent more likely to develop cancer and 36 percent more likely to die. Black women have a 6 percent lower incidence rate but this is more than made up for with a death rate, which is 17 percent higher than that seen in white women.
• The five-year survival rate for children with cancer is now 80 percent, up from only 58 percent for those diagnosed in the mid-1970s. But cancer is still the second leading cause of death in youngsters aged 1 to 14 (after accidents), with leukemia being the most common cancer diagnosed.
• And in a special section, the report finds that cancer survivors are about 14 percent more likely to develop a new cancer than individuals who have never had a cancer diagnosis; almost 900,000 cancer survivors have been diagnosed with more than one cancer. Patients diagnosed with tobacco-related cancers, such as cancers of the oral cavity, lung, esophagus, kidney, and urinary bladder, have the highest risk for a second cancer because smoking is a risk factor for at least 15 types of cancer. Breast cancer survivors comprise almost half of women who develop a second cancer.

Unfortunately, cancer remains the leading killer (surpassing heart disease) for persons under 85, and one-quarter of deaths in the United States still come from cancer, the report stated.

"It's good news that the death rates for the most common cancers are on the decline, but there are still too many Americans dying of cancer every year," said Dr. Alan Astrow, director of medical oncology and hematology at Maimonides Cancer Center in New York City. "It's troubling that African-Americans continue to experience higher rates of mortality from cancer than whites. It's also troubling that Americans with less education have higher death rates. There are continued high rates of deaths from lung cancer. It's hard to feel good about 160,000 Americans dying of lung cancer every year. That's a disturbing statistics which we, as a nation, need to address."

The report appears online and in the July/August print issue of CA: A Cancer Journal for Clinicians.