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Cancer mortality falls by 29 percent over nearly three decades


Death by cancer fell by 29 percent between 1991 and 2017, with a 2.2 percent decrease taking place between 2016 and 2017 the largest single-year drop in cancer-related mortality ever recorded, according to the American Cancer Society.


The almost three decade decrease is attributed to long-term drops in death for patients with lung, colorectal, breast and prostate cancer. Pace of mortality among these cancer types differs, however, with reductions in lung cancer deaths increasing from two to four percent per year overall in recent years, while those from colorectal, breast and prostate cancers have stalled, says the ACS Cancer Statistics, 2020 report.


"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, said cancer epidemiologist Rebecca Siegel, MPH, lead author of the report and director of surveillance research at ACS, in a statement. It's a reminder that increasing our investment in the equitable application of existing cancer control interventions, as well as basic and clinical research to further advance treatment, would undoubtedly accelerate progress against cancer."


Cancer survival has improved since the mid-1970s for all of the most common cancers, excluding cervical and uterine. Death rates for breast cancer dropped by 40 percent from 1989 to 2017; for prostate cancer by 52 percent from 1993 to then; and for colorectal cancer by 53 percent from 1980 among men and by 57 percent among women, from 1969 onward.


Lung cancer death rates have dropped by 51 percent for men since 1990 and by 26 percent among women since 2002. The disease stands out from other forms of cancer due to increased progress made in recent years, with decreases in mortality among men growing from three percent annually between 2008 and 2013 to five percent per year between 2013 and 2017. The drop in deaths for women rose from two percent to almost four percent throughout these same time frames.


Lung cancer is still responsible for almost a quarter of all cancer deaths, outpacing those of breast, prostate and colorectal combined. Incidents of lung deaths increase annually, with a recorded two-to-three percent annual rise in case numbers between 2007 and 2016. The rate, though, has slowed compared to previous years. Incidents of cancers for kidney, pancreas, liver, oral cavity and pharynx (among non-Hispanic whites) and melanoma of the skin also continue to build.


Rapid declines, however, have been observed in deaths from melanoma, with breakthrough FDA approvals for treatments such as ipilimumab and vemurafenib pushing one-year survival for metastatic patients from the 2008-2010 rate of 42 percent to the 2013-2015 rate of 55 percent. Overall, melanoma death rates recorded in 2006-2010 were two-to-three percent for patients aged 20-24, and one percent for patients aged 50-64. Bundled together, the two dropped to seven percent annually from 2013 to 2017. Individuals aged 65 and up, initially dying from melanoma at increasing rates, have experienced decreases of five to six percent.


Improvements in treatment protocols have also helped combat death from hematopoietic and lymphoid malignancies such as leukemias and lymphomas, with 5-year relative survival from chronic myeloid leukemia going from 22 percent in the mid-1970s to 70 percent between 2009 and 2015. This is due to the development of targeted therapies, with most patients treated with tyrosine kinase inhibitors today experiencing close to normal life expectancy, according to the report.


"The accelerated drops in lung cancer mortality as well as in melanoma that we're seeing are likely due, at least in part, to advances in cancer treatment over the past decade, such as immunotherapy," said Dr. William G. Cance, chief medical and scientific officer for the American Cancer Society, in a statement. "They are a profound reminder of how rapidly this area of research is expanding, and now leading to real hope for cancer patients."


Estimates were based on computer models of cancer trends and population, and may vary. Trends were based on age-adjusted cancer incidence and death rates expressed as the number of cancer deaths per 100,000 people.


Overall cancer incidence rate in men decreased fast between 2007 and 2014, but stabilized in 2016. It has generally remained stable in women over the past few decades. The U.S. is projected to face 1,806,590 new cancer cases and experience 606,520 cancer deaths in 2020.


The findings were published in CA: A Cancer Journal for Clinicians, and include a consumer version, Cancer Facts & Figures 2020.

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