New Report Shows Decline in US Cancer Deaths Continues

The latest Annual Report to the Nation on the Status of Cancer has provided an update on the most recent statistics and trends in cancer cases and deaths in the United States. This year’s report, published in Cancer, also places focus on pancreatic cancer.

Knowledge in the fight against cancer

Cancer is one of the leading causes of death worldwide. It is expected that the number of new cancer cases globally will grow to 27.5 million, with 16.3 million cancer deaths, by 2040. Breast, lung, colon and prostate cancers are the four most common cancers worldwide, accounting for approximately 40% of all new cases collectively.

In the US, annual reports on the statistical trends in cancer cases have been published since 1998 as part of a collaboration between the Centers for Disease Control and Prevention (CDC), the American Cancer Society, the National Cancer Institute (NCI) and the North American Association of Central Cancer Registries (NAACCR).

These reports examine a plethora of data, analyzing trends in cancer incidence, mortality and survival by cancer type, sex, age and racial/ethnic groups.

The current report combined information about race and ethnicity to create five mutually exclusive groups: non‐Hispanic White (White), non‐Hispanic Black (Black), non‐Hispanic American Indian/Alaska Native (AI/AN), non‐Hispanic Asian/Pacific Islander (API) and Hispanic (of any race).

Additionally, data for the various groups analyzed in the current report were collected at time points ranging from 2001–2019 – therefore, it is important to note that all data were collected before the COVID-19 pandemic.

Cancer incidence rates

Overall incidence rates per 100,000 individuals were 497 for males and 431 for females from 2014–2018.

API and Black males had the lowest and highest incidence rates among men, respectively, and API and AI/AN females also had the lowest and highest rates respectively for women.

However, incidence varied across 18 of the most common cancer types included in this report:

• For males – incidence rates for three of these cancers increased (including pancreas and kidney), seven were stable (including prostate) and eight decreased (including lung and larynx).
• For females – incidence rates of seven cancers increased (including melanoma, liver and breast), four cancers were stable (including uterine) and seven decreased (including thyroid and ovary).

Additionally, for breast cancer – the most common cancer among adolescents and young adults (15–39 years of age) – the incidence rate increased by 1.0% per year on average between 2010 and 2018.

Mortality rates

Combining data from males and females showed that the decline in overall death rates from cancer steepened from 2001 to 2019, decreasing by 2.1% per year. Similar trends in overall death rates were also observed in each of the racial/ethnic groups analyzed in the report.

Data from adolescents and young adults showed a decrease in death rates by 3% per year between 2001 and 2005, however, this rate of decline slowed to around 0.9% per year thereafter.

Racial and ethnic disparities

The report also highlighted racial and ethnic disparities, in both the incidence rates (2014–2018) and death rates (2015–2019) across many cancer types, as summarized in the table below.

Lisa C. Richardson MD, director of the CDC’s Division of Cancer Prevention and Control, elaborated on these findings in a press release: “Factors such as race, ethnicity and socioeconomic status should not play a role in people’s ability to be healthy or determine how long they live. [The] CDC works with its public health partners – within and outside the government – to address these disparities and advance health equity through a range of key initiatives, including programs, research and policy initiatives. We know that we can meet this challenge together and create an America where people are free of cancer.”

A special focus on pancreatic cancer

The pancreas is an organ located behind the stomach which produces enzymes that help digest food, as well as hormones like insulin and glucagon that regulate our blood sugar levels.

Cancer of the pancreas is commonly diagnosed once it is already in its advanced stages – early pancreatic cancers often have vague symptoms or even none at all. For these reasons, the combined five-year survival rate for pancreatic cancer is just 5–10%.

In the current report, the researchers explain that diagnoses of pancreatic cancer account for around 3% of new cancer cases – however, it also accounts for 8% of cancer deaths.

Nevertheless, the report also highlights significant steps forward for the survival rates of certain types of pancreatic cancer. Between 2001 and 2017, one-year relative survival for patients with neuroendocrine tumors increased from 65.9% to 84.2%, and there was also an increase from 24% to 36.7% for patients with adenocarcinomas.

“Pancreatic cancer incidence and survival reflect both the underlying risk of disease as well as the difficulty of diagnosing pancreatic cancer at a treatable stage,” said Betsy A. Kohler, M.P.H, NAACCR executive director. “As advancements in screening technology and effective treatments for early-stage disease become available, we are hopeful for greater improvements in pancreatic cancer survival, which historically has been a particularly lethal cancer type.”