ACS: Cancer Mortality has Decreased 33%

Newer treatments, including targeted and immunotherapies, have contributed to an increase in five-year survival rates for patients with some cancers.

In 2023, there will 1.96 million new cancer cases and 609,820 cancer deaths in the United States, according to new statistics released by the American Cancer Society (ACS) and published in CA: A Cancer Journal for Clinicians. Researchers predict the greatest number of deaths will be from lung, prostate, and colorectal cancers in men and lung, breast, and colorectal cancers in women.

Researchers, led by Rebecca L. Siegel, MPH, senior scientific director, cancer surveillance research at the American Cancer Society, analyzed several sources of population-based data, including the National Cancer Institutes Surveillance, Epidemiology, and End Results program; the CDC’s National Program of Cancer Registries; the North American Association of Central Cancer Registries; and the National Center for Health Statistics.

Incidence rates have decreased for some cancers, such as lung cancer in women and cervical cancer, which saw a 65% drop in incidence during 2012 through 2019 among women in their early 20s. This represents the first group to have received the human papillomavirus vaccine. (Merck’s initial vaccine, Gardasil, was approved in 2006 to prevent infection from four strains of HPV. These are the strains most associated with cervical cancer, anal cancer, and throat cancer.)

Decreases in incidence during 2012 through 2019 was similar across race and ethnicity (White, 64%; Black, 69%; Hispanic, 70%). But researchers said there wasn’t enough data to analyze for rate among Asian American and Pacific Islander and the American Indian and Alaska Native populations.

The incidence, however, is increasing for other cancers, such as breast and uterine cancers, as well as liver cancer and melanoma in women, both of which stabilized in older men and decreased in younger men. Additionally prostate cancer incidence increased by 3% annually from 2014 through 2019 after two decades of decline, according to the ACS data.

The good news is that newer treatments, including targeted and immunotherapies, have contributed to an increase in five-year survival rates for patients with some cancers. For all cancers combined, the five-year relative survival rate has increased from 49% for during the mid-1970s to 68% for during 2012 through 2018. The highest survival is among those with thyroid, prostate, testis and for melanoma, and lowest for cancers of the pancreas, liver and esophagus.

But for cancers were there are targeted therapies, survival rates are even higher. For example, for chronic myeloid leukemia, five-year survival was at 70% for those diagnosed during 2012 through 2018, compared with 22% of those diagnosed in the 1970s.

The data, however, show that survival for women with uterine cancer has not increased, which the authors suggest reflects a lack of treatment advances. Uterine cancer is the fourth most commonly diagnosed cancer in women, but research is lacking. Uterine cancer research ranked 24th in NCI funding in 2018. The ACS researchers said the lack of progress disproportionately affects Black women, who are less likely to be diagnosed with localized-stage disease and have lower rates of survival. In fact, survival rates for Black people are lower than survival rates for White people for all cancers.

But the highest cancer mortality rate is among American Indian and Alaska Native, followed by Black people. the death rate in American Indian and Alaska Native and Black men is 18% higher than that in White men. “Racial disparities are largely a consequence of less access to high-quality care across the cancer continuum. However, increasing access alone is insufficient to close these gaps,” the researchers wrote. “Racial disparities in cancer occurrence and outcomes are largely the result of longstanding inequalities in wealth that lead to differences in both risk factor exposures and access to equitable cancer prevention, early detection, and treatment.”

They said expanding access to care and increasing investment in research and cancer control could help reduce inequities.