Cancer death rates drop 20 percent over two decades

Cancer death rates have fallen by 20% from their peak about 20 years ago, according to the latest statistics from the American Cancer Society.

This means that from 1991 to 2009, 1.2 million lives were spared, including 152,900 lives in 2009 alone.

“The big picture is that progress is steady, and for the four major cancer sites, progress is even more rapid,” says researcher Rebecca Siegel, MPH. She is the director of surveillance information at the American Cancer Society in Atlanta. The four major cancer sites are breast, prostate, colorectum, and lung. “Cancer death rates peaked in the 1990s, and we have seen a 1% decline per year, but we are seeing much larger declines for the most common cancers.”

Specifically, death rates have dropped by more than 30% for colorectal cancer, breast cancer in women, and lung cancer in men, and by more than 40% for prostate cancer.

There are several factors that may be driving these drops. It’s less smoking for lung cancer, and earlier detection and better treatments for colorectal, breast, and prostate cancers.

Still, not all the news is good. One in four deaths in the U.S. is due to cancer, and rates of certain cancers, including liver, thyroid, and pancreatic cancers, are on the rise.

The findings also make estimates about cancer cases and deaths for 2013. There will be about 1,660,290 new cancer cases and 580,350 cancer deaths in the U.S. this year.

The findings are published as two reports, "Cancer Facts and Figures 2013" and "Cancer Statistics 2013," the latter of which appears in CA: A Cancer Journal for Clinicians.

Room for Improvement Despite Progress

We can do better, Siegel says. Yes, fewer people are smoking, but about 20% of people still smoke. “If we could reduce that rate, we would see much larger declines in numerous other cancers.”

Smoking is a risk factor for many cancers including lung, head and neck, pancreatic, and bladder cancers, among others.

What’s more, some populations are more hard hit by cancer and cancer deaths than others. “If we could apply the knowledge that we have to all populations, including individuals who are poor and uninsured, we would see even more progress,” she says. “Early detection is so important. If we could get more people to get regular cancer screening, their chances for a better outcome are increased.”

“More than a million people are alive. That is a huge number of folks,” says Cy Aaron Stein, MD, PhD. He is the chair of the department of medical oncology and therapeutics research at City of Hope Cancer Center in Duarte, Calf. “This is really wonderful, but we would like to see death rates go down to zero. There is no penicillin for cancer, but good decisions were made and they are bearing fruits now.”

By good decisions, he means regular screening and healthy lifestyle changes such as quitting smoking.

Stein is concerned that recent changes to screening guidelines as well as budget cuts may erode some of this progress.

The obesity epidemic is another wild card. “What obesity will do to these numbers, we don’t know,” he says. Obesity has been linked to higher risk for several cancer types, including breast, colorectal, and pancreatic cancers, among others.

Breast and Pancreatic Cancers

Stephanie Bernik, MD, says that early detection and better treatments are largely responsible for the drop in breast cancer deaths. She is the chief of surgical oncology at Lenox Hill Hospital in New York City.

“We had good cure rates, and now they are excellent,” she says. But If we cut back on screening, it could negatively impact these numbers. According to the new report, there will be an estimated 232,340 new cases of breast cancer diagnosed among women, and 39,620 women are projected to die from breast cancer in 2013.

While other cancer rates are falling, the report shows that more people are being diagnosed with pancreatic cancer than ever before.

In 2013, there will be an estimated 45,220 new cases of pancreatic cancer diagnosed in the U.S., and about 38,460 people are projected to die from this cancer.

And we really don’t know why, says Gagandeep Singh, MD. He is professor at City of Hope Cancer Center in Duarte, Calif. “The key thing is try to make the diagnosis a little bit earlier.”

Yes, the statistics are grim, but pancreatic cancer is not necessarily a death sentence, Singh says.  “We all have patients that are alive 10 to 12 years out and doing well. There is a lot in the pipeline, and the next five to 10 years hold great promise for the detection and treatment of pancreatic cancer.”

SOURCES:Rebecca Siegel, MPH, director, surveillance information, American Cancer Society, Atlanta.Cy Aaron Stein, MD, PhD, chair, department of medical oncology and therapeutics research, City of Hope Cancer Center, Duarte, Calf.Stephanie Bernik, MD, chief, surgical oncology, Lenox Hill Hospital, New York City.Gagandeep Singh, MD, professor of hepatobiliary surgery, City of Hope Cancer Center, Duarte, Calif.Siegel, R. CA: A Cancer Journal for Clinicians, 2013, study received ahead of print.Cancer Facts & Figures 2013.

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