Mixed Findings in Annual Cancer Statistics Report

On January 8, 2020, the American Cancer Society published details of their annual cancer statistics report, including the most recent data on population‐based findings for cancer incidence through 2016 and for mortality through 2017 (CA Cancer J Clin. 2020;70:7-30). The report revealed encouraging news as well as some sobering trends.

According to the authors of the report, cancer remains the second leading cause of death in men and women in the United States, with experts predicting that there will be approximately 1,806,590 new cancer cases and 606,520 cancer-related deaths in 2020; only heart disease kills more people each year. However, cancer mortality rates overall have been on the decline, dropping approximately 29% since 1991. From 2016 to 2017, there was a 2.2% decline in cancer mortality rates overall, which is the greatest single-year decline ever reported.

The authors identified several factors that have contributed to the decline in the number of overall cancer-related deaths, including a reduction in smoking rates, new diagnostic technologies, less invasive surgical techniques, and therapeutic advances, such as the use of T-cell−targeting immunotherapies. Lung cancer, however, continues to be a major cause of cancer-related deaths, killing more people than breast, prostate, colorectal, and brain cancers combined.

The report cited a dramatic decrease in deaths related to metastatic melanoma of the skin, which the authors attributed to such factors as the FDA approval of new therapies for metastatic disease. The use of these agents has led to a 7% annual reduction in deaths per year among patients aged 20 to 64 years, and a 5% to 6% reduction in deaths per year in those aged ≥65 years.

The continuous decline in cancer mortality rates overall since 1991 translates to approximately 2.9 million fewer cancer deaths, which is welcome news. However, declines in mortality rates for some of the most frequently occurring cancers, including colorectal cancer and female breast cancer, have started to taper off, and mortality rates for prostate cancer have stabilized. One factor likely to be contributing to these trends is the increasing rate of obesity among Americans. The authors also reported that obesity-related malignancies of the colon and rectum, liver, kidneys, pancreas, uterus, and breast (in postmenopausal women) have been on the rise in patients aged <55 years. They also noted that racial and geographic disparities present significant challenges for highly preventable cancers, such as those of the cervix and lung.

“Increased investment in both the equitable application of existing cancer control interventions and basic and clinical research to further advance treatment options would undoubtedly accelerate progress against cancer,” the researchers concluded.

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