Death rates are declining for many common cancers in the U.S., report finds

Death rates are declining for more than half of the most common forms of cancer in the U.S., according to a sweeping annual analysis released Thursday.

The new report — released by the American Cancer Society, the National Cancer Institute, the Centers for Disease Control and Prevention, and other collaborators — found that between 2014 and 2018, death rates dropped for 11 out of 19 of the most common cancers among men and 14 of the 20 most prevalent cancers among women.

Accelerating declines in lung cancer deaths may account for much of the overall progress seen in recent years, the authors of the report said. Over the past two decades, the death rate for lung cancer has declined even faster than the rate at which patients are diagnosed with the disease. And while part of the early success in preventing lung cancer can be attributed to the massive drop in smoking rates, the authors note the most recent downward trends seem to correspond with the approval of new treatments for non-small cell lung cancer that improved the likelihood of survival.

Death rates from melanoma also saw an accelerated decline in the past decade, despite a growing number of diagnoses. Like in lung cancer, authors point to the introduction of novel treatments around the same time as the turnaround on the death rate. New targeted and immune checkpoint inhibitors were approved by the Food and Drug Administration in 2011, one year before major declines in death rates were seen in women and two years before they were seen in men.

Farhad Islami, the lead author of the report and a scientific director at the American Cancer Society, said the findings point to areas where treatments or new advances are benefiting patients and underscore which forms of cancer may need more attention from scientists and research funding organizations.

“It’s important that people have timely access to quality treatment,” Islami said. “Not just any treatment, but something that evidence shows is effective.”

While the report showed improved survival rates for many patients over recent years, others, such as prostate, colorectal, or female breast cancers, have seen progress stalled or stopped. Breast cancer continues to be one of the three deadliest cancers for women of all races, and the most frequently fatal cancer for Hispanic women.

While the rates of death from breast cancer are declining, the pace of the decline has slowed over the past two decades, according to the report.

And across the board, racial health disparities persist. Black women and white women are diagnosed with breast cancer at similar rates, Islami said, but the mortality rate for Black women is 40% higher. Overall, cancer is more common among white individuals than Black individuals, but Black people die from cancer at higher rates.

Islami emphasized the importance of preventive measures for certain cancers, noting that while cancers related to smoking have continued to decrease, those related to excess body weight have increased. Early and consistent access to screenings has also been critical, he said, as demonstrated by the apparent effect of adapted screening guidelines for colorectal cancer.

From 2000 to 2010, the number of people between the ages of 50 and 75 who received a regular colonoscopy more than doubled from 19% to 55%. But between 2010 and 2015, that same rate only rose to 59%. While it’s not a clear cause and effect, this slowdown in screening uptake is closely correlated with slower improvements in the death rates from colorectal cancer.

Each year, the report on cancer is meant to provide guidance to clinicians in speaking directly with their patients. But Islami said that authors are also looking toward a wider audience.

“We hope that policymakers read the paper,” Islami said. “Many of these things need community-level policies to be implemented.”