Steepest decline in US cancer mortality ever recorded, study finds
Declining smoking rates, rapid diagnosis, and newer treatments are thawing mortality rates for cancer, which only lags behind heart disease as the biggest killer in the United States — researchers suggested in a new study on Wednesday.
The largest-ever one-year decline in the US cancer death rate — driven primarily by diminishing lung cancer mortality — was a 2.2% drop from 2016 to 2017, according to the American Cancer Society (ACS) report, which calculated an overall drop of 29% in US cancer rates from 1991 to 2017.
The decline in mortality over the 26-year period has been largely steady due to long-term drops in death rates in the four most common cancer types: lung, colorectal, breast, and prostate, although progress in reducing colorectal, breast, and prostate cancers has slowed, the researchers found, noting that this works out to more than 2.9 million deaths avoided since 1991 when the mortality rate was at its peak.
“(T)reatment breakthroughs have also contributed, such as those for hematopoietic and lymphoid malignancies in both children and adults, and more recently checkpoint blockade immunotherapies and targeted therapies for metastatic melanoma,” they wrote.
Peter Bach, director of Memorial Sloan Kettering’s center for health policy and outcomes, took issue with attributing the decline in cancer mortality to new medicines in the study led by ACS’ Rebecca Siegel.
The study does not test this hypothesis, the renowned researcher and epidemiologist wrote on Twitter. “Epidemiology may be opaque but it is not opinion.”
On average, the death rate has fallen by 1.5% per year between 2008 and 2017, Siegel et al calculated.
“Nevertheless, progress is slowing for cancers that are amenable to early detection through screening (ie, breast cancer, prostate cancer, and CRC), and substantial racial and geographic disparities persist for highly preventable cancers, such as those of the cervix and lung,” the authors wrote.
“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.”
In 2016, the United States spent nearly twice as much as 10 high-income countries on medical care and performed less well on many population health outcomes, data shows.
And although the US has lower-than-average mortality rates for cancer, it does have higher than average rates in the other causes of mortality versus countries that are similar in size and wealth (based on GDP and GDP per capita), according to an analysis conducted by The Peterson Center on Healthcare and the Kaiser Family Foundation.
Source: The Peterson Center on Healthcare & KFF, 2020
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These categories accounted for nearly 74% of all deaths in the United States in 2015, according to the data compiled.
“My biggest concern, however, is that the nation is so hyper-focused on cancer (as reflected in (the) disproportionate amount of R&D in oncology space) that it’s ignoring the alarming fact that overall life (US) expectancy is in decline,” health economist Joshua Cohen wrote in response to Bach’s comments on Twitter.