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Senior Citizen Health & Medicine

Cancer Death Rates Continue Decline but at Lower Rate Causing Deaths to Jump

Half million cancer deaths have been avoided says American Cancer Society report

Feb. 20, 2008 – There is good news and there is bad news in the latest statistics on cancer in the United States. The bad news - there was an increase of 5,424 deaths (559,312 in 2005 compared to 553,888 in 2004). The good news – The cancer death rate continues to decline and has decreased by 18.4% among men and by 10.5% among women since the decline in rates began in the early 1990s. This means 534,500 fewer deaths, according to the report by the American Cancer Society.

Society epidemiologists predict that in 2008 there will be 1,437,180 new cancer cases (745,180 in men and 692,000 in women) and 565,650 cancer deaths (294,120 among men and 271,530 among women).

The findings come from Cancer Statistics 2008, published in the March/April issue of CA: A Cancer Journal for Clinicians, as well as in the 57th edition of its companion publication, Cancer Facts & Figures 2008.

The increase in actual number of deaths in 2005 follows a decrease in the number of cancer deaths in the two previous years. The change is largely due to a smaller decline in the cancer death rate between 2004 and 2005 compared with that in the two previous time periods.

From 2004 to 2005, overall cancer mortality dropped about 1 percent, compared to a 2 percent drop from both 2002 to 2003 and 2003 to 2004.

Deaths rates up for colorectal, lung, prostate, breast

With respect to the four major cancer sites, colorectal cancer death rates decreased by about 3 percent from 2004 to 2005, compared to about 6 percent from 2003 to 2004. The decrease in death rates for cancers of the lung and bronchus and prostate in men and breast in women was also smaller from 2004 to 2005 than from 2003 to 2004.

It is important to understand, says the ACS, that for the number of cancer deaths to decrease, the decline in the overall cancer mortality rate must be large enough to offset the increasing numbers due to growth and aging of the population.

“The increase in the number of cancer deaths in 2005 after two years of historic declines should not obscure the fact that cancer death rates continue to drop, reflecting the enormous progress that has been made against cancer during the past 15 years.” said John R. Seffrin, Ph.D., American Cancer Society chief executive officer.

 “While in 2005 the rate of decline was not enough to overtake other population factors, the fact remains that cancer mortality rates continue to drop, and they’re doing so at a rate fast enough that over a half million deaths from cancer were averted between 1990/1991 and 2004.”

The cancer incidence and mortality data were collected by the Centers for Disease Control, the National Cancer Institute, the North American Association of Central Cancer Registries, state and local health agencies, and thousands of cancer registrars throughout the country.

Since 1952, when the first edition of Cancer Facts & Figures consisted of four typewritten pages, the American Cancer Society’s annual estimates of new cancer cases and deaths has become a critical tool for scientists, public health experts, and policymakers in assessing the current burden of cancer. These estimates are some of the most widely quoted cancer statistics in the world.

The Society’s leading team of epidemiologic researchers, in collaboration with scientists from the National Center for Health Statistics, compiles and analyzes incidence and mortality data to estimate the number of new cancer cases and deaths for the current year nationwide and in individual states. Highlights from this year’s publications:

   ● Among men, cancers of the prostate, lung and bronchus, and colon and rectum account for one in two (50 percent) of all newly diagnosed cancers. Prostate cancer alone accounts for one in four (25 percent) of the total cases in men.

   ● The three most commonly diagnosed types of cancer among women in 2008 will be cancers of the breast, lung and bronchus, and colon and rectum, accounting for 50 percent of estimated cancer cases in women. Breast cancer alone is expected to account for one in four (26 percent) new cancer cases among women.

   ● Lung cancer surpassed breast cancer as the leading cause of cancer death in women in 1987. Lung cancer is expected to account for 26 percent of all female cancer deaths in 2008.

   ● Cancer incidence rates stabilized in men from 1995 to 2004 and in women from 1999 to 2004. Between 2002 and 2004, death rates for all cancer sites combined decreased from by 2.6 percent per year in males and by 1.8 percent per year in females.

   ● Mortality rates have continued to decrease across all four major cancer sites in men and in women except for female lung cancer, in which rates continued to increase by 0.2 percent per year from 1995 to 2004.

   ● Death rates from all cancers combined peaked in 1990 for men and in 1991 for women. Between 1990/1991 and 2004, death rates from cancer decreased by 18.4 percent among men and by 10.5 percent among women

   ● Lung cancer incidence rates are declining in men and appear to be plateauing in women after increasing for many decades.

   ● Colorectal cancer incidence rates decreased from 1998 through 2004 in both males and in females.

   ● Female breast cancer incidence rates decreased by 3.5% per year from 2001 to 2004, after increasing since 1980. The decreases may reflect the saturation of mammography utilization and reduction in hormone replacement therapy use that followed the publication of study results from the Women’s Health Initiative in 2002.

   ● Among males under age 40 years, leukemia is the most common fatal cancer, while lung cancer predominates in men aged 40 years and older.

   ● Among females, leukemia is the leading cause of cancer death before age 20 years, breast cancer ranks first at age 20 to 59 years, and lung cancer ranks first at ages 60 and older.

   ● African American men have a 19 percent higher incidence rate and 37 percent higher death rate from all cancers combined than white men. African American women have a six percent lower incidence rate, but a 17 percent higher death rate than white women for all cancers combined.

   ● Among other racial and ethnic groups, cancer incidence and death rates are lower than those in whites and African Americans for all cancer sites combined and for the four most common cancer sites.

   ● Cancer is the second leading cause of death among children between ages one to 14 years in the U.S., after accidents. The five-year relative survival rate among children for all cancer sites combined improved from 58 percent for patients diagnosed in 1975 to 1977 to 80 percent for those diagnosed in 1996 to 2003.

Estimates of the expected numbers of new cancer cases and cancer deaths should be interpreted with caution. These estimates may vary considerably from year to year, particularly for less common cancers and in states with smaller populations.

Despite these limitations, the American Cancer Society’s estimates of the number of new cancer cases and deaths in the current year provide reasonably accurate estimates of the burden of new cancer cases and deaths in the United States. Such estimates will assist in continuing efforts to reduce the public health burden of cancer.

Each year, Cancer Facts & Figures features a Special Section highlighting one aspect of cancer prevention, early detection, or treatment. In recent years, the section has focused on tobacco, obesity, infectious causes of cancer, environmental pollutants, and cancer-related pain. The Special Section of Cancer Facts and Figures 2008 is “Insurance and Cost-Related Barriers to Cancer Care.”

About 47 million people in the U.S. are uninsured; minority populations and/or those with low income are disproportionately represented in this category. Recognizing that reducing barriers to cancer care is critical in the fight to eliminate suffering and death due to cancer, the American Cancer Society and its sister advocacy organization the American Cancer Society Cancer Action Network (ACS CAN) are working together to bring the need for meaningful healthcare reform to the forefront of public and political debate.

One important goal of this campaign is to educate Americans about the extent of the access to care problem and to motivate them to take action in support of change. The Special Section provides an overview of systems of health insurance and describes the impact of being uninsured or underinsured on cancer prevention, diagnosis, treatment, and outcome.

“The progress that has been made in reducing cancer death rates is a direct result of investment in approaches that we know work, such as comprehensive tobacco control and screening for breast, cervical and colorectal cancers, as well as research that has identified more successful treatments,” said Otis W. Brawley, MD, chief medical officer of the American Cancer Society.

“However, we believe that lack of health insurance and inadequate health insurance is one of the most important barriers to continued progress. A growing body of data shows that compared to those with private insurance, those without health insurance are less likely to receive smoking cessation advice and treatment, about half as likely to receive cancer screening, more likely to be diagnosed at late stage and less likely to survive after a cancer diagnosis. We are committed to addressing this critical issue.”

The full report can be viewed after embargo at www.cancer.org/statistics.

The American Cancer Society says it is dedicated to eliminating cancer as a major health problem by saving lives, diminishing suffering and preventing cancer through research, education, advocacy and service. Founded in 1913 and with national headquarters in Atlanta, the Society has 13 regional Divisions and local offices in 3,400 communities, involving millions of volunteers across the United States. www.cancer.org

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