THE CANCER death rate dropped 1.7% from 2014 to 2015, continuing a drop that began in 1991 and has reached 26%, resulting in nearly 2.4 million fewer cancer deaths during that time.
The data are reported in “Cancer Statistics, 2018,” the American Cancer Society’s comprehensive annual report on cancer incidence, mortality, and survival. It was published by Siegel et al in CA: A Cancer Journal for Clinicians1 and is accompanied by a consumer version, Cancer Facts & Figures 2018.2
THE REPORT estimates that there will be 1,735,350 new cancer cases and 609,640 cancer deaths in the United States in 2018. The cancer death rate dropped 26% from its peak of 215.1 per 100,000 population in 1991, to 158.6 per 100,000 in 2015. A significant proportion of the drop is due to steady reductions in smoking and advances in early detection and treatment. The overall decline is driven by decreasing death rates for the four major cancer sites: lung (declined 45% from 1990 to 2015 among men, and 19% from 2002 to 2015 among women); female breast (down 39% from 1989 to 2015); prostate (down 52% from 1993 to 2015); and colorectal (down 52% from 1970 to 2015).
Over the past decade, the overall cancer incidence rate was stable in women and declined by about 2% per year in men.
“Strikingly, tobacco remains by far the leading cause of cancer deaths today, responsible for nearly 3 in 10 cancer deaths.”— Otis W. Brawley, MD
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The report also finds that while the racial gap in cancer mortality continues to narrow, this mainly reflects progress in older age groups and masks stark persistent inequalities for young and middle-aged black Americans. Among all ages combined, the cancer death rate in 2015 was 14% higher in non-Hispanic blacks than in non-Hispanic whites, down from a peak of 33% higher in 1993. However, while the gap narrowed to 7% in those 65 or older—likely in part due to universal health-care access for seniors through Medicare—mortality rates remain 31% higher in blacks than in whites younger than age 65, with much larger disparities in many states.
While the new report also finds death rates were not statistically significantly different between whites and blacks in 13 states, a lack of racial disparity is not always indicative of progress. For example, cancer death rates in Kentucky and West Virginia were not statistically different by race but are the highest of all states for whites.
Other Highlights From the Report
THE OVERALL ESTIMATE of 1,735,350 cases for 2018 equals more than 4,700 new cancer diagnoses each day. In addition:
“This new report reiterates where cancer control efforts have worked, particularly the impact of tobacco control,” said Otis W. Brawley, MD, Chief Medical Officer of the American Cancer Society. “A decline in consumption of cigarettes is credited with being the most important factor in the drop in cancer death rates. Strikingly, tobacco remains by far the leading cause of cancer deaths today, responsible for nearly 3 in 10 cancer deaths.” ■
DISCLOSURE: Dr. Brawley reported no conflicts of interest.
1. Siegel RL, Miller KD, Jemal A: Cancer statistics, 2018. CA Cancer J Clin 68:7- 30, 2018.
2. American Cancer Society. Cancer Facts & Figures 2018. Available at www. cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2018.html. Accessed January 8, 2018.