Largest Single-Year Drop in Cancer Mortality Ever Reported: 2016–2017

The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017—the largest single-year drop in cancer mortality ever reported. These findings were reported in “Cancer Statistics, 2020,” the latest edition of the American Cancer Society’s annual report on cancer rates and trends. The article was published by Rebecca L. Siegel, MPH, and colleagues in CA: A Cancer Journal for Clinicians¹ and is accompanied by a consumer version, Cancer Facts & Figures 2020.²

Rebecca L. Siegel, MPH

The steady 26-year decline in overall cancer mortality is driven by long-term drops in death rates for the four major cancers—lung, colorectal, breast, and prostate—although recent trends are mixed. The pace of mortality reductions for lung cancer—the leading cause of cancer death—accelerated in recent years (from 2% per year to 4% overall), spurring the record 1-year drop in overall cancer mortality. In contrast, progress slowed for reductions in mortality from colorectal, breast, and prostate cancers.

Progress in Rates of Cancer Mortality

Overall cancer death rates dropped by an average of 1.5% per year during the most recent decade of data (2008–2017), continuing a trend that began in the early 1990s and resulting in the 29% drop in cancer mortality in that time. The drop translates to approximately 2.9 million fewer cancer deaths than would have occurred had mortality rates remained at their peak. Continuing declines in cancer mortality contrast with a stable trend for all other causes of death combined, reflecting a slowing decline for heart disease, stabilizing rates for cerebrovascular disease, and an increasing trend for accidents and Alzheimer’s disease.

Lung cancer death rates have dropped by 51% (since 1990) in men and by 26% (since 2002) in women, with the most rapid progress occurring in recent years. For example, reductions in mortality accelerated from 3% per year from 2008 to 2013 to 5% per year from 2013 to 2017 in men, and from 2% to almost 4% in women. However, lung cancer still accounts for almost one-quarter of all cancer deaths—more than breast, prostate, and colorectal cancers combined.

The most rapid declines in mortality occurred in melanoma of the skin, perhaps due to breakthrough treatments approved in 2011, which pushed 1-year survival for patients diagnosed with metastatic disease from 42% from 2008 to 2010 to 55% from 2013 to 2015. This progress is likewise reflected in the overall melanoma death rate, which dropped by 7% per year from 2013 to 2017 in people aged 20 to 64, compared with declines from 2006 to 2010 (prior to the U.S. Food and Drug Administration’s approval of ipilimumab and vemurafenib) of 2% to 3% per year in those aged 20 to 49 and 1% per year in those aged 50 to 64. There were also mortality declines of 5% to 6% in individuals aged 65 and older, among whom rates were previously increasing.

“The news this year is mixed,” said Ms. Siegel, the lead author of the report. “The exciting gains in reducing mortality for melanoma and lung cancer are tempered by slowing progress for colorectal, breast, and prostate cancers, which are amenable to early detection. It’s a reminder that increasing our investment in the equitable application of existing cancer control interventions, as well as basic and clinical research to further advance treatment, would undoubtedly accelerate progress against cancer.”

Highlights From the Report

More news from the report include the following findings:

• The death rate for breast cancer dropped by 40% from 1989 to 2017.
• The death rate for prostate cancer dropped by 52% from 1993 to 2017.
• The death rate for colorectal cancer dropped by 53% from 1980 to 2017 among men and by 57% from 1969 to 2017 among women.
• Decades-long rapid increases in liver cancer mortality appear to be abating in both men and women.
• Cervical cancer caused 10 premature deaths per week in women between the ages of 20 and 39 in 2017.

Other recent data include:

• In 2020, 1,806,590 new cancer cases and 606,520 cancer deaths are projected to occur in the United States.
• Progress in hematopoietic and lymphoid malignancies has been especially rapid due to improvements in treatment protocols, including the development of targeted therapies. The 5-year relative survival rate for chronic myeloid leukemia increased from 22% in the mid-1970s to 70% for those diagnosed from 2009 through 2015, and most patients treated with tyrosine kinase inhibitors now experience a nearly normal life expectancy.
• The overall cancer incidence rate in men declined from 2007 to 2014, but it stabilized through 2016, reflecting slowing declines for colorectal cancer and stabilizing rates for prostate cancer.
• The overall cancer incidence rate in women has remained generally stable over the past few decades, because lung cancer declines have been offset by a tapering decline in colorectal cancer and increasing or stable rates for other common cancers in women.
• The slight rise in breast cancer incidence rates since 2004 has been attributed, at least in part, to continued declines in the fertility rate and increased obesity, factors that may also contribute to increasing incidence for uterine cancer.
• Lung cancer incidence continues to decline twice as fast in men as in women, reflecting historical differences in tobacco use.
• Colorectal cancer incidence patterns are generally similar in men and women, with the rapid declines noted during the 2000s in the wake of widespread colonoscopy uptake appearing to taper in more recent years.
• Incidence continues to increase for cancers of the kidney, pancreas, liver, and oral cavity and pharynx (among non-Hispanic white individuals) and melanoma of the skin.
• The 5-year relative survival rate for all cancers combined diagnosed from 2009 to 2015 was 67% overall, 68% in white individuals, and 62% in black individuals.
• Cancer survival has improved since the mid-1970s for all of the most common cancers, except cervical and uterine cancers.

“The accelerated drops in lung cancer mortality as well as in melanoma that we’re seeing are likely due, at least in part, to advances in cancer treatment over the past decade, such as

William G. Cance, MD

immunotherapy,” said William G. Cance, MD, Chief Medical and Scientific Officer for the American Cancer Society. “They are a profound reminder of how rapidly this area of research is expanding and now leading to real hope for [patients with cancer].” ■

DISCLOSURE: For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.

REFERENCES

1. Siegel RL, Miller KD, Jemal A: Cancer statistics, 2020. CA Cancer J Clin. January 8, 2020 (early release online).

2. American Cancer Society: Cancer Facts & Figures 2020. Available at www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2020.html. Accessed January 9, 2020.