Report on The Status of Cancer: Good and Bad News

By Jane Farrell

Although cancer is still one of the greatest health dangers facing Americans, an analysis by the federal National Cancer Institute (NCI) and other agencies has found that overall death rates from the illness continue to decline.

But disparities in survival rates remain affected by an array of socioeconomic factors, and more progress needs to be made in weight reduction and elimination of tobacco use.

The findings were contained in the latest Annual Report to the Nation on the Status of Cancer, 1975-2014. Among the key conclusions:

*Overall cancer death rates from 2010-2014 decreased by 1.8% per year in men, by 1.4% per year in women, and by 1.6% per year in children.

*Death rates during the period 2010-2014 decreased for 11 of the 16 most common types of cancer in men and for 13 of the 18 most common types of cancer in women, including lung, colorectal, female breast, and prostate cancers.

*For breast cancer in women, the death rate decreased by 1.6% between 2010-2014. However, between 2009 and 2013, the incidence of breast cancers in women increased 0.4% – a rate the report called statistically significant.

*There were increased death rates for cancers of the liver, pancreas, and brain in men and for liver and uterine cancer in women.

*Overall cancer incidence rates, or rates of new cancers, decreased in men but stabilized in women during the period 1999-2013.

The Report to the Nation is released each year in a collaborative effort by the American Cancer Society; the NCI; the federal Centers for Disease Control and Prevention (CDC); and the North American Association of Central Cancer Registries (NAACCR).

The report, which appeared in the Journal of the National Cancer Institute, also includes a section that focuses on survival as a percentage of cases. Some statistics on survival:

Compared to cases diagnosed in 1975-1977, five-year survival for cancers diagnosed in 2006-2012 increased significantly for all but two types of cancer: cervix and uterus. The greatest absolute increases in survival (25 percent or greater) were seen in prostate and kidney cancers as well as non-Hodgkin lymphoma, myeloma, and leukemia.

Cancers with the lowest five-year relative survival for cases diagnosed in 2006-2012 were pancreas (8.5 percent), liver (18.1 percent), lung (18.7 percent), esophagus (20.5 percent), stomach (31.1 percent) and brain (35 percent); those with the highest were prostate (99.3 percent), thyroid (98.3 percent), melanoma (93.2 percent) and female breast (90.8 percent).

The report also indicated that survival rates varied significantly by race, ethnicity and state, because of biological differences, socioeconomic status, and access to health care.

“While trends in death rates are the most commonly used measure to assess progress against cancer, survival trends are also an important measure to evaluate progress in improvement of cancer outcomes,” lead study author Ahmedin Jemal, D.V.M., Ph.D., of the American Cancer Society , said in the news release from NCI. “We last included a special section on cancer survival in 2004, and as we found then, survival improved over time for almost all cancers at every stage of diagnosis. But survival remains very low for some types of cancer and for most types of cancers diagnosed at an advanced stage.”

“While this report found that five-year survival for most types of cancer improved among both blacks and whites over the past several decades, racial disparities for many common cancers have persisted, and they may have increased for prostate cancer and female breast cancer,” said Lynne T. Penberthy, M.D., M.P.H., associate director of NCI’s Surveillance Research Program. “We still have a lot of work to do to understand the causes of these differences, but certainly differences in the kinds and timing of recommended treatments are likely to play a role.”

Tobacco use continues to be a significant public-health issue, as does weight.

“This report found that tobacco-related cancers have low survival rates, which underscores the importance of continuing to do what we know works to significantly reduce tobacco use,” said Lisa C. Richardson, M.D., M.P.H., director of CDC’s Division of Cancer Prevention and Control. “In addition, every state in the nation has an adult obesity prevalence of 20 percent or more. With obesity as a risk factor for cancer, we need to continue to support communities and families in prevention approaches that can help reverse the nation’s obesity epidemic. We need to come together to create interventions aimed at increasing the uptake of recommended, effective cancer screening tests, and access to timely cancer care.”

Additionally, the authors said, more attention and resources are needed to identify major risk factors for common cancers, such as colorectal, breast, and prostate, as are concerted efforts to understand the increasing incidence trends in uterine, female breast, and pancreatic cancer.

“The continued drops in overall cancer death rates in the United States are welcome news, reflecting improvements in prevention, early detection, and treatment,” said Betsy A. Kohler, M.P.H., C.T.R., executive director of NAACCR. “But this report also shows us that progress has been limited for several cancers, which should compel us to renew our commitment to efforts to discover new strategies for prevention, early detection, and treatment, and to apply proven interventions broadly and equitably.”

To read the full report, click here.