Annual Report to the Nation: Cancer Death Rates Still Dropping

By Stacy Simon

The death rate from cancer in the United States is continuing the decline that began in the early 1990s, according to the latest Annual Report to the Nation on the Status of Cancer. It shows the rate of death from cancer in the United States is going down among both men and women, for children, and for the most common types of cancer, includinglung, colon, breast, and prostate. However, the report identified some cancer types with increasing incidence or death rates among certain populations.

The American Cancer Society, the North American Association of Central Cancer Registries, the Centers for Disease Control and Prevention, and the National Cancer Institute work together to create the report, which has been published each year since 1998. It provides an update of new cancer cases, death rates, and trends in the United States.

The report was published early online Monday in Journal of the National Cancer Institute.

Breast cancer subtypes

For the first time this year, the report uses national data to provide statistics about the prevalence of 4 major subtypes of breast cancer. These subtypes depend on whether the cancer cells contain certain hormone receptors and whether they have too many copies of the HER2 gene. Both these conditions can help breast cancer cells grow.

These subtypes are now being recorded by cancer registries across the nation, giving researchers and medical experts a more detailed picture of breast cancer rates and trends, and helping women better understand what their breast cancer subtype may mean for their health.

The breast cancer subtypes respond differently to treatment and have different survival rates. According to the report, some of the differences in rates of breast cancer incidence and death across racial and ethnic groups are related to differences in the incidence of different subtypes. The authors also observed differences based on age, poverty level, and geography.

Rates of the least aggressive breast cancer subtype were highest among white women. Rates of this subtype decreased with increasing levels of poverty for every racial and ethnic group. Black women had higher incidence rates of the most aggressive subtype, known as triple-negative breast cancer, than other racial and ethnic groups. Black women also had the highest rates of late-stage disease. Both of these factors are associated with lower survival and correspond with black women having the highest rates of breast cancer deaths.

Cancer death rates continue to fall

For the most recent reporting period, the rates of lung cancer incidence and death have decreased in both men and women, most likely due to public health efforts to decrease smoking rates. Colon cancer incidence and death rates among both men and women, and prostate cancer incidence and death rates in men, continued to fall.

“The drop in incidence in lung and colorectal cancers shows the lifesaving impact of prevention,” said John R. Seffrin, Ph.D., American Cancer Society Chief Executive Officer, in a statement. “But we have a long way to go, not only in these two cancers but in the many other cancers where the trend has not been so positive.”

Overall cancer incidence rates decreased by 0.5% per year from 2002 to 2011. Among men, incidence rates decreased an average of 1.8% per year from 2007 to 2011; incidence rates were stable in women from 1998 to 2011. Among children up to 19 years of age, incidence rates have increased by 0.8% per year over the past decade, continuing a trend since 1992. The cause for the increase remains uncertain.

Incidence and death rates increased for some cancer types

The authors pointed out some trends that call for further study.

• Incidence rates of thyroid and kidney cancers are increasing among both men and women, but no increase in death rates has been noted for these cancer types.
• Incidence and death rates of liver cancer are increasing among both men and women. These increases may reflect, in part, increasing rates of hepatitis C and/or behavioral risk factors, such as alcohol abuse.
• Incidence rates are increasing for oral and throat cancers overall among white men. This may be associated with increased HPV-linked throat cancers.
• Incidence and death rates are increasing for uterine cancer among white, black, and Asian Pacific Islander women, with the largest increase seen in black women. The cause of these increases is unknown.

Among the risk factors for some of these cancer types are excess weight and lack of physical activity.

Citation: Annual Report to the Nation on the Status of Cancer, 1975–2011, Featuring Incidence of Breast Cancer Subtypes by Race/Ethnicity, Poverty, and State. Published early online March 30, 2015 in Journal of the National Cancer Institute. First author: Betsy A. Kohler, MPH, CTR, North American Association of Central Cancer Registries, Springfield, Ill.