Overall cancer death rates continue to decrease in men, women, and children for all major racial and ethnic groups, according to the latest Annual Report to the Nation on the Status of Cancer, 1975–2014, published by Jemal et al in the Journal of the National Cancer Institute.1 The report finds that death rates during the period from 2010 to 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. Meanwhile, death rates increased for cancers of the liver, pancreas, and brain in men and of the liver and uterus in women. The report finds overall cancer incidence rates decreased in men but stabilized in women during the period from 1999 to 2013.
The Report to the Nation on the Status of Cancer is released each year in a collaborative effort by the American Cancer Society; the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI), both parts of the Department of Health and Human Services; and the North American Association of Central Cancer Registries (NAACCR).
Features and Findings
The report includes a special section, which this year focuses on survival expressed as percentage. It finds that several—but not all—cancer types showed a major improvement over time for both early- and late-stage disease and varied significantly by race/ethnicity and state.
“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,” said Ahmedin Jemal, DVM, PhD, of the ACS and lead author of the study. “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 5-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.— Lynne T. Penberthy, MD, MPH
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Compared with cases diagnosed between 1975 and 1977, 5-year survival for cancers diagnosed from 2006 to 2012 increased significantly for all but two types of cancer: cervical and uterine. The greatest absolute increases in survival (25% or more) were seen in prostate and kidney cancers, as well as in non-Hodgkin lymphoma, myeloma, and leukemia.
Ahmedin Jemal, DVM, PhD
Betsy A. Kohler, MPH, CTR
Cancers with the lowest 5-year relative survival for cases diagnosed between 2006 and 2012 were pancreatic (8.5%), liver (18.1%), lung (18.7%), esophageal (20.5%), stomach (31.1%), and brain (35%). Those cancers with the highest 5-year relative survival were prostate (99.3%), thyroid (98.3%), melanoma (93.2%), and female breast (90.8%).
“While this report found that 5-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, MD, MPH, 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.”
Focus on Risk Factors
“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, MD, MPH, Director of CDC’s Division of Cancer Prevention and Control. “In addition, every state in the nation has an adult obesity prevalence of 20% 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.”
Every state in the nation has an adult obesity prevalence of 20% 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.— Lisa C. Richardson, MD, MPH
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The authors also stated that 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 cancers.
“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, MPH, CTR, 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.” ■
Disclosure: For full disclosures of the study authors, visit academic.oup.com/jnci.
1. Jemal A, Ward EM, Johnson CJ, et al: Annual Report to the Nation on the Status of Cancer, 1975–2014, featuring survival. J Natl Cancer Inst 109:djx030, 2017.