Cancer Deaths Continue to Drop

Steepest Decline Seen in Colorectal Cancer

Medically Reviewed by Louise Chang, MD on October 12, 2007
From the WebMD Archives

Oct. 15, 2007 - Cancer deaths continue to decline in the United States, and at a faster rate than has been seen in the past, a new report from the nation’s leading cancer groups confirms.

Deaths from all cancers dropped by an average of 2.1% annually from 2002 through 2004 -- nearly twice the annual decrease reported from 1993 to 2002.

Significant declines were seen in deaths from lung, prostate, and colorectal cancers in men and colorectal and breast cancers in women.

The report was issued by the American Cancer Society (ACS), the CDC, the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries.

“Cancer deaths have been decreasing since the mid '90s, but to see the rate of decline accelerate and almost double was both surprising and very heartening,” David Espey, MD, of the CDC’s Division of Cancer Prevention and Control, tells WebMD.

Colorectal Cancer Deaths

Deaths dropped for the majority of the top 15 cancers in men and women, but the steepest declines were seen in colorectal cancer mortality.

Increased screening and better treatments led to an almost 5% annual reduction in colorectal cancer mortality among men and 4.5% annual reduction in death rate among women between 2002 and 2004, compared with annual declines of about 2% over the previous two decades.

The incidence of colorectal cancer among men and women has also fallen over the last decade, by slightly more than 2% per year.

Espey says the sharp drop in incidence and deaths highlights the success of screening as well as an even bigger opportunity for future declines.

Only about half of people in the U.S. who should get screened for colorectal cancer do so.

“The message is that something is working, and screening is probably a big part of it,” he says. “But this sends a very clear message that we could do better by screening more people.”

Lung Cancer Deaths

Lung cancer remains the leading cancer killer of both men and women, and upwards of 90% of these deaths can be attributed to smoking, according to the ACS.

Although more men than women still die of lung cancer, lung cancer death rates have been dropping steadily among men while they have been increasing among women.

This upward trend has slowed dramatically over the past few years, however, and now shows signs of stabilizing.

“It looks as if we may have reached a plateau,” ACS Director of Surveillance Research Elizabeth Ward, PhD, tells WebMD. “We are hopeful that we will see declines in lung cancer deaths among women over the next few years, but we aren’t quite there yet.”

Declines in lung cancer deaths among men are also projected to continue as smoking rates continue to drop.

Breast Cancer Deaths

Deaths from breast cancer have dropped an average of 2% a year since 1990.

Breast cancer incidence rates also dropped significantly between 2001 and 2004, with a widely reported single-year decrease of nearly 7% between 2002 and 2003 thought to be due to declines in hormone replacement therapy (HRT) usage.

The average drop in incidence was 3.5% per year from 2001 to 2004.

Mammography screening has played a big part in the drop in breast cancer deaths, but screening rates have begun to decline slightly despite a federal program making mammograms available to uninsured women, Ward says.

About 75% of women who should get mammograms are being screened, she says.

“Screening rates are much lower for uninsured women and recent immigrants,” Ward says. “Certainly this is an area where improvement is needed.”

American Indians and Alaska Natives

A special feature of the report highlighted cancer incidence and death trends among two medically underserved groups in the United States: American Indians and Alaska Natives.

Poverty rates are roughly three times higher among these populations than among non-Hispanic whites, and health coverage rates for adults are roughly half that of whites.

As a result, these populations were less likely to have highly treatable malignancies like colorectal and breast cancers detected in the early stages.

Lung and colorectal cancer rates were also significantly higher among Northern Plains and Alaska Natives than among non-Hispanic whites.

In a written statement, National Cancer Institute Director John E. Niederhuber, MD, discusses the gap between more medically served and underserved populations.

“We are firmly committed to addressing cancer health disparities so that the benefits of decades of research can reach all Americans,” he writes. “The fact that lung and colorectal cancer rates were higher in some American Indian and Alaska Native populations points to the work we still have to do.”

Show Sources

SOURCES: Cancer, Nov. 15, 2007; vol 110: online edition. Elizabeth Ward, PhD, director of surveillance research, American Cancer Society, Atlanta. David Espey, MD, epidemiologist; Indian Health Service Team, CDC. John E. Niederhuber, MD, director, National Cancer Institute.

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