Death Rates from Cancer Continue to Fall in the US

Death rates from common cancers have continued a 25-year decline throughout the United States. From 1991-2016, the overall death rate from cancer declined 27%, resulting in an estimated 2.6 million fewer deaths. Cancer is currently the second leading cause of death in the US.

The American Cancer Society (ACS) annual report, Cancer Statistics 2019, projects that more than 4,800 cases of cancer will be diagnosed each day. Monitoring and modeling new cancer rates and trends, the report considers gender, age, and cancer type.1,2

Invasive cancers and prognosis rates

The probability of being diagnosed with invasive cancer is 39.3% for men and 37.7% for women. The differential between men and women is not completely understood. Contributing factors include hormones, environmental exposures and their interactions.2

In the US, around 1,700 deaths from cancer are expected each day with 25% of those attributable to lung cancer.1,2 There are some gender associated differences. For men, lung, prostate and colorectal cancers are most prevalent. For women, lung, breast, and colorectal are the leading causes.2

Lung cancer statistics

Although lung cancer is recognized as the leading cause of cancer death in men and women, the incidence of new cases is declining twice as quickly among men than women. This is likely because more women from certain age groups became smokers during the 20th century. According to the available data, death rates for lung cancer dropped 48% from 1990 to 2016 among men and by 23% from 2002 to 2016 among women. This is due in part to smoking cessation and advances in early detection and treatment.1,2

Men versus women

In the last decade, death rates from cancer declined around 2% per year in men and have been more stable in women. The number of deaths avoided is larger for men than for women reflecting the total decline in cancer mortality, 34% vs 24%.1,2

Half of all cancers diagnosed in women are breast, lung, and colorectal cancer, with breast cancer representing nearly one third of all new cancer diagnoses.2 Meanwhile, mortality rates for breast cancer have dropped by 40% over the last 25 years. This is due in part to earlier diagnoses and improved and targeted treatments.

Prostate, lung, and colorectal cancers represent 42% of all cases in men.2 However, mortality rates for prostate cancer declined 51% from 1993 to 2016. These changes are attributable in part to identification of disease at an earlier stage due to PSA screening and advances in treatment. These rates have stabilized in recent years.2

Liver cancer and Hepatitis C

While cancer rates overall are declining, the incidence of liver cancer is on the rise, as is the rate of uterine cancer.1 The baby boomer population is the group most notably affected by liver cancer, with 75% of cases of those diagnosed. Heavy alcohol use, obesity, Hepatitis C infection, and smoking are all contributing causes.1,2 For many, liver cancer could be prevented as some risk factors can be addressed by changes in lifestyle. Due to the habits common among the baby boom generation, including opioid use, the Centers for Disease Control and Prevention (CDC) has recommended hepatitis screenings.

Pediatric cancer

Cancer is second behind accidents as the most common cause of death among children ages 1 to 14. The incidence of cancer rates in children and adolescents has been rising slightly since 1975. Although the rate of new cases is increasing (less than 1% per year), the death rate has been declining. This group is 60% less likely to die from cancer than they would have in 1970. A primary factor is a 78% decline in death from leukemia.2

Racial and socioeconomic factors

Effective cancer prevention, early detection, and treatment strategies all have an impact on cancer incidence and death.2 In general, the decline is greater in men than women, but the likelihood of either gender dying from these cancers is higher in poorer counties around the US than more affluent ones.

The relative risk of dying from cancer is also 33% higher amongst black over white patients when accounting for basic statistical adjustments. The gap is even wider for Native Americans and Alaska Natives. Although the incidence rate is significantly lower, they are 51% more likely to die from their cancers than white patients.2

As the racial gap in cancer mortality diminishes, socioeconomic differences are growing, particularly regarding preventable cancers. Better cancer prevention education, access to early detection screening, and access to current treatment strategies significantly impact both the incidence and effective treatment of preventable cancers.2

According to the ACS report, one third of cancer-related deaths of those aged 25 to 74 could be avoided if socioeconomic disparities were eliminated. This is due in part to the fact that the rate of smoking and obesity is twice as high in poor communities as in the most affluent areas. Geographic variation also plays a role in cancer incidence. People are more likely to develop lung cancer in a tobacco growing state like Kentucky than in Utah.1 Also, diagnosis tends to be at a later stage in minority populations, and is accompanied by lower stage‐specific survival rates for many types of cancer.2

Death from cervical cancer is twice as likely among women in poorer counties than in affluent ones, particularly amongst women ages 20-39.2 Men with lung and liver cancer in similarly lower income areas are 40% more likely to die from their disease than men in wealthier areas.

Survival rates for common cancer

Some positive news is that survival rates are increasing in prostate cancer (98%), melanoma (92%), and female breast cancer (90%). While the deadliest cancers with the lowest survival rates were for pancreatic (9%), liver (18%) and esophageal and lung cancers (19%).1,2

Data collection and sources

The findings detailed in this article were gathered from American Cancer Society reports.1,2 They estimate new cancer cases and deaths in the United States and compile recent data on cancer incidence, mortality, and survival.2 Cancer cases were classified according to the International Classification of Diseases for Oncology for adults and the International Classification of Childhood Cancer (ICCC) for childhood and adolescent cancers.2 Sources used to collect the data include the National Center for Health Statistics (NCHS), the National Cancer Institute’s (NCI’s) Surveillance, Epidemiology, and End Results (SEER) Program and by the Centers for Disease Control and Prevention's National Program of Cancer Registries.

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