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Cancer Mortality Continues to Spiral Downward in the US

Mortality rates from the most common cancers continue to decline across the United States, with several notable exceptions, including liver cancer in men and especially in women, and also uterine cancer in women. These findings come from the latest American Cancer Society annual report on cancer rates and trends, "Cancer Statistics 2019."

The report was published online January 8 in CA: A Cancer Journal for Clinicians.

Overall cancer death rates dropped by 27% in the 25 years from 1991 to 2016, Rebecca Siegel, MPH, scientific director of surveillance research, American Cancer Society, Atlanta, Georgia, and colleagues report.

There are approximately 2,629,200 fewer deaths from cancer now than would have been expected had death rates remained at their peak, the researchers observe.

The number of averted deaths is greater for men than for women because the total decline in cancer mortality has been steeper for men than for women (34% vs 24%), they point out.

People living in the poorest counties of the country are experiencing a disproportionate burden of the most preventable cancers, including cervical, lung, liver, and colorectal cancer (CRC). The mortality rates for these cancers are considerably higher than they are for residents in more affluent counties, the authors note.

Nearly 1700 Deaths Each Day

The authors estimate that in 2019, 606,880 US residents will die from cancer — corresponding to nearly 1700 deaths per day.

"The greatest number of deaths are from cancers of the lung, prostate, and colorectum in men and the lung, breast, and colorectum in women," Siegel and colleagues note.

One quarter of all cancer deaths are from lung cancer, they add.

That said, the incidence of lung cancer continues to decline twice as quickly among men than among women, a reflection of an uptick in smoking by women in some birth cohorts.

The death rate for lung cancer dropped by 48% from 1990 to 2016 among men and by 23% from 2002 to 2016 among women. The decline in lung cancer deaths accelerated among both sexes in recent years.

For breast cancer, death rates dropped by 40% from 1989 to 2016. Mortality for prostate cancer declined by 51% from 1993 to 2016.

Death from CRC also dropped by a similar percentage, at 53%, although the trajectory of the decline in CRC deaths was longer than it was for prostate cancer, from 1970 to 2016.

Overall, the incidence of cancer during the past decade has declined by approximately 2% per year in men; for women, the incidence rate has remained relatively stable during the past few decades.


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