For the second time this year, the National Cancer Institute has released its Annual Report to the Nation on the Status of Cancer, covering the period 1975–2010, the most recent year for which complete data are available.
The newer report, like the first, which was published in January 2013, showed that death rates for lung cancer have been falling at a faster pace than in previous years. Lung cancer death rates for men fell by 2.9 percent per year from 2005-2010, a significant improvement over the 1.9 percent per year drop during the period 1993-2005.
For women, rates declined 1.4 percent per year during the period 2004-2010. This was an encouraging change from an increase of 0.3 percent per year during the period 1995-2004.
“We continue to make great strides against cancer,” said lung cancer specialist Ravi Salgia MD, PhD, professor of medicine, pathology and dermatology and Director, Chest Oncology and Thoracic Oncology Research Program.
The report attributed the gains to many factors, primarily the reduced prevalence of cigarette smoking in the United States – particularly among women. The drop in lung cancer deaths, which account for more than one in four cancer deaths, combined with declines in colorectal, breast, and prostate cancer death rates, helped drive decreases for all cancer types combined — a trend that began about 20 years ago.
“It’s encouraging to see a consistent decrease in the death rate in these major cancers over several years,” said Stanley Liauw, MD, associate professor of radiation & cellular oncology. “We hope that larger drops will be possible in the near future with improvements in prevention, screening, staging, and individualized therapy.”
The report noted, however, that death rates did increase for some cancers, such as cancers of the liver and pancreas, cancers of the uterus in women, and, in men only, melanoma of the skin and cancers of the soft tissue.
“As a cancer researcher, it is gratifying to see the number of cancer deaths decrease,” said Michelle Le Beau, PhD, professor of medicine and Director of the University of Chicago Medicine Comprehensive Cancer Center. “But we also know there is a much work to be done, especially in the area of cancer health disparities, where we are particularly concerned about education, access to care, and identifying variations in its molecular basis.”
A special feature of this year’s report focused on the prevalence of other disease conditions in cancer patients over 65 years of age, and how they affect survival. One-third of patients in this population have comorbidities, with a higher frequency in patients with lung or colorectal cancer.
“The sustained fall in death rates for most cancers is an important indicator of our success in controlling this large set of complex diseases but is not as fast as we’d like,” said NCI Director Harold Varmus, M.D. “In addition, the Report emphasizes the need to consider the entire health status of cancer patients since many have other significant medical conditions that may affect their survival.”
The results were a welcome change for those who have followed the statistics since former President Richard Nixon’s War on Cancer began in 1971.
In 1986, John C. Bailar III, MD, PhD — then at Harvard University, now a professor emeritus of health studies at the University of Chicago — declared that the first 15 years of intense effort, which had focused largely on improving treatment, “must be judged a qualified failure.”
Twelve years later, he saw “little reason to change that conclusion”.
“The salient fact remains,” Bailar wrote in the New England Journal of Medicine in 1997, “that age-adjusted rates of death due to cancer are now barely declining. Hopes for a substantial reduction in mortality by the year 2000 were clearly misplaced.”
But by the beginning of 2013, and again at the end, the reduction in cancer death rates had become substantial and they appear to be accelerating. That’s worth proclaiming twice.
The Report, produced annually since 1998, is co-authored by researchers from the National Cancer Institute (NCI) which is part of the National Institutes of Health; the American Cancer Society (ACS); the Centers for Disease Control and Prevention (CDC); and the North American Association of Central Cancer Registries (NAACCR). It appeared online in the journal Cancer on Dec. 16, 2013.
The previous Annual Report was published January 7, 2013, in JNCI. “Publication dates,” the NCI notes, “are determined by journal editors.”