American cancer deaths have declined by 33% since 1991, according to a new report – saving an estimated 3.8m lives.
The report by the American Cancer Society attributed the three-decade trend largely to better early detection, lower rates of smoking, and improvements in treatment. Researchers also credited the human papillomavirus (HPV) vaccine.
The improved outcomes are “truly formidable”, Karen Knudsen, chief executive officer of the American Cancer Society, told CNN. “New revelations for prevention, for early detection and for treatment have resulted in true, meaningful gains in many of the 200 diseases that we call cancer.”
From 2019 and 2020, the most recent date for which data is available, cancer mortality decreased by 1.5%. Researchers and doctors have cautioned that Covid-19, which delayed cancer screenings for many Americans, was a serious setback, though to what extent is not yet known.
The Society’s report, which was published on Thursday in a medical journal for cancer clinicians, noted that although cancer deaths are declining, mortality rates and incidences of cancer have fluctuated widely across types of cancer and different demographic groups.
Perhaps the most striking change was a “65% drop in cervical cancer incidence during 2012 through 2019 among women in their early 20s”, the report said – “the first cohort to receive the human papillomavirus [HPV] vaccine”.
“The large drop in cervical cancer incidence is extremely exciting” and “probably foreshadows steep reductions in other HPV-associated cancers”, Rebecca Siegel, the lead author of the report, said in a statement.
There were also some cancer resurgences, the report found. For example, after declining for two decades, prostate cancer increased 3% annually from 2014 to 2019 – a reversal that researchers described as concerning. The study drew on data from central cancer registries and the National Center for Health Statistics.
Recent cancer data is, however, marked by racial disparities. Incidence of prostate cancer is 70% higher in black men than in white men, and black women are more likely to die of breast cancer than other groups despite white women having higher rates of breast cancer.
Last year Joe Biden announced that he was relaunching the White House’s “cancer moonshot” initiative with a goal of reducing cancer deaths by at least 50% over 25 years. In a statement on Thursday, the cancer moonshot coordinator, Dr Danielle Carnival, said that the new report demonstrated “great progress”.
The decline in cancer mortality rates mirrors similar long-term trends in some other major illnesses.
From 2010 to 2017, death rates among people with HIV decreased by 37%, according to the US Centers for Disease Control and Prevention (CDC).
Age-adjusted cardiovascular mortality rates – meaning deaths from heart disease and stroke – declined by 22% from 1990 to 2013, according to a study published in the journal Circulation Research.
After increasing from 1980 to 2000, the mortality rate for diabetes fell by 26% between 2000 and 2014, according to a study published last year in the journal Population Metrics.
In contrast, deaths of drug overdose have increased dramatically in recent years. The age-adjusted rate of deaths involving synthetic opioids other than methadone increased 1,040% from 2013 to 2019, according to the CDC, and deaths involving psycho-stimulants – such as meth – increased 317%.
