By Ann Miller Baker
A continued decline in overall cancer death rates led news coverage of the latest Annual Report to the Nation on the Status of Cancer. But a closer look at the numbers shows areas for improvements.
The detailed document from the National Cancer Institute (NCI), the Centers for Disease Control and Prevention (CDC), the American Cancer Society (ACS) and a national association of cancer registries covers data through 2015. It looks at how many people were diagnosed with cancer per year, as well as how many people died from cancer per year. Those numbers are further broken down into what types of people received a particular cancer diagnosis or died, within categories such as age, gender, and racial or ethnic background.
And that’s where the news is not as uplifting.
Overall cancer deaths down, but highest among blacks
Deaths from all cancers combined among American men, women and children were down from 1999 to 2015. The decline was a little greater among men (1.8 percent per year) than among women (1.4 percent per year). Black men and women had the highest overall cancer death rates compared to other racial groups.
Fewer men diagnosed with cancer, women about the same
From 2008 to 2014, the number of men newly diagnosed with any type of cancer declined 2.2 percent per year. But among women, the newly diagnosed number remained about the same. For all types of cancer combined, black men and white women had the highest incidence rates compared with other racial groups.
Racial cancer disparities persist, require focused efforts
Disproportionate cancer incidence and death rates for the black community are persistent issues that require greater focus, said Dr. B. Lee Green, vice president of Diversity, Public Relations and Strategic Communications at Moffitt Cancer Center. “Changing that dynamic requires the leaders in cancer care and research to look at all aspects of the problem, from issues in access, screening and clinical trial participation to studying the underlying genetic differences in cancers across racial and ethnic populations. Moffitt Diversity has been committed to this effort for 15 years. In fact, our partnerships within the black community are funding disparities research through Moffitt’s George Edgecomb Society in hopes of reducing cancer’s inordinate burden on minorities.”
Progress depends on specific cancer types
While death rates are decreasing or stable for the most common types of cancer, including lung, colorectal, breast and prostate, other types of cancer are proving more deadly. Liver, pancreas and brain cancer death rates are up overall. Among men, death rates climbed for oral cavity, throat, soft tissue and non-melanoma skin cancers. Uterine cancer death rates were up for women.
Focus on prostate cancer
This year’s Report included a separate study of trends in prostate cancer incidence and death rates.
- Fewer men of all ages were diagnosed with prostate cancer – a drop of 6.5 percent annually from 2007 to 2015.
- But the number of patients whose prostate cancer had already spread at the time of diagnosis actually increased from 2010 to 2014.
- Deaths from prostate cancer, which had been declining steadily each year, plateaued from 2013 to 2015.
- A decline in the use of prostate-specific antigen (PSA) screening was also noted between 2008 and 2013.
Some have suggested that changes in PSA screening recommendations from the U.S. Prevention Task Force may be linked to the changes in advanced-stage incidence and stabilizing death rates.
Dr. Julio Pow-Sang, who chairs Moffitt’s Genitourinary Oncology Department, says this is a very sensitive topic and any causative relationships will take years to establish. “Prostate cancer is a very protracted disease,” noted Dr. Pow-Sang. “The PSA test is not perfect, but we now have a better understanding of what types of patients would benefit most from this type of screening. We can better tailor treatment to the specific patient. I would expect we will see these data improve with next-generation screening options, as well as new treatment options currently being researched.”