Plunging mortality rates for four major cancers contributed to an ongoing decline in the overall cancer death rate in the U.S., according to a report on cancer mortality published January 5 by the American Cancer Society (ACS). The decline comes out to 2.1 million fewer cancer deaths from 1991 to 2014.
The overall cancer death rate dropped 25% in the U.S. over the period covered by the report, which the ACS issues annually on cancer incidence, mortality, and survival in the U.S. The report was published in CA: A Cancer Journal for Clinicians.
The ACS estimated that in 2017 there will be 1.7 million new cancer cases and 601,000 cancer deaths in the U.S. The cancer death rate has declined about 1.5% in men and women, driven mainly by lower death rates from lung cancer as fewer Americans -- particularly men -- are smoking. With respect to cancer incidence, the rate dropped 2% in men and remained stable in women.
Indeed, the cancer death rate has dropped from a peak of 215.1 deaths per 100,000 individuals in 1991 to 161.2 deaths in 2014, a decline of 25%. The death rate has fallen 31% in men since 1990 and 21% in women since 1991, translating to 2.1 million fewer deaths over the report period. Still, the cancer death rate is 40% higher in men than women.
The ACS attributed the decline to "steady reductions in smoking and advances in early detection and treatment" that have resulted in lower mortality rates for four major cancers: lung, breast, prostate, and colorectal. Specifically, lung cancer death rates fell 43% for men and 17% for women due to lower tobacco use; since the U.S. surgeon general's landmark report on smoking and health in 1964, 8 million premature smoking-related deaths have been averted.
Among other cancers, the mortality rate for breast cancer fell 38%, and the death rate fell 51% for both prostate cancer and colorectal cancer.
The ACS also found that racial disparities in cancer mortality are narrowing. Black men have historically had a higher risk of cancer death, but that difference dropped from 47% in 1990 to 21% in 2014. The disparity between black and white women also declined, from a high of 20% in 1998 to 13% in 2014.
The ACS found that better access to healthcare as a result of the Patient Protection and Affordable Care Act (ACA) may help accelerate the narrowing racial gap -- at least while the ACA remains in effect. While the cancer death rate was 15% higher in blacks than in whites in 2014, from 2010 to 2015 the proportion of blacks who were uninsured dropped in half, from 21% to 11%. Hispanics also saw gains, from a 31% uninsured rate to 16%.
