The death rates for most forms of cancer continue to decline at a modest pace among men, women and children in the United States, according to the Annual Report to the Nation on the Status of Cancer 1975 – 2011.
The report from the National Cancer Institute, a division of the National Institutes of Health, was published online March 30 in the Journal of the National Cancer Institute. Investigators found that there has been a relatively consistent decline in overall cancer death rates since the early 1990s.
Specifically, cancer death rates decreased:
• Among men, by about 1.8 percent per year from 2002 through 2011
• Among women, by about 1.4 percent per year from 2002 through 2011
• Among children up to age 19, death rates have continued to mostly decrease since 1975
There was also a lower incidence of many forms of cancer. According to the study, the drop in the number of new lung cancer cases coincides with the steady decline in tobacco use in in recent years.
However, while incidence and death rates for most forms of cancer are declining, there has been an increase in some forms of cancer, including thyroid and kidney cancer among men and women, and oral cancer among white men. This increase in oral/oropharyngeal cancers may be associated with the human papilloma virus (HPV), despite a decline in oral cancers that are more closely linked with tobacco use.
For the first time, researchers also were able to quantify breast cancer incidence and mortality based on subtypes of the disease. For example, 73 percent of all breast cancer cases are considered hormone receptor positive (HR+) and are negative for the HER2 receptor (HER-). In HER2 cancer, the tumor makes high levels of a protein called HER2/neu which makes the cancer more aggressive. The HR+/HER2- molecular subtype of cancer is more easily treated in early stages of the disease.
Only 13 percent of breast cancer cases were found to be “triple negative,” which means that the tumor is not driven by the hormones estrogen and progesterone or by the HER2 mutation. However, triple negative breast cancer is the most difficult to treat and is more common among black women at all age and poverty levels.
Michael Neuss, M.D., chief medical officer at Vanderbilt-Ingram Cancer Center, said the report offers good news with the promise of even better outcomes in the future.
“The overall incidence of cancer is down for adults, nicely paralleling the falling rate of smoking. Vaccination for human papilloma virus promises to decrease the incidence of several cancers. Treatments for advanced cancers are improving survival for those who fall through prevention and screening efforts.
“The improvement in treatment effect is most clearly seen in childhood cancers where survival is up despite the worrisome and as yet unexplained trend of increased childhood cancer incidence. The clinical and research efforts at Vanderbilt will contribute to the efforts of many to sustain and build upon this encouraging news,” Neuss said.
