After Declining for Years, Mortality Rates May Be Stagnating

Given the many advances in medicine and technology over the past half-century, it’s no surprise that Americans are living longer than they did in the 1960s. But new research from the American Cancer Society suggests our gains in longevity appear to be stagnating.

The study, which was recently published in JAMA, examined death rates – the number of deaths per 100,000 people in a given year – for stroke, heart disease, unintentional injuries, cancer, diabetes, and COPD. The authors analyzed data from 1969 to 2013. While previous research looked at mortality rates from these six leading causes of death during 1970 to 2002, this is the first study to also analyze trends since then.

Here’s the great news: During the 44-year study period, the overall death rate dropped about 43%. For stroke, it declined by 77%; for heart disease, 68%; for unintentional injuries, 40%; for cancer, 18%; for diabetes, 17%. Meanwhile, death rates for COPD increased by 101%.

An unexpected finding, according to study author Ahmedin Jemal, DVM, PhD, head of surveillance and health services research at the American Cancer Society, is the pace of decline in death rates from 2009 to 2013. Mortality wise, we’re not doing much better now than in 2003.

Jemal helps put the data into context.

Q: What do you think is behind this unexpected finding?

A: We are not certain what contributed to the recent slowing of the reduction in mortality, but we suspect that the obesity epidemic that has unfolded since the early 1980s may be behind this unfavorable trend. Obesity is a risk factor for cancer, heart disease, stroke, and diabetes that contributed to the slowdown in declining of mortality rates for all causes combined.

Q: What are some of the key advances in cancer research that have contributed to the 18% decline in cancer deaths?

A: Advances in prevention, early detection, and treatment over the past four decades have contributed to the continued decrease in cancer mortality rates. For example, tobacco use, which accounts for about a third of cancer deaths in the US, halved since the 1964 US Surgeon General’s report on the health hazards of smoking. Effective early detection methods have been developed for breast and colorectal cancer screening. Targeted and less toxic therapies have been developed for several cancers including breast, colon, rectum and prostate, as well as for melanoma and non-Hodgkins lymphoma.

Q: The study also looked at years of potential-life lost. What does that mean in general – and what did you find about potential-life lost in people with cancer?

A: In contrast to death rates, which give equal weight to deaths at any age, years of potential-life lost gives more weight to deaths at a younger age, or premature deaths. When it comes to cancer, we have avoided deaths at younger ages because of improvements in prevention, early detection and treatment. Potential-life lost due to cancer decreased by 40% from 1969 to 2013, and the decrease has especially accelerated since the mid-1980s.

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