Annual Report to the Nation: Cancer Death Rate Continues Decades-long Decline

The American Cancer Society, the North American Association of Central Cancer Registries, the Centers for Disease Control and Prevention, and the National Cancer Institute work together to create the report, which has been published each year since 1998. It provides an update of new cancer rates, death rates, and trends in the United States.

This year’s special section focuses on adults ages 20 to 49. The report was published May 30, 2019 in the Journal of the National Cancer Institute.

National trends

The report shows that among all ages combined, the rate of new cases and deaths in the United States is decreasing for several cancers related to smoking, including lung, bladder, and laryngeal cancers. But the rate of new cases is increasing for some cancers related to excess weight and lack of exercise. These include endometrial cancer and breast cancer in postmenopausal women. Colorectal cancer has also increased in recent decades, but only among young adults.

Death rates for melanoma skin cancer declined significantly in recent years. They had been stable in men and falling slightly in women, then declined by 8.5% in men each year from 2014 to 2016 and by 6.3% in women each year from 2013 to 2016.

"The declines seen in mortality for melanoma of the skin are likely the result of the introduction of new therapies, including immune checkpoint inhibitors, that have improved survival for patients diagnosed with advanced melanoma," said J. Leonard Lichtenfeld, MD, MACP, interim chief medical officer of the American Cancer Society. "This rapid change shows us how important it is to continue working to find effective treatments for all kinds of cancer.”

Disparities remain

Differences persist among racial and ethnic groups for new cases and deaths from cancer. Black men and Black women had the highest cancer death rates, both for all cancer types combined and for about half of the most common cancers in men and women.

Black men and white women had the highest rates of new cancer cases overall, and Asian/Pacific Islander men and women had the lowest overall rates. Non-Hispanic men and women had higher overall rates of new cancer cases than Hispanic men and women.

Among the findings:

• Overall cancer death rates went down by 1.8% per year in men from 1999 to 2016, and by 1.4% per year in women from 2002 to 2016.
• Among men, death rates decreased for 10 of the 19 most common cancers from 2012 to 2016. Some of the steepest decreases were for lung, colorectal, and melanoma skin cancer. Death rates went up for 6 cancers, with the steepest increases for liver cancer, mouth and throat cancer, and non-melanoma skin cancer.
• Among women, death rates decreased for 13 of the 20 most common cancers from 2012 to 2016. That included the 3 most common cancers (lung, breast, and colorectal). But rates increased for 5 cancer types, with the steepest increases for endometrial and liver cancers.
• Overall rates for new cancers stayed the same in women and decreased by 2.1% per year in men from 2011 to 2015.

Special section: Adults ages 20-49

The report’s special section shows a differing trend for new cancers and cancer death rates for people ages 20 to 49 than for people of all ages combined. Among people of all ages, men had higher rates of new cancer cases and deaths from 2011 to 2015. However, among people ages 20 to 49, women had higher rates of new cancer cases and deaths than men.

• Ages 20-49: from 2011 to 2015, the rate of new cancers decreased an average 0.7% per year among men and increased an average 1.3% per year among women.
• Ages 20-49: From 2012 to 2016, death rates decreased 2.3% per year among men and 1.7% per year among women.

The most common cancers among women in this age group were breast, thyroid, and melanoma skin cancer. Breast cancer had the highest new cancer rate by far. The most common cancers among men ages 20 to 49 were colorectal, testicular, and melanoma skin cancer.

The authors point out that some cancers and their treatments affecting young adults tend to have long-term side effects. That means access to timely and high-quality health care – for treatment and survivorship – is important for the health outcomes and quality of life of younger adults diagnosed with cancer.