Annual Report Shows Cancer Death Rates Continue to Drop, Late-Stage Prostate Cancer Incidences Rise

Ned Sharpless, MD

Ned Sharpless, MD

According to results from the Annual Report to the Nation on the Status of Cancer, cancer incidence rates have declined in men while remaining stable in women. Additionally, there have been significant declines in cancer death rates, but differences between race and ethnic groups remain.

In a companion report, researchers said the decline in prostate cancer mortality has leveled out, and incidence of late-stage prostate cancer has increased.

Data for this report was collected from the National Cancer Institute (NCI), the Centers for Disease Control and Prevention (CDC), the American Cancer Society (ACS), and the North American Association of Central Cancer Registries (NAACCR).  The collaborative report looks at overall cancer incidence rates, which is defined as new cancers, and overall cancer death rates. A companion study looks at incidences and mortality trends of prostate cancer in the United States.

“This year’s report is an encouraging indicator of progress we’re making in cancer research,” said NCI director Ned Sharpless, MD. “As overall death rates continue to decline for all major racial and ethnic groups in the United States, it’s clear that interventions are having an impact.”

“The report also highlights areas where more work is needed,” Sharpless added. “With steadfast commitment to patients and their families, we will be able to lower the mortality rates faster and improve the lives of those affected by cancer.”

From 1999 to 2014, overall cancer incidence rates have decreased by an average of 2.2% in men. From 1999 — 2015, cancer death rates also decreased by an average of 1.8% in men and 1.4% in women. However, incidence and cancer death rates were higher in men than in women. Black men and white women had the highest cancer death rates, while non-Hispanic men and women had higher incidence and cancer death rates than individuals with Hispanic ethnicity.

“There continues to be significant declines in the cancer death rate with significant differences in rate by sex, race, and ethnicity,” said Otis W. Brawley, MD, chief medical officer at ACS. “We need to continue working to understand the reasons for the disparities and how to most efficiently continue supporting and, if possible, accelerate these declines.”

From 2010­—2014, there was an average increase in overall cancer incidence rate of 0.8% each year amongst children (ages 0-14 years). Cancer deaths in children, however, decreased by 1.5% between 2011 to 2015.

Data from 2010 to 2014 also demonstrated a decreased incidence of 7 of the 17 most common cancer types in men, while there was a decreased death rate in 11 of 18 most common types. Women experienced an incidence rate decrease in 7 of the 18 most common cancer types and a decreased death rate in 14 of 20.

Among these common cancer types, both women and men showed a decrease in lung and bronchus cancers, as well as brain and other nervous system-related cancers. The death rate in breast and prostate cancers decreased as well.

Investigators found an increased cancer death rate in several common cancer types, including liver, pancreas, and brain and other nervous system-related cancers for both men and women. There was also an increase in death rates among men in oral cavity and pharynx cancers and soft tissue cancers involving the heart and nonmelanoma skin. An increase was also found in uterus cancer.

“It’s encouraging to see progress in decreasing death rates for many types of cancer. Yet the fact that death rates from several cancers are still on the rise means we need to keep working to find strategies to encourage prevention and continue to make improvements in screening and treatment,” said Betsy A. Kohler, executive director at NAACCR.

Prostate cancer trends were investigated further in a companion study investigating data from US cancer registries between 2000 to 2014. Trends for mortality were determined based on data available from 1975 to 2015.

Overall incidences decreased by 6.5% annually between 2007 to 2014. In 2007, there were 163 new cases of prostate cancer for every 100,000 men, but this decreased to 104 of every 100,000 men in 2014.

While these trends show a decline in prostate cancer, investigators found an increase between 2010 to 2014 for incidences of distant disease, where cancer spread beyond the original tumor to other parts of the body. According to national surveys from 2010 and 2013, there was a decline in prostate-specific antigen (PSA) screening among men between ages 50 and 74 years.

Serban Negoita, MD, DrPH, lead author of the prostate cancer study and chief of Data Quality, Analysis, and Interpretation Branch at NCI’s Surveillance Research Program, says this increase in late-stage disease occurred simultaneously with a trend between 2013 to 2015 of cancer deaths leveling out. Prior to this stabilization, overall prostate cancer mortality was on a significant decline from 1993 to 2013.

“Although suggestive, this observation does not demonstrate that one caused the other, as there are many factors that contribute to incidence and mortality, such as improvements in staging and treating cancer,” said Negoita. “Additional research is needed to get a more comprehensive understanding of the recent trends and the possible relationship with PSA screening, as well as the relationship with other factors that may be associated with these trends.”

References:

1. Cronin K, Lake A, Scott S, et al. Annual Report to the Nation on the Status of Cancer, part I: National Cancer statistics. Cancer. 2018; 0(0): 1-16. https://doi.org/10.1002/cncr.31551 Accessed May 23, 2018.
2. Negoita S, Feuer E, Mariotto A, et al. Annual Report to the Nation on the Status of Cancer, part II: Recent changes in prostate cancer trends and disease characteristics. Cancer. 2018: 0(0): 1-14. https://doi.org/10.1002/cncr.31549 Accessed May 23, 2018.