“The pace of the annual decline in lung cancer mortality doubled from 3.1% during 2009 through 2013 to 5.5% during 2014 through 2018 in men, from 1.8% to 4.4% in women, and from 2.4% to 5.0% overall,” Siegel et al stated. They noted that beyond improvements in lung cancer diagnostics and treatment modalities, recent strides made in NSCLC survival have also contributed to the plunge in lung cancer deaths.
Similar activity has been seen in the melanoma setting, which has also been associated with an “accelerated” decline in mortality. From 2014 to 2018, the disease-specific mortality rate fell by 5.7% annually. As with lung cancer, the improvement in melanoma mortality is thought to be due to new treatment developments that have effectively moved the needle in the space.
The reduction in lung cancer mortality has since caused breast cancer to supplant lung cancer as the most commonly occurring cancer globally, according to new World Health Organization (WHO) findings that identify breast cancer as responsible for 12% of new cancer cases around the world annually.3
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Breast cancer incidence rates have increased by approximately 0.5% annually, according to ACS data.1 This rise “is attributed at least in part to continued declines in the fertility rate and increased body weight,” Siegel et al observed.
Despite Declines, Mortality Is Rising for Some Malignancies
It is important to note that even amid decreases in some disease-specific mortality rates, increases in cancer-related deaths have been observed for select malignancies. For example, uterine corpus cancer mortality has increased from 0.3% per year from 1997 through 2008 to 1.9% annually from 2008 through 2018.
Death rates have also spiked for cancers of the oral cavity and pharynx, translating to a cumulative rise of 0.5% per year from 2009 to 2018. However, “this trend is confined to subsites associated with HPV [human papillomavirus].”
Further, an arch in pancreatic cancer-associated mortality has been documented in men, a group for whom the death rate has risen by 0.3% each year. By contrast, the pancreatic cancer death rate has remained stable in women.
Health Disparities Play a Part
In addition to trends in disease-specific mortality rates, the ACS report also accounts for health equity patterns, identifying “persistent” racial, socioeconomic, and geographic disparities for cancers considered “highly preventable,” such as those of the cervix and lung.1 The discrepancies are significant because the incidence and mortality rates for these diseases can vary up to 5-fold and 3-fold, respectively, across states.2
Of note, the disparity between Black and White patients in overall cancer mortality among both men and women has declined from a peak of 33% in 1993 (279.0 vs 210.5 per 100,000, respectively) to 13% in 2018 (174.2 vs 154.1 per 100,000). This percentage drop can be credited to decreases in smoking-related deaths among Black individuals, according to the report.1
“While recent advances in treatment for lung cancer and several other cancers are reason to celebrate, it is concerning to see the persistent racial, socioeconomic, and geographic disparities for highly preventable cancers,” concluded William G. Cance, MD, chief medical and scientific officer of the ACS. “There is a continued need for increased investment in equitable cancer control interventions and clinical research to create more advanced treatment options to help accelerate progress in the fight against cancer.”2
References
- Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2021. CA Cancer J Clin. 2021;71(1):7-33. doi:10.3322/caac.21654
- American Cancer Society staff. Record drop in cancer mortality for second straight year due to improved lung cancer treatment; COVID-19 impact still unknown. American Cancer Society. Published January 12, 2021. Accessed February 2, 2021.
- Reuters staff. Breast cancer overtakes lung as most common cancer-WHO. Reuters. Published February 2, 2021. Accessed February 2, 2021.
