Cancer mortality has been steadily declining for two decades, falling to 21% in men and 12.3% in women between 1990 and 2006, according to new data from the American Cancer Society.
Decreases have occurred in three major cancer sites: lung, prostate, and colorectal cancers accounted for most of the decrease in men, while breast and colorectal cancer accounted for the majority of the change for women. The improved survival rates have prevented an estimated 767,000 deaths over the period.
The success can be attributed to a combination of better prevention, earlier detection, and improved treatments, says Ahmedin Jemal, DVM, PhD, researcher with the American Cancer Society. Despite the good news, however, there is still room for improvement, particularly when it comes to cancer prevention, he says.
“We have to celebrate what has been achieved so far because there is a continuous decrease in cancer death rates,” Jemal says. “But there is an opportunity to accelerate the decrease if we apply what we know to all segments of the population.”
He points to smoking, one of the most preventable causes of cancer, as an example. Although smoking in the U.S. has decreased, nearly 20% of adults continue to smoke, and better smoking cessation programs could prevent even more cancer deaths.
There is also room for improvement in screening rates. The CDC this week released new data on breast and colorectal cancer screening findings:
—At least 10,000 people die each year because they have not been screened
—Only 63% of recommended adults were screened for colorectal cancer in 2008, although that is up from 52% in 2002
—Breast cancer screening rates have remained steady at around 81%.
Health insurance coverage is one of the primary factors affecting screening, but physicians also play a large role, the CDC says. ”The new studies indicate that physician recommendation for screening remains an important but underused motivator for cancer screenings.”
Deaths from cancer declined across all demographic groups, however racial and ethnic disparities remain a problem. African–American men had a 34% higher death rate than white men, and African–American women had a 17% higher death rate than white women. Screening rates tend to be lower for African Americans and Hispanics, as well. The differences are tied to poverty and access to care, says Jemal.
In recent years, the better cancer survival rates have led to more focus on follow–up care from providers. Hospitals and physicians have to put more effort into survivorship programs and monitoring patients to detect any recurrence of cancer. However, the healthcare system could improve early prevention efforts, Jemal says.
For providers, this means more effort to advise patients to quit smoking, to maintain a healthy body weight, and to stick to regular screening schedules, he adds. “In the U.S., [healthcare] is treatment–driven, but there is not much attention given to prevention. But it is very, very important.”