Farhad Islami, MD PHD  Scientific Director, Cancer Disparity Research American Cancer Society

Cancer Death Rates Decline for All Groups, but Racial Disparities Persist

MedicalResearch.com Interview with:

Farhad Islami, MD PHD  Scientific Director, Cancer Disparity Research American Cancer Society

Dr. Islami

Farhad Islami, MD PHD
Scientific Director, Cancer Disparity Research
American Cancer Society

MedicalResearch.com: What is the background for this study?

Response: The Centers for Disease Control and Prevention (CDC), the American Cancer Society (ACS), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) have collaborated annually since 1998 to provide updated information about cancer occurrence and trends by cancer type, sex, age group, and racial/ethnic group in the United States.

In this year’s report, we focus on national cancer statistics and highlight trends in stage-specific survival for melanoma of the skin, the first cancer for which effective immune checkpoint inhibitors were developed.

MedicalResearch.com: What are the main findings? What were the social or ethnic health disparities in cancer rates or survival?

Response: The report shows a decrease in death rates for 11 of the 19 most common cancers among men, and for 14 of the 20 most common cancers among women, over the most recent period (2014-2018). Although declining trends in death rates accelerated for lung cancer and melanoma over this period, previous declining trends for colorectal and female breast cancer death rates slowed, and those for prostate cancer leveled off. In addition, death rates increased for brain and other nervous system cancers, as well as pancreas cancer, in both sexes; oral cavity and pharynx in males, and liver and uterus in females. We also found that 2-year age-standardized relative survival for distant-stage skin melanoma was stable for those diagnosed during 2001-2009 but increased by 3.1% per year for those diagnosed during 2009-2014.

Death rates for multiple cancer types and overall remain higher among Black persons than in other racial/ethnic groups. For example, breast cancer death rates were 40% higher among Black women than among White women in 2014–2018 (28.2 vs. 20.1 deaths per 100,000 population), despite relatively similar incidence rates (129.8 and 133.8 cases per 100,000 population among Black and White women in 2013–2017, respectively).

MedicalResearch.com: What should readers take away from your report?

Response: Overall cancer death rates continue to decline in men and women for all racial and ethnic groups in the United State. During 2001 to 2018, declines in lung cancer death rates accelerated, and death rates for melanoma declined considerably in more recent years, reflecting a substantial increase in survival for metastatic melanoma. However, for several other major cancers, including prostate, colorectal and female breast cancers, previous declining trends in death rates slowed or stalled.

Death rates of lung cancer and several other smoking-related cancers (such as laryngeal cancer) have substantially declined during the past few decades, following a great decline in smoking prevalence. However, recent accelerations in declines in lung cancer and melanoma death rates can largely be attributed to advances in treatment. In contrast, many cancer types with rising incidence rates, notably among younger people, are associated with excess body weight. Our results also indicate strong associations between patterns of cancer screening utilization and trends in deaths rates for corresponding cancer types.

In summary, our findings underscore the importance of cancer prevention and screening according to guidelines and having access to timely and evidence-based treatment.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Despite a substantial decline in lung cancer death rates, lung cancer is still the leading cause of cancer death in both sexes, accounting for more than 22% of all cancer deaths in the United States, underscoring the need for broader implementation of tobacco control interventions. Effective individual- and community-based interventions are also needed to promote healthy foods and physical activity and reduce excess body weight. Many other cancer cases could be prevented by increases in the utilization of effective interventions, such as human papillomavirus (HPV) vaccination and hepatitis C virus (HCV) infection testing and treatment. More investments to improve early detection and develop more effective treatments (including for late- stage cancers) are also needed. Broad and multifaceted interventions to reduce exposure to cancer risk factors and increase access to evidence-based cancer screening and treatment can help close the racial mortality gap across the continuum of care. 

MedicalResearch.com: Is there anything else you would like to add?

Response: The findings and conclusions in this article are those of the authors and do not necessarily represent the official positions of the authors’ agencies (the American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute, or the North American Association of Central Cancer Registries). Several authors are employed by the American Cancer Society, which receives grants from private and corporate foundations, including foundations associated with companies in the health sector for research outside the submitted work. These authors are not funded by any of these grants and their salary is solely funded through American Cancer Society funds, and they have nothing else to disclose.

The other authors have no conflicts of interest to disclose. 


Article: Annual Report to the Nation on the Status of Cancer, Part I: National Cancer Statistics. JNCI: The Journal of the National Cancer Institute. doi: 10.1093/jnci/djab131.

URL upon embargo: https://doi.org/10.1093/jnci/djab131 

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Last Updated on July 8, 2021 by Marie Benz MD FAAD