Cancer Deaths Drop 25% in Less Than 25 Years Interview with:

Rebecca Siegel, MPH Strategic Director, Surveillance Information Services American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303

Rebecca Siegel

Rebecca Siegel, MPH
Strategic Director, Surveillance Information Services
American Cancer Society, Inc.
250 Williams St.
Atlanta, GA 30303 What is the bottom line for incidence and mortality trends?

Response: The bottom line for cancer mortality is that in contrast to many other major causes of death, cancer death rates continue to decline, dropping by 25% from 1991 to 2014. This translates to about 2 million fewer cancer deaths over this time period than would be expected if cancer death rates had remained at their peak. Death rates are the best measure of progress against disease.

Cancer incidence rates also dropped in men over the past decade of data, whereas in women they are flat. The drop in men is because of large declines for the top 3 cancers (prostate, lung, and colorectum), which account for more than 40% of cancers diagnosed in men. The stable trend in women is largely because declines in lung and colorectal cancers are offset by a flat trend for both breast and uterine corpus (i.e., endometrial) cancers, which combined account for almost 40% of cases in women, as well as rapid increases for thyroid cancer over the past decade — increasing by almost 5% annually. Importantly, thyroid incidence rates have stabilized in the past few data years because of modifications in diagnostic criteria. Why are cancer death rates continuing to decline?

Response: The drop in cancer mortality is primarily the result of large declines in the 4 major causes of cancer death (lung, colorectal, breast, and prostate), which account for almost half of all cancer deaths. Declines for these, as well as many other cancers, are driven by large drops in smoking – which causes about one-third of all cancer deaths – that began in the 1960s, as well as improvements in the early detection of cancer (through both screening and increased awareness), and advances in cancer treatment. Why have males been more affected by cancer than females?

Response: Reasons for higher cancer risk in men than in women include differences in exposure to environmental and genetic (e.g., hormones) risk factors, as well as complex interactions between these influences. Men are more likely to smoke, to drink excessively, to have chronic infection with hepatitis B and C viruses, and to have occupational exposures that increase cancer risk. Adult height is also thought to contribute to excess risk. What is happening with racial disparities?

Response: Some very good news is that the large disparity in cancer mortality between blacks and whites, which peaked in 1990 in men and in 1998 in women, has been slowly narrowing. For example, in 1990, the overall cancer death rate was almost 50% higher in black men than in white men, whereas in 2014 it was about 20% higher. This progress is largely driven by rapid declines in smoking-related cancers because of steep drops in smoking initiation among black teens in the 1970s and early 1980s. There is hope that the progress in reducing the black-white cancer disparity will accelerate in the future because of the recent dramatic drop in the proportion of blacks who do not have health insurance coverage – from 21% in 2010 to 11% in 2015 – because of the Affordable Care Act. However, with the incoming administration and Congress, the future of health care coverage in the United States is uncertain, particularly for the newly insured. Thank you for your contribution to the community.


Cancer Statistics, 2017
American Cancer Society
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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