Cancer mortality continues to fall amid ‘major advances’ in early detection and treatment of lung cancer


The overall cancer death rate fell by about a third (32%) from its highest in 1991 to 2019, from about 215 deaths for every 100,000 people to about 146, which according to the data averted about 3.5 million deaths during that time. Most of this decrease can be attributed to a decrease in mortality among lung cancer patients.

The American Cancer Society estimates that there will be about 1.9 million new cancer diagnoses and more than 609,000 cancer deaths in the United States by 2022, including about 350 deaths a day due to lung cancer, the leading cause of cancer death.

In 2019, about one in four cancer deaths was among lung cancer patients, but lung cancer deaths are falling faster than the general trends. Mortality from lung cancer fell by about 5% each year between 2015 and 2019, while overall cancer mortality fell by about 2% during that time.

And the continued downward trends are cause for optimism, experts say.

“I am an oncologist, so I am an incarnated optimist. But I think the key message to the public is that there is room for optimism across all types of cancer,” said Dr. Deb Schrag, chairman of the medical department of the medical department. Memorial Sloan Kettering Cancer Center.

Continued progress in driving the curve down will require a three-pronged approach with strong, unified efforts across prevention, screening and treatment, she said.

Programs aimed at smoking prevention or smoking cessation can have a major impact, as well as annual screening, according to the American Cancer Society report.

“The data actually tells us from a wellness perspective, in every possible way, that smoking cessation at any age, at any time, at any habit level, matters to a person’s health,” said Karen Knudsen, CEO of American Cancer Society, to CNN.

“Studies have shown that if they stop smoking at the time of the cancer diagnosis, it is strongly associated with a better outcome, no matter what the cancer is – lung cancer or another form of cancer – that smoking cessation is important to not only prevent cancer. , but to give yourself the greatest chance of a good outcome if you are being treated for cancer. “

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And although screening for lung cancer has only increased slightly recently – from 2% of eligible people in 2010 to 5% in 2018 – the effects have been much greater.

About 28% of lung cancer diagnoses in 2018 were detected early in the “localized stage”, up from 17% in 2004. And more than 30% of patients lived at least three years after their diagnosis, an increase from 21%.

Increased screening for all types of cancer is critical, Knudsen tells CNN.

“Even before Covid, the screening was not where it should be for the American public,” she said, with screening for lung cancer among the worst.

In her previous role at a cancer center designated by the National Cancer Institute, Knudsen said she noted that screenings dropped every time the Covid-19 cases peaked. However, these delayed screening can lead to tens of thousands of deaths that can be prevented in the coming years, and it is “unfortunate” that individuals make a screening plan.

“For all individuals, what I would hope for is that they feel empowered to have that conversation with their primary care physician – I can not stress this enough – to ask ‘what is the right screening plan for me based on my personal history and my family history and, if I know, my genetic history? ‘”

While lung cancer is the most common overall and causes the most deaths among men and women, prostate cancer is the most common type among men, and breast cancer is the most common type among women, according to the report.

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Advanced diagnoses are on the rise for both prostate cancer and breast cancer, both of which can be detected early. And cervical cancer still causes thousands of deaths, despite being virtually preventable.

Advances in treatment are able to effect changes in a more immediate way than changes in health behaviors.

Overall, precision medicine – understanding the molecular driving forces or genetic features of cancers to treat them more strategically – and immunotherapies developed through better understanding of the immune system have been “game changers,” Schrag said.

Improvements in life expectancy after diagnosis of lung cancer were mostly among those with non-small cell lung cancer, and in terms of treatment, they were driven by advances in diagnostic and surgical procedures, such as video-assisted thoracoscopic surgery, as well as medical therapies such as for example. as immunotherapy approved by the U.S. Food and Drug Administration in 2015.

But trends in cancer deaths are largely driven by changes in lifestyle and care over decades, experts say.

“For example, when we see progress today and continued declines in lung cancer deaths, some of it is because smoking rates began to decline 20 and 30 years ago,” Schrag said. “We are reaping some of those benefits today.”

Not all long-term effects are positive. Racial and sociodemographic differences in cancer incidence and mortality also continue due to the long-term effects of systematic racism in the United States, according to the American Cancer Society report.

Black patients have a lower five-year survival rate than white patients for most cancers, and black women have a higher cancer mortality rate than any other group, according to data from the American Cancer Society. While the incidence of breast cancer is 4% lower among black women than among white women, breast cancer mortality is 41% higher among black women.

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