June 23, 2011 — The continuing decrease in cancer mortality means that about 898,000 Americans dodged death between 1990 and 2007, and the most educated were more than twice as likely to escape cancer death as the least educated, according to statistics issued by American Cancer Society (ACS) researchers. Education level is a marker for poverty, and closing that gap could have prevented 60,370 premature deaths (37%) of people 25 to 64 years of age in 2007, the authors note.
The new statistics were published online June 17 in CA: A Cancer Journal for Clinicians.
"The nearly 900,000 cancer deaths avoided over a 17-year period stand in stark contrast to the repeated claim that cancer death rates have not budged," said John R. Seffrin, PhD, chief executive officer of the ACS and its advocacy affiliate, the Cancer Action Network, in a press statement.
The overall cancer death rate decreased by 1.9% per year from 2001 to 2007 in males, and by 1.5% from 2002 to 2007 in females. Between 1990/91 and 2007, cancer death rates decreased by 22.2% in men and by 13.9% in women.
Senior author Ahmedin Jemal, DVM, PhD, told Medscape Medical News that education is thought to be a marker for socioeconomic differences and that for African Americans, closing the gap in death rates between the most and least educated could prevent twice as many cancer deaths as eliminating racial disparities between blacks and whites. Dr. Jemal is vice president of surveillance research at the ACS in Atlanta, Georgia.
"Over a third of premature cancer deaths in the United States are potentially avoidable by closing the gap in knowledge about risk factors and access to healthcare (from prevention, early detection, and treatment)," he added.
ACS estimates of new cancer cases and deaths expected in the United States in 2011 are based on incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries, and from mortality data from the National Center for Health Statistics.
The report predicts that in 2011 in the United States, there will be 1,596,670 new cancer cases and 571,950 deaths from cancer.
In men, overall cancer incidence rates have stabilized, after decreasing by 1.9% per year from 2001 to 2005. In women, incidence rates have been declining by 0.6% annually since 1998.
Overall, cancer death rates have been dropping since the early 1990s, and since 1998 have continued to decrease in all racial/ethnic groups in both men and women, except for American Indian/Alaska Native women, among whom rates were stable.
African American and Hispanic men showed the largest annual decreases in cancer death rates during this time period (2.6% and 2.5%, respectively). Lung cancer death rates showed a significant decline in women after continuously increasing since the 1930s.
Racial Disparities Linked to Money
The data also show that much of the racial disparity in cancer death rates is linked to socioeconomic status. Level of education is often used as a marker for socioeconomic status. In 2007, cancer death rates in the least educated segment of the population were 2.6 times higher than those in the most educated segment. This disparity was largest for lung cancer; the death rate was 5 times higher in the least educated than in the most educated.
Dr. Jemal said that education level is also a good predictor of smoking behavior. "For example, current smoking prevalence among men decreases from 53% in those with a GED, 30.5% in those with 12 years or less of education, 24% in those with some college, 12.4% in those with an undergraduate degree, to 5% in those with a graduate degree," Dr. Jemal said.
Eva Szabo, MD, who is chair-elect of the Cancer Prevention Committee of the American Society of Clinical Oncology (ASCO), explained that "health disparities present challenges at many different levels. Some of the health disparities are highly likely to be due to education/access to care/lifestyle factors, while others may reflect biology in groups that also happen to have different socioeconomic levels." Dr. Szabo is chief of the Lung and Upper Aerodigestive Cancer Research Group in the Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland.
ACS Report Finds Wide-Ranging Improvements in Cancer Mortality
Among the 2011 findings:
The downward trend in cancer mortality might be under threat from the upward trend in Americans' waistlines, however.
"Rising obesity rates may ultimately negatively affect these gains," Carol J. Fabian, MD, who chairs the ASCO Cancer Prevention Committee, told Medscape Medical News. Dr. Fabian is also director of Breast Cancer Prevention and Survivorship Centers, Kansas Masonic Cancer research chair, and professor in the Department of Internal Medicine, University of Kansas Medical Center in Westwood.
"Obesity increases the risk of developing several common malignancies, such as breast, colon, and prostate cancer. It also increases the risk of recurrence and death once several common cancers have been diagnosed," she said, adding that breast cancer is a good example.
"One clear message for cancer prevention and survivorship is to find more effective ways of both preventing weight gain and treating individuals who are already overweight or obese," she said.
Dr. Jemal, Dr. Szabo, and Dr. Fabian have disclosed no relevant financial relationships.
CA Cancer J Clin. Published online June 17, 2011. Abstract
The new statistics were published online June 17 in CA: A Cancer Journal for Clinicians.
"The nearly 900,000 cancer deaths avoided over a 17-year period stand in stark contrast to the repeated claim that cancer death rates have not budged," said John R. Seffrin, PhD, chief executive officer of the ACS and its advocacy affiliate, the Cancer Action Network, in a press statement.
The overall cancer death rate decreased by 1.9% per year from 2001 to 2007 in males, and by 1.5% from 2002 to 2007 in females. Between 1990/91 and 2007, cancer death rates decreased by 22.2% in men and by 13.9% in women.
Senior author Ahmedin Jemal, DVM, PhD, told Medscape Medical News that education is thought to be a marker for socioeconomic differences and that for African Americans, closing the gap in death rates between the most and least educated could prevent twice as many cancer deaths as eliminating racial disparities between blacks and whites. Dr. Jemal is vice president of surveillance research at the ACS in Atlanta, Georgia.
"Over a third of premature cancer deaths in the United States are potentially avoidable by closing the gap in knowledge about risk factors and access to healthcare (from prevention, early detection, and treatment)," he added.
ACS estimates of new cancer cases and deaths expected in the United States in 2011 are based on incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries, and from mortality data from the National Center for Health Statistics.
The report predicts that in 2011 in the United States, there will be 1,596,670 new cancer cases and 571,950 deaths from cancer.
In men, overall cancer incidence rates have stabilized, after decreasing by 1.9% per year from 2001 to 2005. In women, incidence rates have been declining by 0.6% annually since 1998.
Overall, cancer death rates have been dropping since the early 1990s, and since 1998 have continued to decrease in all racial/ethnic groups in both men and women, except for American Indian/Alaska Native women, among whom rates were stable.
African American and Hispanic men showed the largest annual decreases in cancer death rates during this time period (2.6% and 2.5%, respectively). Lung cancer death rates showed a significant decline in women after continuously increasing since the 1930s.
Racial Disparities Linked to Money
The data also show that much of the racial disparity in cancer death rates is linked to socioeconomic status. Level of education is often used as a marker for socioeconomic status. In 2007, cancer death rates in the least educated segment of the population were 2.6 times higher than those in the most educated segment. This disparity was largest for lung cancer; the death rate was 5 times higher in the least educated than in the most educated.
Dr. Jemal said that education level is also a good predictor of smoking behavior. "For example, current smoking prevalence among men decreases from 53% in those with a GED, 30.5% in those with 12 years or less of education, 24% in those with some college, 12.4% in those with an undergraduate degree, to 5% in those with a graduate degree," Dr. Jemal said.
Eva Szabo, MD, who is chair-elect of the Cancer Prevention Committee of the American Society of Clinical Oncology (ASCO), explained that "health disparities present challenges at many different levels. Some of the health disparities are highly likely to be due to education/access to care/lifestyle factors, while others may reflect biology in groups that also happen to have different socioeconomic levels." Dr. Szabo is chief of the Lung and Upper Aerodigestive Cancer Research Group in the Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland.
ACS Report Finds Wide-Ranging Improvements in Cancer Mortality
Among the 2011 findings:
- In men, cancers of the prostate, lung and bronchus, and colorectum account for about 52% of all newly diagnosed cancers. Prostate cancer alone accounts for 29% of incident cases.
- In women, the 3 most commonly diagnosed types of cancer are breast, lung and bronchus, and colorectum, accounting for about 53% of estimated cancer cases in women. Breast cancer alone is expected to account for 30% of all new cancer cases among women.
- The lifetime probability of being diagnosed with an invasive cancer is higher for men (44%) than for women.
- Cancers of the lung and bronchus, prostate, and colorectum in men, and cancers of the lung and bronchus, breast, and colorectum in women continue to be the most common causes of cancer death. These 4 cancers account for almost half of all cancer deaths.
- Lung cancer is expected to account for 26% of all cancer deaths among women. The lung cancer mortality rate in women has finally begun to decline, more than a decade later than the decline began in men. This lag in lung cancer trends reflects a later uptake of cigarette smoking in women, in whom smoking peaked about 20 years later than in men.
- Recent rapid declines in colorectal cancer incidence rates largely reflect increases in screening that can detect and remove precancerous lesions.
- Mortality rates have continued to decrease for colorectum, female breast, and prostate cancers. Among men, the reduction in death rates for lung, prostate, and colorectal cancers account for nearly 80% of the total decrease in the cancer death rate. Among women, a reduction in death rates for breast and colorectal cancers account for almost 60% of the decrease.
The downward trend in cancer mortality might be under threat from the upward trend in Americans' waistlines, however.
"Rising obesity rates may ultimately negatively affect these gains," Carol J. Fabian, MD, who chairs the ASCO Cancer Prevention Committee, told Medscape Medical News. Dr. Fabian is also director of Breast Cancer Prevention and Survivorship Centers, Kansas Masonic Cancer research chair, and professor in the Department of Internal Medicine, University of Kansas Medical Center in Westwood.
"Obesity increases the risk of developing several common malignancies, such as breast, colon, and prostate cancer. It also increases the risk of recurrence and death once several common cancers have been diagnosed," she said, adding that breast cancer is a good example.
"One clear message for cancer prevention and survivorship is to find more effective ways of both preventing weight gain and treating individuals who are already overweight or obese," she said.
Dr. Jemal, Dr. Szabo, and Dr. Fabian have disclosed no relevant financial relationships.
CA Cancer J Clin. Published online June 17, 2011. Abstract
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