Is It Too Soon to Celebrate the Cancer Death Rate Decline?

Earlier this year, the American Cancer Society reported the biggest one-year decline in cancer mortality ever recorded from 2016 to 2017. While fewer deaths from cancer seems like an obvious reason to celebrate, STAT spoke with cancer specialists who are only cautiously optimistic about this figure.

For example, while immunotherapies are helping some patients with cancer live longer than they would otherwise, they can’t receive all the credit for reducing the cancer death rate. Declining smoking rates are the greatest driver of declining cancer rates since 1991.

U.S. life expectancy has been falling due to deaths from opioid addiction and suicide. These shorter life expectancies tend to affect people with lower education and income levels – people who are also likely to die from cancer. Peter Bach, MD, from Memorial Sloan Kettering Cancer Center, points out that premature deaths aren’t evenly distributed across the population, so they aren’t discounted in the normal statistical model of aging.

In addition, looking at a single year’s decline may not provide a clear view of the long-term trend, when there are likely to be good years and bad years. Even if the 2.2% drop in 2016 is an accurate representation of the overall trend, it may not be good enough. “For all the money that’s going in and all the research, which I of course am thrilled to see, there hasn’t been a major reduction in mortality,” said Eric Topol, MD, founder and director of the Scripps Research Translational Institute in La Jolla, California. “They really should be more forthright that it’s a very serious problem that we have not had a substantive overall [impact on].”

Experts agree that closing racial and income gaps and ensuring high-quality prevention and care across the U.S. will help cancer mortality rates continue to fall. “The cancer death rate could certainly be jump-started by increasing access to high-quality screening and treatment to all individuals,” Rebecca Siegel, director of Surveillance Information at the American Cancer Society, said. “There’s obviously that opportunity there.”

Source: STAT, January 10, 2020.