March 10, 2010
Death Rate Dropping From Cancer

Death rates from cancer declined over the period of 1970 to 2006 in the United States.

ATLANTA--A new American Cancer Society study finds progress in reducing cancer death rates is evident whether measured against baseline rates in 1970 or in 1990. The study appears in the open access journal PLos ONE, and finds a downturn in cancer death rates since 1990 results mostly from reductions in tobacco use, increased screening allowing early detection of several cancers, and modest to large improvements in treatment for specific cancers.

Temporal trends in death rates are the most reliable measure of progress against cancer, reflecting improvements in prevention, early detection, and treatment. Although age-standardized cancer death rates in the U.S. have been decreasing since the early 1990s, some reports have cited limited improvement in death rates as evidence that the "war on cancer", which was initiated in 1971, has failed. Many of these analyses fail to account for the dominant and dramatic increase in cancer death rates due to tobacco-related cancers in the latter part of the 20th century.

To investigate further, researchers led by American Cancer Society epidemiologist Ahmedin Jemal, Ph.D., used nationwide cancer mortality data for the years 1970 through 2006 from the SEER*Stat database, which defines major cancer sites consistently over time in order to facilitate reporting of long term mortality trends. They found for all cancers combined, death rates (per 100,000) in men increased from 249.3 in 1970 to 279.8 in 1990, and then decreased to 221.1 in 2006, yielding a relative decline of 21% from 1990 (peak year) and a drop of 11% since 1970 (baseline year). Similarly, the death rate from all-cancers combined in women increased from 163.0 in 1970 to 175.3 in 1991, and then decreased to 153.7 in 2006, a relative decline of 12% and 6% from the 1991 (peak year) and 1970 rates, respectively.

You can get a much better picture of the trends by looking at the slideshow graphs associated with the research report. Colorectal cancer has been in decline since 1970. But other cancers didn't start declining until the mid 1990s.

You can read the full text of the report for more details. Death rates declined for a large assortment of cancers including those of the stomach, bladder, brain, kidney, and Non-Hodgkin lymphoma.

During the most recent time period, death rates decreased for cancers of the oral cavity, stomach, bladder, kidney, brain, and Non-Hodgkin lymphoma, and leukemia in both males and females and for cancers of the esophagus and ovary and melanoma and Hodgkin lymphoma in females. In contrast, rates increased for esophagus cancer and melanoma in men, liver cancer in both men and women, and pancreas cancer in women. Death rates stabilized for pancreatic cancer and Hodgkin lymphoma in men and for cervix and corpus and uterus cancers in women. Notably, the 2006 death rates for Hodgkin lymphoma in men, cervical cancer in women, and stomach cancer in both men and women were less than one-third of the 1970 rates.

Many factors contribute to these trends. Early detection, reduced smoking by men, and better treatments all have worked to lower death rates. Hepatitis C, obesity, and a surge in smoking by women all contributed to delaying declines or causing surges in some cancer types.

Most treatments for cancer are still far too crude. Some of the big advances in the next 20 years will come in the form of delivery methods that much more precisely target just the cancer cells with toxins. Also, pieces of regulatory RNA delivered into cells will instruct cancer cells to either die or at least stop dividing.

Share |      Randall Parker, 2010 March 10 10:52 PM  Aging Cancer Studies


Comments
Brett Bellmore said at March 11, 2010 3:51 AM:

"Some of the big advances in the next 20 years will come in the form of delivery methods that much more precisely target just the cancer cells with toxins."

On the morning of what my oncologist expects will be my last cycle of R-CHOP, I'd certainly go for that. It's no fun being poisoned every three weeks; This treatment is easily the worst "disease" I've ever suffered through.

In the case of my cancer, a large B cell lymphoma, the primary contributor to higher survival rates has been an engineered antibody which directly targets that cell type, combined with a drug that causes the immune system to return faster, so the treatments can come more often without killing you.

LAG said at March 11, 2010 8:48 AM:

Unbelievable. We MUST reform this antiquate medical care system. The European Gold Standard results can be seen by Googling "comparison cancer rates US Europe". Here's a sample.

http://www.medscape.com/viewarticle/561737

Randall Parker said at March 11, 2010 6:50 PM:

Brett,

Sounds like you are getting the monoclonal antibody Rituximab. I know one of the first people to get a monoclonal antibody for NHL and he's still alive over 10 years later with apparently complete destruction of the cancer. I'm hoping the same for you.

LAG,

The rates of cancer will differ for lots of reasons. It is hard to do these comparisons unless one adjusts for lots of factors. Last I looked the US led for survival rates for some cancers but not for others. But unless adjusted for age, race, and lots of other factors you can't draw conclusions from a simple comparison.

Brett Bellmore said at March 12, 2010 2:28 AM:

Randall, that's what the "R" in "R-CHOP" stands for. My oncologist said it boosted the cure rate for my cancer from 60-70%, to 95-99%. The first time I got it they had to stretch the treatment over two days, because the Rituximab has to be given very gradually at first, and ramped up, to see how you'll tolerate it. They first give you a massive IV dose of Benadryl, and whole while they're standing around watching to see if you'll go into anaphylactic shock when the Rituximab hits your system. Fortunately, I tolerated it quite well, just get flu like symptoms the next couple of days.

My life has become very interesting medically, the last six months. Diagnosed with prostate cancer, lymphoma found during the pre-operative physical, cured of prostate cancer, and now maybe cured of the lymphoma. My recovery from the chemo is probably going to be slow, though; The same blood testing that caught the high PSA found my testosterone level was only 40 nanograms per deciliter, which is incredibly low for a guy. I won't qualify for supplementation until a year after the surgery, assuming I keep my 0.01 PSA level.

Wonder if there's any chance I could get into a myostatin inhibitor trial? It might be very helpful for prostate cancer survivors who suffer muscle wasting due to lack of testosterone.

Tj Green said at March 12, 2010 4:58 PM:

The release of cytochrome c from mitochondria can cause cell death (apoptosis) in some cancers with the use of aspirin. Even aspirin has some unpleasant side effects. RNA to instruct cell death (apoptosis) is the way forward, and getting all of us sequenced.

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