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There’s good news about cancer survival rates. Getty Images
  • Over the past 26 years, the overall cancer death rate in the United States has fallen significantly, driven by improvements for four major cancers, including lung cancer.
  • The largest single drop ever was reported in 2017 with a 2.2 percent decline.
  • Falling smoking rates and new treatments largely drove this drop.

The cancer death rate in the United States dropped 29 percent between 1991 and 2017, the American Cancer Society said Wednesday. This includes a 2.2 percent decline in 2017 — the largest single-year drop ever reported.

The declines over the past 26 years have been mainly driven by decreases in death rates for lung, colorectal, breast, and prostate cancers.

Over the past decade, lung cancer saw an increase in the speed of the decline. However, declines slowed for female breast and colorectal cancers. Death from prostate cancer held steady during this time.

Reductions in deaths due to lung cancer — the leading cause of cancer death — largely accounted for the record drop in 2017. Falling smoking rates and new treatments drove this trend.

Dr. David Chan, a breast cancer specialist at Hunt Cancer Institute at Torrance Memorial Medical Center in Torrance, California, who wasn’t involved in the study, says the report is “very positive.”

Dr. Wasif M. Saif, deputy physician-in-chief and medical oncology director of Northwell Health Cancer Institute in Lake Success, New York, says in spite of the drop in the cancer death rate, cancer remains a major threat to health.

The American Cancer Society estimates that 1.8 million new cancer cases will be diagnosed in the United States this year, with more than 606,000 deaths.

Nationally, cancer is the second-leading cause of death after heart disease for both women and men. But it’s the leading cause of death in many states and for Hispanic and Asian Americans, the report said.

Lung cancer remains the leading cause of cancer death, accounting for almost one-quarter of all cancer deaths. As a result, improvements in lung cancer survival can have a big impact on the overall cancer death rate.

Since 1990, lung cancer death rates have dropped by 51 percent in men and by 26 percent in women since 2002. This has occurred alongside significant declines in smoking rates among both adults and youth.

Gains were also seen in death rate due to melanoma of the skin, which saw the most rapid decline. From 2013 to 2017, the melanoma death rate fell an average of 7 percent per year, compared to 1 to 3 percent per year from 2006 to 2010.

Adults over age 65 saw even greater declines in death due to melanoma — 5 to 6 percent. Before 2013 the death rate for this group had been increasing.

The 1-year survival rate for metastatic melanoma also increased, from 42 percent for cases diagnosed from 2008 to 2010 to 55 percent for those diagnosed from 2013 to 2015.

Metastasis is when a cancer spreads beyond the tissue where it started. Cancers that reach this stage are often more difficult to treat.

While improved cancer survival rates is good news, it may also present challenges later on.

“With the increase in the geriatric population and increased survival of cancer patients, other issues arise, such as delayed toxicities of cancer treatment or the development of other malignancies,” Saif said.

In a news release, Rebecca Siegel, MPH, lead author of the report, called the reductions in death due to lung cancer and melanoma “exciting,” but she said the overall report is “mixed” because of slowing progress for breast, colorectal, and prostate cancers.

The report also said “substantial” racial and geographic disparities remain for preventable cancers, such as lung and cervical cancer.

Saif says factors like smoking cessation, awareness and implementation of cancer screening, and improved cancer detection tools have all contributed to the drop in the cancer death rate.

Chan points to the importance of low-dose CT screening of smokers and recent former smokers over the age of 55 for reducing lung cancer deaths.

“Similarly, breast cancer screening with mammograms, with corresponding improvements in technology, have diagnosed breast cancer earlier, allowing a greater opportunity for effective treatment,” he said.

In recent years, new treatments — including immunotherapy and targeted therapies — have also improved cancer survival rates.

For example, treatments that target HER2-positive breast cancers “have turned a very dangerous type of breast cancer into one of the more curable breast cancers, and has also improved survival of those with metastatic disease by many years,” Chan said.

Immunotherapy, a type of therapy that helps the immune system fight the cancer, has also contributed to declines in cancer death rates.

Chan says checkpoint inhibitor immunotherapies have led to “significant improvements in survival” for cancers like melanoma, kidney cancer, and lung cancer.

These new therapies have radically improved how some cancers are treated, but Saif says the high cost of some of these treatments is a “huge burden on the health system.”

While it’s not always possible to prevent cancer, you can reduce your risk for many cancers by maintaining a healthy weight, exercising regularly, eating a healthy diet, avoiding all forms of tobacco, and limiting alcohol intake.

The HPV vaccine can also prevent cancers caused by human papillomavirus (HPV) infections, including anal, mouth, and throat cancer.

Chan says the improvement in cancer survival rates seen in the report is the result of a “team effort,” with the American Cancer Society, physicians, and researchers all working together to promote cancer screening, diagnose cancers earlier, and find more effective treatments.

The full Cancer Statistics 2020 report appears online in CA: A Cancer Journal for Clinicians, with an educational companion report on the American Cancer Society’s website.