Cancer deaths are down in the US, but overall cases are on the rise
- A new American Cancer Society report finds that cancer deaths in the US have significantly decreased since the 1990s, with over 4 million deaths prevented since 1991.
- Lung cancer, the most common cause of cancer death, has seen a decline in diagnoses, partly due to reduced smoking rates. However, it remains one of the deadliest cancers, especially for Black men.
- Screening and vaccination efforts have effectively reduced diagnoses and deaths from cervical, colorectal, and breast cancers. But here again, racial disparities persist, particularly in breast cancer death rates among Black women.
- Immunotherapy has emerged as a vital advancement in cancer treatment by stimulating the body’s immune system to fight cancer cells.
- The report highlights ongoing challenges, including an increase in new cancer cases, partially due to aging population and rising obesity rates.
For the first time in history, more effective treatments have surpassed prevention and screening as the main factor behind the decline in cancer deaths, a new report by the American Cancer Society (ACS) reveals. The report estimates that over 4 million cancer deaths have been averted since the early 1990’s, thanks in part to advances in diagnosis and therapy.
Yet the fight against cancer has seen mixed results. While deaths from some cancers have dropped, lung cancer still poses a significant threat, especially to Black men who are twice as likely to die from the disease as White men. And Black women remain 40% more likely to die of breast cancer than White women.
Immunotherapy has changed the game
Read MoreWatch: Dr. Jim Allison explains how immunotherapy works
Allison won a Nobel Prize for his work on how to make the body’s own cells fight cancer. His studies showed that blocking a part of the cell called CTLA-4 removed a brake on the immune system, allowing it to attack cancer more effectively. He went on to develop immunotherapies that have helped save the lives of people living with skin cancer and other cancers.
Immunotherapy for lung cancer
The first FDA-approved immunotherapy was a cancer vaccine for prostate cancer in 2010. Since then, its use has expanded to more than a dozen types of cancers, but has shown particular success in treating lung cancer, the deadliest form of cancer.
“It is rare that in cancer epidemiology, that you can point to one treatment, and say that overall death rate from all cancers is going down because this one treatment became available. In this case we can do that,” Dr. Otis Brawley, Bloomberg Distinguished Professor of Oncology and Epidemiology at Johns Hopkins University, told SurvivorNet in an interview last year.
“Immunotherapies for lung cancer, which won the Nobel prize in 2018, are actually preventing people from dying,” Brawley, who previously served as chief medical and scientific officer for the American Cancer Society, added.
One of the main types of immunotherapy for lung cancer is a class of drugs known as immune checkpoint inhibitors. These are drugs that block proteins on the surface of cancer cells or immune cells that prevent the immune system from attacking the cancer. By blocking these proteins, these drugs allow the immune system to “see” and kill the cancer cells.
Immunotherapy with immune checkpoint inhibitors has been proven to extend the lives of some people with lung cancer, especially those whose tumors have high levels of a protein called PD-L1. According one recent study, an immunotherapy drug called pembrolizumab helped more than 15% of people with advanced non-small cell lung cancer live for at least five years. This is a remarkable improvement compared with the previous five-year survival rate of less than 5% for this group of patients.
However, immunotherapy is not a cure for lung cancer. And it does not work for everyone. It can also cause serious side effects, such as inflammation of the lungs, liver, kidneys, or other organs. That said, for some people with lung cancer, immunotherapy has offered a real chance of living a longer and better life.
Prevention and screening
According to the current ACS report, prevention and screening remain key factors in reducing cancer death rates because they help people avoid or detect cancer early. The report estimates that 45% of the cancer deaths in 2023 are attributable to potentially modifiable risk factors, such as smoking, excess body weight, alcohol intake, and physical inactivity.
Reduced smoking rates, for example, have contributed to fewer cancer deaths by preventing people getting lung cancer and other smoking related diseases. However, lung cancer still remains among the deadliest cancers, accounting for about 1 in 5 of all cancer deaths. Even though their death rate from lung cancer has declined by 31% in the past decade, Black men still have the highest lung cancer death rate of any racial or ethnic group.
Watch: medical oncologist, Dr. Ronald Natale discusses lung cancer risks.
Meanwhile, screening and vaccination efforts have reduced the diagnoses and deaths from cervical, colorectal, and breast cancers.Breast cancer death rates have dropped by 43% between 1989 and 2020.
Yet breast cancer is the most commonly diagnosed cancer among women in the US, and the second leading cause of cancer death after lung cancer. And Black women still have the highest breast cancer mortality rate of any racial or ethnic group. Their chances of dying from the disease is 40% higher than for White women. Even more concerning, the disparity in survival has actually increased over time. This is partly due to lower rates of screening leading to delayed diagnosis for women of color.
Watch: Dr. Anita Johnson talks racial disparities in breast cancer outcomes and how to close the gap.
“With later stage breast cancer, stage 4, we have no cure for that. So, if patients are known to have later stages, compared to other populations, they are going to be more likely to die,” Dr. Oluchi Oke, a breast medical oncologist at MD Anderson Cancer Center in Houston, TX, told SurvivorNet.
Oke says that education campaigns and better access to screenings are helping to close the gap in preventive screenings between racial and ethnic groups but Black women are less likely to have insurance and access to healthcare.
Challenges ahead
The ACS report underscores the major public health challenges that remain.
More people are developing cancers than ever before. New cancer diagnoses are projected to top 2 million for the first time in 2024, up from 1.9 million last year.
An aging and growing population are partially to blame for the growing number of cancer cases. And obesity, one of the main risk factors for cancer, is linked to at least 13 types of cancer, including breast, colorectal, endometrial, esophageal, kidney, liver, and pancreatic cancers.
Another challenge is the persistent racial and ethnic divide in cancer outcomes, which reflect the social and economic inequalities in the US. Black Americans have the highest cancer death rate of any racial or ethnic group. They are also more likely to be diagnosed with advanced or aggressive cancers. Native Americans also face higher risks of certain cancers, such as liver, stomach, and kidney cancers. The higher cancer risk for these groups seem to be influenced by factors including access to healthcare, environment, lifestyle, and genetics.
What’s next?
The report concludes that more efforts are needed to prevent and control cancer in the US, especially among the most at-risk populations. It calls for increased investment in cancer research, education, and advocacy. The report also made a plea for stronger policies and regulations to reduce the exposure to cancer-causing substances and more programs to promote healthy behaviors and increase access to quality care for all.
Scientists are working on developing new and better immunotherapies, such as cancer vaccines. Cancer vaccines are different from regular vaccines, because they do not prevent cancer, but rather try to shrink or eliminate existing tumors. They do this by teaching the immune system to recognize and attack cancer cells. Some of these vaccines use a new technology called mRNA, which was also used for the COVID-19 vaccines. Researchers are hopeful that cancer vaccines will be the next big thing in cancer treatment, and that they will be available for more patients in the near future.
Learn more about immunotherapy
If you want to get immunotherapy or learn more about it, here are some steps you can take:
- Ask your cancer doctor. They can tell you if immunotherapy can help you, what it does, and how to get ready for it.
- Look for research studies that test immunotherapy. You may be able to join a clinical that gives immunotherapy for your cancer. You can find current trials here.
- Read more about people who have tried immunotherapy. You can learn from their stories, challenges, and tips.
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