A new report says 3.5 million cancer deaths have been prevented in recent decades, thanks to declines in smoking, advances in treatments and improved early detection.
But the cancer statistics paper published Wednesday, a companion to the American Cancer Society’s 2022 annual report, cautions pandemic-related impacts to cancer detection and treatment aren’t yet known. The scientific paper also calls out racial disparities in cancer rates that have long persisted.
The report says cancer diagnoses and treatments were adversely affected by the COVID-19 pandemic, as access to healthcare was limited for many Americans. But data to quantify the problem won’t be available for years.
“We are all … anxious about what this report is going to look like … in February 2024,” said Dr. Deb Schrag, the Department of Medicine Chair at New York’s Memorial Sloan Kettering Cancer Center.
What is clear from the the new data: Longstanding race and geographic inequality continues to plague cancer detection and treatment in America, even as the overall risk of cancer death is markedly lower than it was several decades ago.
The authors of the peer-reviewed paper published this week in “CA: A Cancer Journal for Clinicians” also said rising rates of breast and advanced-stage prostate cancer, which can both be detected early, are “concerning.”
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‘Alarming’ racial disparities persist
Authors say the data shows “alarming … persistent racial, socioeconomic, and geographic disparities.”
Among the most stark contrasts: Risk of cancer death is 33% higher for Black people and more than 50% higher in Native Americans and Alaska Natives, when compared with white people, according to data cited by the report. That data was adjusted for several factors, including stage at diagnosis.
The disparities stem from “longstanding inequalities in wealth” resulting in different risk factors and access to healthcare, authors say.
“The place where we still need to move the needle is variation based on race and place,” Schrag said. “Race and place is the problem.”
Among women, breast cancer death rates differ by race, with Black women having a 41% higher death rate from breast cancer than white women, even though Black women have a 4% lower rate of breast cancer incidence.
The importance of geography can be seen in the report as well. In the U.S., the average breast cancer mortality rate per 100,000 is 19.9. But rates are higher in some states — including Mississippi, where the number is closer to 23. Meanwhile, in Hawaii the number is less than 17.
Breast, prostate cancer rates increasing slightly
In recent years, rates of prostate cancer among men and breast cancer among women – both of which can be easily detected early – have been increasing slightly, the report shows.
At the same time, the prostate cancer death rate has leveled off, likely reflecting reductions in blood testing to detect the cancer since 2008. Before then, men were over-screened for prostate cancer, said Schrag.
“When you back off on screening a little bit, you just kind of take off the brakes, what happens is proportionally a few more of those cancers that you find are going to be advanced,” Schrag said.
For breast cancer, “it has a really good case you can make for early detection reducing mortality,” said Dr. Electra Paskett, director of the Division of Cancer Prevention and Control at The Ohio State University College of Medicine.
“But if you miss your mammogram your cancer grows,” she said.
Female breast cancer mortality peaked in 1989 and has decreased by more than 40% since then because of earlier diagnosis and improvements in treatment, according to the report.
Lung cancer progress continues
Aside from decreases in smoking, more people are being diagnosed with lung cancer earlier and getting better and more personalized treatment, leading to patients living longer post-diagnosis. More than 30% of patients are living at least three years after diagnosis in the most recent data cited, compared to 21% in 2004, the report said.
Lung cancer patients being diagnosed earlier, according to the report, which is when patients have more treatment options.
Pills blocking certain genes that cause cancer cells to grow, as well as immunotherapies that help a patient’s own immune system respond to cancer are leading to better outcomes, said Dr. Lauren Byers, a lung cancer expert at MD Anderson Cancer Center.
Over the past two years, there were more than 15 new drugs approved for lung cancer, including “big milestone” drugs that were the first of their kind, Byers said.