Cancer mortality continues to decline in the United States: quitting smoking and drinking, keeping a good mouth and early screening are important



On January 8, 2019, the Journal of Clinical Cancer, sponsored by the American Oncology Society, published a statistical report on cancer in the United States in 2019. It was concluded that the cancer mortality rate continued to decline from 1991 to 2016, thanks to the historic success of effective cancer prevention and treatment measures such as abstinence from smoking and alcohol, early screening and immunotherapy. The report points out that cancer prevention and treatment are still not optimistic, with an estimated 4,800 new cases per day in 2019.



Every year, the American Oncology Association predicts new cancer cases and deaths in the United States in the new year, and this year is no exception. On January 8, the top medical journal, Cancer Journal for Clinicians, published Cancer Statistics (2019) published by the American Cancer Society in 2019. It was concluded that the mortality rate of cancer has been declining continuously for 25 years from 1991 to 2016, especially for lung cancer, breast cancer, prostate cancer and colorectal cancer, which are four common high-fatal tumors. Thanks to the historic success of effective cancer prevention and treatment measures such as smoking and alcohol cessation, early screening and immunotherapy.



Prediction of New Tumors and Deaths in the United States in 2019


The number of cancer deaths decreased in both sexes from 1991 to 2016. Red is the predicted death data and blue is the actual data.



A quick overview of highlights of the report:


1. Tumor mortality in the United States has been declining for 25 years


2. The incidence of lung cancer decreased significantly, but there were differences between men and women. This was related to the difference in the history of smoking control between men and women.


3. New cases of hepatocellular carcinoma continue to rise. Detection of hepatitis C virus (HCV) and quitting smoking and alcohol are helpful to control hepatocellular carcinoma.


Older people over the age of 4 or 85 are very special and have a high risk of cancer.


5. The incidence of cancer varies according to the gap between the rich and the poor. The living standards in poor areas have improved, but the burden of cancer is increasing.


1. Tumor mortality in the United States has been declining for 25 years


In 1991, the cancer mortality rate in the United States reached the peak of 215.1/100,000, and then decreased year by year, with a decline of about 1.5% per year. In the 25 years to 2016, the overall decline was 27%, and the number of cancer deaths was estimated to have decreased by more than 26 million people. Among them, the mortality rate of male lung cancer decreased by 48%, which is the remarkable achievement of effective smoking control.


The report shows that the mortality rate of female breast cancer has decreased by 40%, largely due to early screening and timely treatment, and the mortality rate of colorectal cancer has also decreased by 53% due to effective prevention and treatment such as early screening and immunotherapy. However, mortality rates of liver cancer, pancreatic cancer, melanoma, uterine cancer, nervous system and oropharyngeal cancer increased. Professor Siegel, the chief scientist of the study, pointed out that obesity-related cancer mortality is on the rise and the number of prostate cancer deaths is no longer decreasing.



Trends in total incidence and mortality



2. New cases of cancer differ between men and women.


For new cancer cases, the incidence of cancer in men continued to decline (by 2% a year), while that in women remained unchanged. Prostate cancer accounts for about one-fifth of men's new tumors, and its incidence declines by 7% annually between 2010 and 2015. This is due to the abolition of the recommended routine prostate specific antigen (PSA) test for men and the avoidance of overtreatment, thus reducing the number of deaths. Lung cancer and colorectal cancer, as high-risk cancers for both men and women, have declined, but the incidence of breast cancer in women shows an upward trend (every year). The increase was about 0.4%.


The report also points out that in 2011-2015, the incidence of new lung cancer in men dropped by 3% annually and that in women by 1.5%, reflecting the historical difference between men and women in smoking and smoking control: women started smoking later than men, but quit smoking slowly.



Differences in mortality from different cancers between men and women


Incidence and mortality of different types of tumors in male and female patients



3. Incidence of hepatocellular carcinoma has increased most significantly, which deserves vigilance.


Recent findings show that the incidence of liver cancer is faster than any other cancer, and people infected with hepatitis C virus (HCV) have a higher risk of liver cancer. The "baby boomers" (babies born between 1945 and 1965) are recommended for HCV testing because about 75% of this generation are HCV-infected. In addition, other risk factors for liver cancer include obesity, heavy drinking and smoking. Therefore, quitting smoking and drinking and keeping your mouth closed can reduce the risk of liver cancer.


Cancer is the second leading cause of death in the elderly aged over 4 and 85


The report also focuses on older people over 85 years of age, who are the fastest growing group in the United States (accelerated population ageing) and the fastest growing group of cancer survivors, so their demand for cancer care is particularly evident.


The report points out that the risk of cancer in this particular group is significantly higher, accounting for about 8% of all new cases of cancer. Even those who do not have a history of cancer, the risk of cancer will be as high as 12%. Cancer is the second leading cause of death in this elderly population, and the first leading cause of death is heart disease.

5. The incidence of cancer varies with the gap between the rich and the poor.


Racial differences in cancer incidence and mortality remain, with African Americans having the highest incidence and Asian Americans the lowest. At the same time, the incidence of cancer varies with the gap between rich and poor. Women in poor areas in the United States have twice as many cervical cancer deaths as women in wealthy counties, and men in poor areas have more than 40% higher lung and liver cancer deaths than men in wealthy areas. For cancers that are not suitable for prevention or treatment, such as pancreatic and ovarian cancer, there is little or no difference in cancer mortality between rich and poor.



Mortality changes in lung cancer, prostate cancer, colorectal cancer and breast cancer among people of different economic status


The most striking reversal in the mortality rate of colorectal cancer has occurred. Male mortality rate of colorectal cancer in poor areas is 35% higher than that in rich areas, but it is about 20% lower in the early 1970s. This reversal is due to the emergence of more obesity caused by smoking and diet in these areas, which increase the risk of colorectal cancer. At the same time, the lack of basic medical care, the slow spread of screening and treatment progress in poor areas are also important factors in the rising incidence of colorectal cancer. Making full use of the existing cancer prevention measures and paying attention to the vulnerable groups in these poor areas will be of great benefit to the prevention and treatment of cancer.


On the contrary, the current situation of cancer prevention and treatment in China is worth learning in many parts of the United States, such as the implementation of tobacco control actions, the dissemination of knowledge on early screening and treatment of alcohol abstinence, breast cancer and colorectal cancer.



(Originally titled "The latest report: cancer mortality continues to decline in the United States, smoking and alcohol cessation, good mouth, early screening is very important")


(This article is from Peng Mei News)