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The American Cancer Society's 2019 Annual Report

Much has been written in the past weeks about the American Cancer Society’s Annual Report.
 
Here are some facts from the report:
The Good News
·      The U.S. cancer death rate has hit a milestone, falling for the past 25 years.  The nation’s cancer death rate was increasing until the early 1990s. It has been dropping since, falling 27% between 1991 and 2016
·      This decline translates into more than 2.6 million fewer cancer deaths from 1991 to 2016.  This progress has been driven by steady declines in death rates for the four most common cancer types – lung, colorectal, breast, and prostate. 
·      More than 15.5 million Americans with a history of cancer were alive on January 1, 2016, most of who were diagnosed many years ago and have no current evidence of cancer. 
·      Lower smoking rates are translating into fewer deaths. 
·      Advances in early detection and treatment also are having a positive impact.
·      The 5-year relative survival rate for all cancers combined has increased substantially since the early 1960s, from 39% to 70% among whites and from 27% to 63% among blacks. Improvements in survival reflect advances in treatment, as well as earlier diagnosis for some cancers. 
 
The Bad News:
·      Cancer remains the nation’s No. 2 killer
·      The ACS predicts there will be more than 1.7 million new cancer cases, and more than 600,000 cancer deaths, in the U.S. this year.
·      Obesity-related cancer deaths are rising.  Of the most common types of cancer in the US, all the ones with increasing death rates are linked to obesity, including cancers of the pancreas and uterus.  Another is liver cancer. Liver cancer deaths have been increasing since the 1970s, and initially most of the increase was tied to hepatitis C infections spread among people who abuse drugs. But now obesity accounts for a third of liver cancer deaths, and is more of a factor than hepatitis.  The nation’s growing obesity epidemic was first identified as a problem in the 1990s. It can take decades to see how a risk factor influences cancer rates, so we may just be starting to see the effect of the obesity epidemic on cancer.
·      Prostate cancer deaths are no longer dropping.  The prostate cancer death rate fell by half over two decades, but experts have been wondering whether the trend changed after a 2011 decision by the U.S. Preventive Services Task Force to stop recommending routine testing of men using the PSA blood test. That decision was prompted by concerns the test was leading to overdiagnosis and overtreatment.  The prostate cancer death rate flattened from 2013 to 2016. So while the PSA testing may have surfaced cases that didn’t actually need treatment, it may also have prevented some cancer deaths.
·      There’s been a decline in the historic racial gap in cancer death rates, but an economic gap is growing — especially when it comes to deaths that could be prevented by early screening and treatment, better eating and less smoking.  In the early 1970s, colon cancer death rates in the poorest counties were 20 percent lower than those in affluent counties; now they’re 30 percent higher. Cervical cancer deaths are twice as high for women in poor counties now, compared with women in affluent counties. And lung and liver cancer death rates are 40 percent higher for men in poor counties.

 

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