Understanding Cancer Annual Report to the Nation: Overall Cancer Mortality Continues to Decline

Annual Report to the NationThe latest Annual Report to the Nation on the Status of Cancer finds that, for all cancer sites combined, cancer death rates continued to decline in men, women, and children in the United States from 1999 to 2016. Overall cancer incidence rates (or rates of new cancers) decreased in men from 2008 to 2015, after increasing from 1999 to 2008, and were stable in women from 1999 to 2015. In a special section of the report, researchers looked at cancer rates and trends in adults ages 20 to 49.

“We are encouraged by the fact that this year’s report continues to show declining cancer mortality for men, women, and children, as well as other indicators of progress,” says Betsy A. Kohler, executive director of the North American Association of Central Cancer Registries. “There are also several findings that highlight the importance of continued research and cancer prevention efforts.”


Special Section: Cancer Rates and Trends in Adults Ages 20 to 49
  
The special section shows a different picture for cancer incidence and mortality among men and women ages 20 to 49 than among people of all ages. In the main report, from 2011 to 2015, the average annual incidence rate for all cancer sites combined was about 1.2 times higher among men than among women, and from 2012 to 2016, the average annual death rate among men (all ages) was 1.4 times the rate among women. However, when the researchers looked only at men and women ages 20 to 49, they found that both incidence and death rates were higher among women. 

The authors report that, in the 20 to 49 age group from 2011 to 2015, the average annual incidence rate for all invasive cancers was 115.3 (per 100,000 people) among men, compared with 203.3 among women, with cancer incidence rates decreasing an average of 0.7 percent per year among men and increasing an average of 1.3 percent per year among women. During the period from 2012 to 2016, the average annual cancer death rate was 22.8 (per 100,000 people) among men and 27.1 among women in this age group. 

“The greater cancer burden among women than men ages 20 to 49 was a striking finding of this study,” says Elizabeth Ward, PhD, lead author of the study and a consultant at NAACCR. “The high burden of breast cancer relative to other cancers in this age group reinforces the importance of research on prevention, early detection, and treatment of breast cancer in younger women.” 

This year’s report finds that, among all ages combined, existing incidence and mortality trends for most types of cancer continue. Rates of new cases and deaths from lung, bladder, and larynx cancers continue to decrease as a result of long-term declines in tobacco smoking. In contrast, rates of new cases of cancers related to excess weight and physical inactivity – including uterine, post-menopausal breast, and colorectal (only in young adults) – have been increasing in recent decades. 

Several notable changes in trends were observed in the report. After decades of increasing incidence, thyroid cancer incidence rates in women stabilized from 2013 to 2015. The authors write that this could be due to changes in diagnostic processes related to revisions in American Thyroid Association management guidelines for small thyroid nodules. 
“We are encouraged by the fact that this year’s report continues to show declining cancer mortality for men, women, and children, as well as other indicators of progress.”The report also shows rapid declines in death rates for melanoma of the skin in recent years. 

“The declines seen in mortality for melanoma of the skin are likely the result of the introduction of new therapies, including immune checkpoint inhibitors, that have improved survival for patients diagnosed with advanced melanoma,” says J. Leonard Lichtenfeld, MD, MACP, interim chief medical officer of the American Cancer Society. “This rapid change shows us how important it is to continue working to find effective treatments for all kinds of cancer.”

Other notable findings about cancer mortality from the report include that from 2012 to 2016 overall death rates decreased 1.8 percent per year in men and 1.4 percent per year in women. For cancer incidence, from 2011 to 2015, incidence rates for all cancers combined were stable in women and decreased 2.1 percent per year in men. 

The report also shows continuing racial and ethnic disparities in cancer mortality and incidence. When data for people of all ages were combined and compared by sex, across racial and ethnic groups, black men and black women had the highest cancer death rates, both for all cancer sites combined and for about half of the most common cancers in men and women. Black men and white women had the highest overall cancer incidence rates, and Asian/Pacific Islander men and women had the lowest overall rates. Non-Hispanic men and women had higher overall incidence rates than Hispanic men and women.

“Major declines overall in cancer mortality point in the right direction, yet significant differences remain in cancer cases and deaths based on gender, ethnicity, and race,” says U.S. Centers for Disease Control and Prevention Director Robert R. Redfield, MD. “A better understanding of these discrepancies improves cancer diagnosis and recovery for all patients and is vital to our public health mission.”


The annual report is a collaborative effort among the National Cancer Institute, part of the National Institutes of Health; the U.S. Centers for Disease Control and Prevention; the American Cancer Society; and the North American Association of Central Cancer Registries. The report appeared in the Journal of the National Cancer Institute.

You can find the full report, as well as more information on current cancer statistics, at
seer.cancer.gov/report_to_nation.