Survival Better for Many Cancers, but for Some, It's Worse, Annual Report Finds

Lynne T. Penberthy, MD, MPH

Lynne T. Penberthy, MD, MPH

The latest Annual Report to the Nation on the Status of Cancer, 1975 to 2014, found that fewer men, women and children of all major racial and ethnic groups are dying from cancer.

The report — a collaborative effort by the American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) — determined that death rates from 2010 to 2014 decreased for 11 of the 16 most common types of cancer in men and for 13 of the 18 most common types of cancer in women. This included lung, colorectal, female breast and prostate cancers.

However, there were instances where death rates from cancer increased. The report found such cases in cancers of the liver, pancreas and brain in men and for liver and uterine cancer in women. Overall cancer incidence rates decreased in men but stabilized in women during the period 1999 to 2013.

“The continued drops in overall cancer death rates in the United States are welcome news, reflecting improvements in prevention, early detection and treatment,” Betsy A. Kohler, MPH, CTR, executive director of NAACCR, said in a statement. “But this report also shows us that progress has been limited for several cancers, which should compel us to renew our commitment to efforts to discover new strategies for prevention, early detection and treatment, and to apply proven interventions broadly and equitably.”

Researchers also examined five-year survival rates and five-year relative survival rates of patients. The American Cancer Society defines the five-year survival rate as the percentage of patients who live at least five years after their cancer diagnosis. Five-year relative survival rates assume that some patients will die of other causes and compare the observed survival with that expected for people without the cancer.

“While trends in death rates are the most commonly used measure to assess progress against cancer, survival trends are also an important measure to evaluate progress in improvement of cancer outcomes,” said Ahmedin Jemal, DVM, PhD, of the American Cancer Society and lead author of the study. “We last included a special section on cancer survival in 2004, and as we found then, survival improved over time for almost all cancers at every stage of diagnosis. But survival remains very low for some types of cancer and for most types of cancers diagnosed at an advanced stage.”

In the report, significant increases in five-year survival rates were seen from 2006 to 2012 compared to cases from 1975 to 1977 for all cancer types except cervical and uterine. The most significant increases in survival — equal to 25% or greater— were seen in prostate, kidney, non-Hodgkin lymphoma, myeloma and leukemia.

The lowest five-year relative survival for cases diagnosed in 2006 to 2012 were pancreas (8.5%), liver (18.1%), lung (18.7%), esophagus (20.5%), stomach (31.1%) and brain (35%). The highest were prostate (99.3%), thyroid (98.3%), melanoma (93.2%) and female breast (90.8%).

“While this report found that five-year survival for most types of cancer improved among both blacks and whites over the past several decades, racial disparities for many common cancers have persisted, and they may have increased for prostate cancer and female breast cancer,” said Lynne T. Penberthy, MD, MPH, associate director of NCI’s Surveillance Research Program. “We still have a lot of work to do to understand the causes of these differences, but certainly differences in the kinds and timing of recommended treatments are likely to play a role.”

Researchers also noted that obesity, which is a risk factor for cancer, is an issue in every state in the country. With that in mind, they suggested that there be continued support in communities to help with prevention approaches. The authors also stated that more attention and resources are needed to identify major risk factors for common cancers.

“While trends in death rates are the most commonly used measure to assess progress against cancer, survival trends are also an important measure to evaluate progress in improvement of cancer outcomes,” said Ahmedin Jemal, DVM, PhD, of the American Cancer Society and lead author of the study. “We last included a special section on cancer survival in 2004, and as we found then, survival improved over time for almost all cancers at every stage of diagnosis. But survival remains very low for some types of cancer and for most types of cancers diagnosed at an advanced stage.”

In a statement, Daniel F. Hayes, MD, FACP, FASCO, president of the American Society of Clinical Oncology said, "The progress described in this report clearly illustrates the immediate impact that comes with our increased knowledge about the biology of cancer. Sustaining this progress will be determined in large part by the level of federal investment in our nation's biomedical research enterprise. Without an ongoing federal commitment to cancer research, we will lose the forward momentum needed to continue to deliver new treatments for all people with cancer. Our patients cannot afford to wait."