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(CNN) --
The rate of people dying of cancer in the United States has declined steadily over the past three decades, according to a new report from the American Cancer Society.
The US cancer death rate has fallen 33% since 1991, corresponding to an estimated 3.8 million deaths averted, according to the report published Thursday in CA: A Cancer Journal for Clinicians.
The rate of lives lost to cancer continued to decline in the most recent year for which data is available, between 2019 and 2020, by 1.5%.
The 33% decline in cancer mortality is "really staggering," said Karen Knudsen, executive director of the American Cancer Society.
The report attributes this steady progress to improvements in cancer treatment, lower smoking rates and increases in early detection.
“Developments in prevention, early detection and treatment have resulted in real and significant advances in many of the 200 diseases we call cancer,” Knudsen said.
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In their report, the American Cancer Society researchers also noted that HPV vaccines are linked to reduced cancer deaths.
HPV, or human papillomavirus, infections can cause cervical and other cancers, and vaccination has been linked to a decrease in new cases of cervical cancer.
Among women in their early 20s, there was a 65% drop in cervical cancer rates between 2012 and 2019, "which coincides exactly with the time HPV vaccines began to be used," said the Dr. William Dahut, scientific director of the society.
"There are other cancers that are related to HPV, whether it's head and neck cancers or anal cancers, so there's optimism that this will play a role," he said.
The lifetime probability of being diagnosed with any type of invasive cancer is estimated at 40.9% for men and 39.1% for women in the US, according to the new report.
The report also includes projections for 2023, estimating that there could be almost 2 million new cases of cancer, the equivalent of about 5,000 cases per day, and more than 600,000 cancer deaths in the United States this year.
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During the early days of the COVID-19 pandemic, many people skipped regular medical exams, and some doctors saw an increase in advanced cancer cases as a result of late screening and treatment due to the pandemic.
The American Cancer Society researchers were unable to track "that reduction in screening that we know we're all seeing during the pandemic," Knudsen said.
"I think next year around this time our report will give an initial idea of what the impact of the pandemic was on cancer incidence and cancer mortality."
"The Continuation of the Good News"
The new report includes data from national registries and programs, including those from the National Cancer Institute, the US Centers for Disease Control and Prevention (CDC), and the North American Association of Central Registries. of Cancer.
The data showed that the US cancer death rate increased during most of the 20th century, largely due to an increase in smoking-related lung cancer deaths.
Then, as smoking rates declined and improvements in early detection and treatments for some types of cancer increased, there was a decline in the cancer death rate from its peak in 1991.
Since then, the pace of the decline has slowly picked up.
Mammography studies.
The new report found that the five-year relative survival rate for all cancers combined increased from 49% for diagnoses in the mid-1970s to 68% for diagnoses between 2012 and 2018.
The types of cancer that now have the highest survival rates are thyroid at 98%, prostate at 97%, testicular at 95% and melanoma at 94%, according to the report.
Current survival rates are lowest for pancreatic cancers, at 12%.
The finding about a declining cancer death rate shows "continuing good news," said Dr. Otis Brawley, a professor of oncology at Johns Hopkins University who was not involved in the research.
"The main reason for the decline that began in 1991 was that the prevalence of smoking in the United States began to decline in 1965," said Brawley, former medical director of the American Cancer Society.
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"That's why we started to have a decline in 1991, and that decline has continued because the prevalence of people who smoke in the United States has continued to decline," he said.
"Now, for certain diseases, our treatment capacity has improved and thanks to that there are some people who do not die."
Some types of cancer are on the rise
Although the cancer death rate has been steadily declining, the new report also notes that new cases of breast, uterine and prostate cancer are "troubling" and on the rise in the United States.
According to the report, breast cancer incidence rates in women have increased by about 0.5% per year since the mid-2000s.
The incidence of uterine cancer has increased by approximately 1% per year since the mid-2000s among women aged 50 years and older and by almost 2% per year since at least the mid-1990s in younger women.
The prostate cancer incidence rate increased 3% per year from 2014 to 2019, after two decades of decline.
Knudsen called prostate cancer "an outlier" as the earlier decline in its incidence has been reversed, and appears to be driven by diagnoses of advanced disease.
This Thursday, the American Cancer Society announced the launch of the Impact initiative, aimed at improving prostate cancer incidence and mortality rates by funding new research programs and expanding support for patients, among other initiatives. .
“Unfortunately, prostate cancer remains the most frequently diagnosed malignancy among men in this country, and nearly 290,000 men are expected to be diagnosed with prostate cancer this year,” Knudsen said.
Cancer diagnosed when it is confined to the prostate has a five-year survival rate of "more than 99%," he said, but for metastatic prostate cancer there is no lasting cure.
“Prostate cancer is the second leading cause of cancer death among men in this country,” he said.
“What we are reporting is not just an increase in the incidence of prostate cancer in all demographic groups, but a 5% year-over-year increase in the diagnosis of men with more advanced disease.
So we're not detecting these cancers early, when we have a chance to cure men."
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“It is time we took health inequalities seriously”
Breast, uterine, and prostate cancers also have large racial disparities, with communities of color having the highest death rates and the lowest survival rates.
In 2020, the overall risk of death from cancer was 12% higher in black people than in white people, according to the new report.
“Not all individuals and not all families are affected equally,” Knudsen said.
For example, "Unfortunately, black men have a 70% increase in prostate cancer incidence compared with white men and a two- to four-fold increase in prostate cancer mortality relative to any other ethnic group." and racial in the United States," he said.
The data in the new report demonstrate "significant and consistent" advances against cancer, Dr. Ernest Hawk, vice president at the University of Texas MD Anderson Cancer Center, cancer prevention and population sciences, said in an email.
“Cancer is preventable in many cases and can be detected at an early stage with better outcomes in many others.
When necessary, treatments improve in both their efficacy and safety.
That's all good news," Hawk wrote.
“However, it is time that we take health inequities seriously and make them a much higher national priority.
Inequalities in cancer risks, in cancer care, and in cancer outcomes are intolerable, and we must not be complacent with these regular reminders of avoidable inequities,” he said.
"With deliberate and dedicated effort, I believe we can eliminate these disparities and make even greater progress in ending cancer."
CancerMedicineDeaths due to smoking