A steady decline over more than two decades has resulted in a 25% drop in the overall cancer death rate in the United States. The reduction equates to 2.1 million fewer cancer deaths between 1991 and 2014. The findings come from Cancer Statistics 2017, the American Cancer Society’s annual report on cancer incidence, mortality, and survival. The report was published in CA: A Cancer Journal for Clinicians.

The report estimates that in 2017 there will be 1,688,780 new cancer cases and 600,920 cancer deaths in the U.S. During the past decade of available data, the overall cancer incidence rate was stable in women and declined by approximately 2% per year in men, whereas the cancer death rate declined by approximately 1.5% annually in both men and women.

The cancer death rate dropped from its peak of 215.1 per 100,000 population in 1991 to 161.2 per 100,000 population in 2014, the latest year for which data were available for analysis. The drop is the result of steady reductions in smoking and advances in early cancer detection and treatment, and is driven by decreasing death rates for the four major cancer sites: lung (–43% between 1990 and 2014 among males and –17% between 2002 and 2014 among females); breast (–38% from 1989 to 2014); prostate (–51% from 1993 to 2014); and colorectal (–51% from 1976 to 2014).

The report also finds significant gender disparities in incidence and mortality. For all sites combined, the cancer incidence rate is 20% higher in men than in women, while the cancer death rate is 40% higher in men.

The gender gap in cancer mortality largely reflects variations in the distribution of cancers that occur in men and women, much of which is due to differences in the prevalence of cancer risk factors, the report says. For example, liver cancer, a highly fatal cancer, is three times more common in men than in women, partly reflecting higher hepatitis C virus infection, historical smoking prevalence, and excess alcohol consumption in men. The largest sex disparities are for cancers of the esophagus, larynx, and bladder, for which incidence and death rates are approximately fourfold higher in men. Melanoma incidence rates are approximately 60% higher in men than in women, whereas melanoma death rates are more than double in men compared with women.

Racial disparities in cancer death rates continue to decline, according to the report. The excess risk of cancer death in black men dropped from 47% in 1990 to 21% in 2014. The black/white disparity declined similarly in women, from a peak of 20% in 1998 to 13% in 2014.

Sources: ACS; January 5, 2017; and Cancer Statistics 2017; December 2016.

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