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The newly released 2021 Annual Report to the Nation on the Status of Cancer found that the rate of death for more than half of the most common cancers for men and women in the United States declined between 2014-2018. Cancer death rates also decreased among children and young adults for this same period. Overall, cancer death rates decreased, on average, 2.2% per year among males and 1.7% per year among females.

Headshot of Lisa Carey
UNC Lineberger’s Lisa Carey, MD, FASCO, the Richardson and Marilyn Jacobs Preyer Distinguished Professor in Breast Cancer Research.

Lisa A. Carey, MD, FASCO, deputy director of clinical sciences at UNC Lineberger Comprehensive Cancer Center and the Richardson and Marilyn Jacobs Preyer Distinguished Professor in Breast Cancer Research, said the findings demonstrate that significant progress is being made in some areas, but it also outlines important shortcomings, especially in eliminating cancer-related racial disparities.

“This report shows we are doing many things right for a number of cancers, but it is clear we need to redouble our efforts to develop better therapies and approaches for underserved populations. Even more ideally, we should aim to prevent the onset of cancer outright,” Carey said.

Fourteen of the 20 most common cancers in women, and 11 of the 19 most common cancers in men showed decreases in mortality. Lung cancer and melanoma had the greatest decline in death rates. However, recent trends of declining death rates for prostate, colorectal and female breast cancers slowed or were flat. Also, several cancers became more deadly, including cancers of the bone, mouth and throat, pancreas, and brain in men, and cancers of the uterus, liver, pancreas, and brain among women.

The report, published in the JNCI: The Journal of the National Cancer Institute, also had mixed news for the incidence of cancer between 2013 and 2017.

The incidence rates in men were lower for six cancers, including lung, laryngeal, bladder, colorectal and brain, but up for five cancers, including melanoma, cancer of the testes, skin, kidney and renal, mouth and throat, and pancreas. The rate at which women were diagnosed for six cancers, including ovary, lung, colorectal and thyroid decreased, but the incidence rates increased for eight of the 18 most common cancers, including liver, melanoma, uterus, pancreas, breast, and mouth and throat. The incidence of cancer also increased in children, adolescents and young adults.

The findings also identified longstanding race-related disparities in cancer survival. Rates of developing cancer were similar amongst White and Black Americans, and death rates decreased in all racial and ethnic subsets. However both Black women and Black men continued to have the highest death rates of all groups; with 10-20% worse survival compared with White cancer patients.

Carey said she is encouraged by the greater investments being made to support research investigating the differences in cancer incidence and outcomes, especially as it relates to racial differences in treatment and survival, but she said the pace of discovery must happen more quickly.

“Despite the many advances in how we diagnose, treat and prevent cancer, not everyone has benefited equally,” Carey said. “For example, Black women who are diagnosed with breast cancer continue to have a 40% higher risk than white women of dying from their cancer. Similar disparities are true with other cancers. This is unacceptable; we need to better understand the reasons for these disparities in order to fix them.”