Updated on September 14, 2023.
Over the past decade, cancer deaths have dropped dramatically due to recent advances in treatment and early detection of the disease as well as prevention, research shows.
Between 1991 and 2020, overall death rates from cancer dropped by 33 percent, according to the 13th edition of the American Association for Cancer Research (AACR) Progress Report 2023. That decrease may translate into 3.8 million deaths averted over that period of time. The AACR report, which was released on September 13, points out this positive trend is likely due in large part to research breakthroughs, which have resulted in more than a dozen new cancer therapies.
The U.S. Food and Drug Administration (FDA) approved 14 new anticancer drugs from August 2022 to July 2023, including treatments for ovarian cancer, certain types of bladder cancer, and several types of blood cancers. During this time, the FDA also expanded use of 12 previously approved therapies for the treatment of additional types of cancer, the AACR 2023 report revealed.
“The advances in cancer research, particularly in the last two decades, have been breathtaking,” AACR President Philip Greenberg, MD, FAACR, faculty member at Fred Hutchinson Cancer Center, said in a press release. “We are in an era of unparalleled opportunity to make even more breakthroughs for patients.”
Much of these breakthroughs involve immunotherapy which has “revolutionized” cancer care, according to the AACR. Since 2011, the FDA has approved 11 immune checkpoint inhibitors that essentially release the “brakes” on immune cells called T-cells, so that they can seek out and destroy cancer cells. Immune checkpoint inhibitors are now treatment options for 20 types of cancer, and any tumors with specific molecular characteristics that T-cells can attack.
The AACR also reports that six CAR T-cell therapies have been approved by the FDA since 2017. CAR T-cell therapies use someone’s own T-cells, which are drawn from blood in their arm then genetically engineered in a lab and injected back into the patient to expand their number of cancer-killing T-cells. The therapy is used to treat a range of blood cancers.
Progress against common cancers
In addition to advances in cancer treatment, progress in cancer prevention and early detection, including smoking cessation programs, use of the HPV vaccine, and routine mammograms, have contributed to declining death rates.
In February 2023, the American Cancer Society (ACS) also reported the same drop in cancer death rates over the past decade, according to the ACS 2023 annual report published in CA: A Cancer Journal for Clinicians.
About 127,000 Americans are projected to die from lung cancer in 2023, according to the ACS report. But new diagnoses of lung cancer – the second most common cancer in both women and men—have steadily declined at about 1.1 percent per year in women and 2.6 percent per year in men since 2006. Deaths from the disease are decreasing at an even faster pace.
Cigarette smoking is linked to 20 percent of all cancers and approximately 30 percent of all U.S. cancer deaths. But over the past few decades, public health campaigns to help curb smoking combined with advancements in early cancer detection and treatment have contributed to a notable drop in lung cancer death rates.
Meanwhile, the ACS report showed a major reduction in cervical cancer incidence, which plummeted by 65 percent between 2012 and 2019 in women ages 20 to 24. This decline is likely due to the introduction of the human papilloma virus (HPV) vaccine, the group points out.
“The large drop in cervical cancer incidence is extremely exciting because this is the first group of women to receive the HPV vaccine, and it probably foreshadows steep reductions in other HPV-associated cancers,” said the report’s lead author, Rebecca Siegel, senior scientific director, surveillance research at the ACS in a press release.
Deaths from breast cancer—the most common cancer in women—declined by 43 percent between 1989 and 2020. This drop translates to roughly 460,000 fewer breast cancer deaths during this time period than would have been expected without the progress that has been made, related to greater awareness, earlier detection through routine mammograms, and treatment advancements, the ACS explained.
Similarly, new diagnoses and deaths from colorectal cancer (the third most common cancer in women and men) have generally decreased since the mid-1980s, with the exception of people younger than 50 for whom new diagnoses and deaths began to increase in the mid-1990s for unknown reasons.
Certain cancers on the rise
While rates of several other common cancers decline, cases of prostate cancer—the top cancer in men—rose by about three percent per year from 2014 to 2019, representing a reversal after two decades of declining rates. This rise is led by increased diagnoses of advanced prostate cancer, which is more difficult to treat and can be incurable. Since 2011, the proportion of men diagnosed with advanced prostate cancer with distant metastases has doubled. Rates of new cases and death from prostate cancer are highest in Black men.
To try and reverse this setback, the ACS started an initiative called IMPACT (Improving Mortality from Prostate Cancer Together), aimed at reducing disparities in prostate cancer.
“We must address these shifts in prostate cancer, especially in the Black community, since the incidence of prostate cancer in Black men is 70 percent higher than in white men and prostate cancer mortality rates in Black men are approximately two to four times higher than those in every other racial and ethnic group,” said William Dahut, MD, chief scientific officer at the American Cancer Society, in a press release.
New cases of pancreatic cancer and uterine cancer have also been steadily rising related to increasing rates of obesity, according to the AACR 2023 report.
“In order to end cancer as we know it, for everyone, it is imperative for us to focus on cancers where trends are going in the wrong direction,” Karen Knudsen, MBA, PhD, chief executive officer at the American Cancer Society, added.
Prevention and early detection are vital
Cancer is expected to claim roughly 610,000 lives in the U.S. this year, and nearly 2 million new cancer diagnoses are predicted for 2023, according to the ACS. Cancer remains the second-leading cause of death in the U.S., second only to heart disease.
It’s important to know your individual risk for the disease.
Anyone can develop cancer, but several factors increase the risk, including older age and lifestyle as well as race and ethnicity. In the U.S., people ages 50 years and older accounted for 88 percent of cancer diagnoses. Certain lifestyle factors and other things people can control may also drive up their chances of developing cancer, such as smoking, excess body weight, alcohol consumption, and an unhealthy diet.
But if you’re young, it doesn’t mean you’re risk-free. Recent years have shown a shift toward earlier age at cancer diagnosis for people born after 1950. So, a young person who is having persistent symptoms—especially if they have a family history of cancer—should get screened.
Black and Hispanic people—groups which often face barriers to care—may also be at increased risk for certain cancers. For example, Black people have a higher overall rate of death from cancers compared to whites.
There are several ways you can be proactive to help reduce your risk for certain forms of cancer, including:
Get screened: Certain cancers may be detected early on when treatments are often more successful. A 2023 study published in JAMA Oncology found that colorectal screening dropped 45 percent, breast cancer screening dropped by 40 percent, and cervical cancer screening fell 36 percent at the beginning of the COVID pandemic in 2020. After rebounding later that year, screening for these cancers declined again and had not yet returned to prepandemic levels by the end of 2021.
Screening tests are recommended for breast, cervical, colorectal, and lung cancers. There are also screening tests available to detect prostate cancer, but the risks and benefits of these tests are less clear. You should weigh the risks and benefits of cancer screenings with your healthcare provider (HCP). Together, you can determine when and how often you should be screened for certain forms of cancer based on your values, age, health preferences, and individual risk for the disease.
Some HCPs perform skin examinations to screen for skin cancer during routine checkups, but it’s important to perform regular self-checks, the ACS advises. During a skin self-exam, you should use a full length and hand mirror to look at all sides of your body—front and back as well as both sides with your arms raised. Be sure to check your elbows, forearms, underarms, the palms of your hands, the soles of your feet and the skin between your toes. A spouse, partner, or close friend or family member may be able to help you check hard-to-see areas like your back or scalp. Ideally, you should perform this skin self-exam once per month and discuss any worrisome or suspicious changes with your HCP.
Kick bad habits: Not smoking, exercising regularly, limiting your alcohol intake (or not drinking at all) and maintaining a healthy weight can help reduce your risk for cancer. For prevention, the ACS also recommends cutting back on the amount of red and processed meats you consume, opt for whole grains instead of refined grains and eat at least two and a half cups of fruits and vegetables each day. About 20 percent of all cancer cases are caused by smoking, and 18 percent are caused by a combination of alcohol, excess body weight, unhealthy diet, and lack of physical activity. In fact, being overweight or obese is associated with an increased risk for 13 types of cancer.
Prevent and treat infections: Other cancers caused by viruses, including the human papillomavirus (HPV), hepatitis B virus (HBV), and hepatitis C virus (HCV)—as well as bacteria, including Helicobacter pylori (H. pylori)—could also be prevented through vaccination or by avoiding or treating these infections.
Wear sunscreen: It’s estimated that the majority of skin cancers are caused by exposure to UV radiation, according to ACS. The most common types of skin cancer are basal cell and squamous cell cancers, which are often found on parts of the body that are most exposed to the sun. While a person’s risk of developing melanoma is associated with genetic and personal characteristics, UV exposure has also been shown to increase risk. ACS estimates that millions of skin cancers diagnosed each year could be prevented if people protected their skin by routinely applying sunscreen and avoiding indoor tanning facilities as well as other human-made sources of UV rays. For the prevention of skin cancer, the American Academy of Dermatology recommends using broad spectrum sunscreen with a sun protection factor (SPF) of at least 30 and reapplying every two hours or after swimming or sweating.
