United States: Decline in cancer mortality, particularly lung cancer

The risk of dying from cancer in the United States has declined over the past 28 years, according to annual statistics published by the American Cancer Society (ACS).[1]Combined cancer death rates for men and women fell by 32% from 1991 to 2019, the most recent year for which data were available.

Cancer is a major public health problem worldwide and the second leading cause of death after cardiovascular disease in the United States. The risk of dying from cancer has fallen by nearly a third in three decades, thanks to earlier diagnosis, better treatments, and a decline in smoking.[2].

A decrease in lung cancer mortality and slightly improved survival

The overall cancer death rate in 2019 fell by about a third (32%) from its peak in 1991, from 215 deaths per 100,000 people to 146. This drop means that about 3.5 million premature deaths were prevented during this period. In 2019, about one in four cancer deaths were among lung cancer patients. However, this relative share of mortality attributable to lung cancers is declining more rapidly. Indeed, lung cancer death rates fell by about 5 TP3T each year between 2015 and 2019, while overall cancer mortality fell by about 2 TP3T during this period.

For all lung cancers, 3-year survival increased from 19 % in 2001 to 21 % in 2004, then 31 % from 2015 to 2017, with a median survival rate that increased from 8 to 13 months, which confirms the still too modest effectiveness of current treatments. This improvement in survival is largely due to earlier diagnosis of the disease; thus, every year from 2014 to 2018 the rate of diagnosis at a localized stage increased by 4.5 % per year.

Decline in smoking has contributed to decline in lung cancer incidence

According to the ACS, this decline in lung cancer mortality is essentially linked to the decline in its frequency, due to the reduction in tobacco consumption which fell from 21% of the adult population in 2005 to 14% in 2019.[3]The organization calls for the continuation of targeted programs on tobacco prevention and cessation, which have a significant impact on reducing mortality from this cancer.

Although these results are encouraging, lung cancer remains the leading cause of cancer death, and the ACS predicts that in 2022 there will still be approximately 1.9 million new cancer diagnoses and more than 609,000 cancer deaths in the United States, including nearly 240,000 new cases of lung cancer with 130,000 deaths. Approximately 106,000 of these 130,000 deaths will be directly caused by smoking, and another 3,650 by secondhand smoke (a total of nearly 85% of lung cancers), knowing that other cancer sites are, at least in part, linked to smoking, such as cancers of the bladder, throat, esophagus, pancreas, etc. The ACS finally points out that quitting smoking after a cancer diagnosis improves overall survival compared to patients who have not quit smoking.[4]. Thus, stopping smoking is important for preventing cancer, but also for improving patient survival.

Keywords: United States, cancers, lung cancer, smoking, smoking cessation

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[1] Rebecca L. Siegel, MPH; Kimberly D. Miller, MPH; Hannah E. Fuchs, B.S.; Ahmedin Jemal, DVM, PhD, Cancer statistics, 2022, American Cancer Society, doi: 10.3322/caac.21708. Available online at cacancerjournal.com [2] Press release, Risk of Dying from Cancer Continues to Drop at an Accelerated Pace, American Cancer Society, published January 12, 2022, accessed January 14, 2021 [3] Current Cigarette Smoking Among Adults in the United States, CDC, last updated December 10, 2020, accessed January 14, 2021 [4] Caini S, Del Riccio M, Vettori V, Scotti V, Martinoli C, Raimondi S, Cammarata G, Palli D, Banini M, Masala G, Gandini S, Quitting smoking at or around diagnosis improves the overall survival of lung cancer patients: a systematic review and meta-analysis, Journal of Thoracic Oncology (2022), doi: https://doi.org/10.1016/j.jtho.2021.12.005. National Committee Against Smoking |