Despite the various tropes from internet scam artists, the American Cancer Society (ACS) reports a falling cancer mortality rate in the USA. Maybe we haven’t won the “war on cancer,” but cancer is definitely losing in this metaphor.
As you know, there are so many cancer myths that make the rounds on social media. Like we’re in a massive cancer epidemic. Or that “Big Pharma is hiding a secret cancer cure. Or that our ancestors never got cancer.
But I like sticking to scientific facts, and the facts are that the cancer mortality rate is dropping fast. Maybe we can’t cure every cancer, but scientists and oncologists are getting better tools every day to increase the survivability of these cancers.
What is cancer?
There are so many myths about cancer that contribute to a lot of the pseudoscientific nonsense pushed by scam artists on the internet. So, let’s digest the millions of pieces of research about cancer into a few paragraphs.
Simply, cancer is a disease in which cells of the body grow in an uncontrolled way, forming a tumor that may spread to different parts of the body. There may be around 200 types of cancer, though many have subtypes that mean there could be over a thousand types of cancer.
Each cancer has a different etiology, pathophysiology, treatment, and prognosis. Whenever I see someone imply that cancer is one disease, I know they have nothing to offer about the science of cancer.
All cancers are essentially related to mutations in the DNA of cells in the body, which can be random or caused by environmental factors. Most of the time, cells deal with these mutations by “fixing” the DNA.
However, sometimes the mutation is so serious that the cell simply dies (it’s really one cell, and cells die in your body constantly). If the mutated cell lives and divides, the body has immune defenses against most mutations – so it’s gone before you would even know that it’s there.
This means that mutations that help those cancer cells survive are selected for (yes, in an evolutionary sense). But let’s get back to the causes since the whole point of this article is to discuss methods to prevent cancer.
Although there are a few ways to significantly reduce your risk of cancer, like avoiding tobacco smoke, cancer researchers accept that most genetic mutations that lead to cancer are more or less random, just bad luck. In the 2017 study, the authors analyzed data for 32 cancer types and found that approximately two-thirds (67%) of the mutations found in these cancers resulted from random or spontaneous errors in the DNA.
You might think that it’s impossible to believe that 67% of cancers are just random, bad luck. Let’s just look at the math, revolving around the law of large numbers.
The average body has around 50 trillion cells each of which contains over 3 billion DNA base pairs. That’s 150,000,000,000,000,000,000,000 base pairs in each person.
Even though people believe that their cells are “perfect” in replicating themselves, that’s not true. Errors may occur in human cells anywhere from 0.0001% to as high as 1% of base pairs.
That could mean billions of mutations, although most are corrected by cellular machinery, it still means millions of mutations over an individual’s lifetime could lead to cancer. Of course, as someone ages, the accumulated risk of cellular mutations leads to a higher incidence of cancer over time.
Well, I’ve just insulted every oncologist in the world by digesting the science of cancer into a few paragraphs. But I hope I gave more information than your typical cancer scam artist.
Falling cancer mortality rate – the ACS study
In an article published on 12 January 2022 in the ACS peer-reviewed journal, AC: A Cancer Journal for Clinicians, by Rebecca L. Siegel of the American Cancer Society and her colleagues, the researchers reported the following key statistics:
- The cancer mortality rate dropped by 32% between 1991 and 2019.
- This rate translates to almost 3.5 million fewer cancer deaths during these years than what would have been expected if the death rate had not fallen.
- The risk of death from cancer dropped by about 2% a year from 2015 through 2019 compared to 1% a year during the 1990s.
- The researchers also reported a 2.2% drop in the cancer death rate from 2016 to 2017, the largest single-year reduction ever recorded.
- Black women have a 41% higher breast cancer death rate than white women even though their incidence of breast cancer is 4% lower.
- Cancer survival rates are lower for Black people than for White people for almost every cancer type.
- American Indians and Alaska Natives (AIANs) have the highest liver cancer incidence of any major racial/ethnic group in the US. The risk of developing liver cancer among AIANs is more than double that in White people.
- Although the cancer incidence rate among children has been increasing some since the mid-1970s, cancer death rates in children have declined by 71% since 1970, largely due to improvements in treatment and more children taking part in clinical trials.
- Leukemia remains the most common childhood cancer, accounting for 28% of all cancers in children. Death rates for leukemia went down by 84% from 1970 through 2019.
- Similar to children, cancer incidence rates among adolescents have increased slightly for decades, while the cancer death rate declined by 61% from 1970 to 2019
- Brain and other nervous system tumors are the most common type, accounting for about 21% of cancers in adolescents, followed by lymphoma (19%).
Some of the factors that contributed to the reduced cancer mortality rate include:
- Chemotherapy after surgery for breast and colon cancer.
- Combination treatments, surgery plus adjuvant therapy (chemotherapy, immunotherapy, and radiation therapy) for many cancers.
- Prevention and/or early detection through screening for some cancers, including cancer in the breast, cervix, colon, prostate, rectum, and lung.
Lung cancer
Lung cancer deserves a separate section because it is the most deadly cancer, and its cause can be narrowed down to one thing — tobacco smoking
The percentage of people living at least 3 years after diagnosis of lung cancer rose from 19% in 2001 to 21% in 2004 and 31% in 2015 through 2017, and median survival increased from 8 to 13 months. Earlier diagnosis and improved treatments have led to these increases. Furthermore, lung cancer incidence declined from 2009 to 2018 by almost 3% annually in men and 1% annually in women.
Much of the drop is because of a lower rate of smoking — in the USA, smoking rates have dropped to around 12.5% of Americans. Unfortunately, in 2019, 27% of men without a high school education smoked cigarettes compared to 6% of men with a college degree. This is partly due to tobacco companies specifically marketing in neighborhoods where many people have low incomes.
- Lung cancer still causes more than 350 deaths each day, which is the highest number of deaths for all types of cancer — more than breast, prostate, and pancreatic cancers combined. It causes 2.5 times more deaths than colorectal cancer, the second leading cause of death from cancer in the US.
- About 8 out of 10 (81%) deaths from lung cancer in 2022 are expected to be caused by smoking cigarettes. Both the amount and how long someone smokes increase the risk of dying from lung cancer. People who smoke are about 25 times more likely to develop lung cancer than those who never smoked.
- Second-hand smoke causes almost 3% of new diagnoses of lung cancer and is expected to cause about 3% of deaths from it in 2022.
Other cancers
- Prostate cancer. The risk of dying from prostate cancer decreased by about 50% from the mid-1990s to the mid-2010s due to improved treatment and earlier detection through screening with prostate-specific antigen (PSA) testing, which helps find cancer when it is only in the prostate (localized).
- Breast cancer. In females, breast cancer incidence rates have been slowly increasing by about 0.5% a year since the mid-2000s. This rise in diagnoses is due in part to more women having obesity, having fewer children, or having their first baby after age 30. Declines in breast cancer mortality rate have slowed in recent years, probably related to rising incidence as well as unchanged mammography rates.
- Liver cancer. The occurrence of liver cancer, which is one of the most fatal, has stabilized. Just a few years ago, it was the most rapidly increasing cancer.
- Cervical cancer. Despite being one of the most preventable cancers (get the HPV vaccine, if it’s not clear), cervical cancer is persistently the second leading cause of cancer death in women aged 20 to 39 years. In total, 4152 women died from cervical cancer in 2019, one-half of whom were in their 50s or younger. Moreover, diagnoses among young women are driving the rising incidence of advanced disease and cervical adenocarcinoma, for which pap smears are less effective at prevention and early detection compared with squamous cell carcinoma. Let me repeat myself — get the HPV vaccine.
Falling cancer mortality rate – better treatments
One of those laughable and unsupported tropes of the internet is that Big Pharma and oncologists do nothing to reduce cancer deaths. They just want patients to shell out money month after month just to die.
Well, we’ve shown you deniers that that is not true. And no, the falling cancer death rates don’t result from everyone chugging their blueberry-kale smoothies (see Note 1). The decline results from earlier detection techniques and better treatment strategies.
Cancer treatment isn’t guesswork (again, despite the laughable claims of pseudoscience-pushing scam artists). It usually is a strategy that employs surgery (if indicated) plus adjuvant therapies like chemotherapy (see Note 2), radiation therapy, and immunotherapy.
For example, the steepest decline in cancer deaths was seen for melanoma skin cancer. This resulted, in part, from new immunotherapy drugs approved by the FDA in 2011. The researchers found the following:
- The overall melanoma mortality rate dropped by nearly 7% per year from 2013 to 2017 in individuals aged 20-64 and 5-6% in individuals 65 and older.
- The improvement in the oldest age group is important because the mortality rates before the release of the new drugs were increasing.
Summary
The falling cancer death rates in the USA are encouraging. And, of course, it contradicts the false narratives from those internet scammers who want you to believe that their urine therapy or other equine feces are THE treatment for cancer.
Or that Big Pharma and Big Oncology are in a giant conspiracy to let everyone die from cancer.
Or that we’re all dying from cancer because…reasons. Maybe not drinking enough blueberry-kale smoothies.
A real scientific study says otherwise. And the news is mostly good. We’re beating cancer, and given the news over the past two years, I’ll take that any day.
Notes
- I have nothing against blueberries or kale. Well, I think kale is nasty, but that’s an opinion, not a scientific claim. I use the “blueberry-kale smoothie” as a strawman for “natural” food claims that aren’t supported by any science. But seriously, who would make a blueberry-kale smoothie?
- There seems to be a belief that chemotherapy is just one drug (usually “mustard gas). It’s not. There are over 100 chemotherapy drugs, but even then, the formulation, mode of delivery, dose, and other considerations mean that chemotherapy drugs are used differently for each cancer.
Citations
- Nowak MA, Waclaw B. Genes, environment, and “bad luck”. Science. 2017 Mar 24;355(6331):1266-1267. doi: 10.1126/science.aam9746. PubMed PMID: 28336626.
- Siegel, RL, Miller, KD, Fuchs, HE, Jemal, A. Cancer statistics, 2022. CA Cancer J Clin. 2022. doi: 10.3322/caac.21708
