Cancer deaths drop overall, but now top cause in many states

Early detection, better treatments contributed to 23 percent decline in two decades, report shows
Graphic by Jim Woolace / Fred Hutch News Service

Heightened health habits and better medicine are curbing cancer’s killing force in America as the nation’s death rate from all malignancies dropped 23 percent during the past two decades, a new analysis shows.

In human terms, that decrease marked more than 1.7 million deaths averted since 1991 – peak of U.S. cancer toll, according to an annual report from the American Cancer Society. That’s more than twice the population of Seattle.

“This is overwhelmingly really good news and information because, mostly, what’s being reported here is there’s been great progress in reducing the burden of cancer in the United States,” said Dr. Steve Schwartz, a member in the epidemiology program at Fred Hutchinson Cancer Research Center. 

“For those of us who have been in the business a long time – working on the research that has helped, in some of these instances, lead to these changes – it just feels like: what a great time,” added Schwartz, also principal investigator of the Fred Hutch Cancer Surveillance System.

That registry – part of the National Cancer Institute’s “Surveillance, Epidemiology, and End Results” [SEER] program – collects population-based data on cancer incidence and survival in 13 counties in western Washington State. The America Cancer Society’s annual report is based, in part, on SEER data from 1991 through 2012.

The overall decline in cancer deaths was fueled by improvements in early detections and treatments as well as fewer people using tobacco, ACS experts said.

But the report also shows that cancer’s impact rose in many large geographic pockets and among some major demographic swaths.

As heart disease deaths fell, cancer became the leading cause of death for residents in 21 states – and among both Hispanics and Asian/Pacific Islanders, who, together, compose one-quarter of the U.S. population, the report finds.

Cancer also is the No. 1 cause of death among Americans ages 40 to 79.

“I don’t think that’s terribly surprising given what we know about the ages people get cancer – and how the aging of the population is ever increasing,” Schwartz said. “So anything that strikes older people, there’s going to be more [deaths by those causes].”

Similarly, among U.S females ages 40 to 59, the number of cancer deaths was more than twice the number of heart disease deaths, while among women 60 to 69, the number of cancer deaths was nearly twice the number of heart disease deaths, the report shows.

“The numbers are important in terms of telling us [about the demographics of] people who are in need of care for cancer,” Schwartz said. “And that has a direct impact on how much money we spend on cancer.”

Reductions in the death rates of lung (down 38 percent among males, 13 percent among females), breast (down 36 percent from 1989) as well as prostate and colorectal cancers (both down about 50 percent from their peaks) helped shrink the larger American cancer toll, ACS experts noted.

But certain increases were measured in deaths caused by individual cancer types:

  • For liver cancer, there was an “annual percentage change” of 3.3 percent among males and 3.2 percent among females between 2008 and 2012.
  • For pancreatic cancer, the annual change was 0.3 percent among males and 0.4 percent among females from 2008 to 2012.
  • For uterine cancer, the annual change was 2.0 percent during that same span.
  • Thyroid cancer continues to be the most rapidly increasing cancer (less than 5 percent per year in both men and women). That’s partially “due to overdiagnosis because of the increased use of advanced imaging techniques,” the report states.

Americans also ate more fatty foods and chugged more sweetened drinks over that timeframe, possibly playing a role in some of those small spikes, experts found.

According to the National Cancer Institute, obesity is associated with elevated risks for cancers of the pancreas and uterine lining as well as of the esophagus, colon, breast, kidney, thyroid and gallbladder.

Among children and adolescents (from birth to 19 years), brain cancer has eclipsed leukemia as the leading cause of cancer death. There, the ACS researchers point to “more rapid therapeutic advances against leukemia.”

“We're gratified to see cancer death rates continuing to drop. But the fact that cancer is nonetheless becoming the top cause of death in many populations is a strong reminder that the fight is not over," Dr. Otis W. Brawley, chief medical officer of ACS, stated in an accompanying news release.

“Cancer is in fact a group of more than 100 diseases, some amenable to treatment; some stubbornly resistant,” Brawley stated. “So while the average American's chances of dying from the disease are significantly lower now than they have been for previous generations, it continues to be all-too-often the reason for shortened lives, and too much pain and suffering."

Bill Briggs is a former Fred Hutch News Service staff writer. Follow him at @writerdude. Previously, he was a contributing writer for and, covering breaking news, health and the military. Prior, he was a staff writer for The Denver Post, part of the newspaper's team that earned the Pulitzer Prize for coverage of the Columbine High School massacre. He has authored two books, including "The Third Miracle: an Ordinary Man, a medical Mystery, and a Trial of Faith." 

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