“We’re encouraged by the steady drop in cancer mortality as a result of less smoking, earlier detection for some cancers and improved treatment,” said Rebecca Siegel, senior scientific director of surveillance research at the American Cancer Society and lead author of the report.
But she said the nation still has dropped the ball on cancer prevention.
Incidence rates continue to rise for many common cancers, like breast, prostate and endometrial, as well as colorectal and cervical cancers in some young adults, the report says.
Rising colorectal cancer incidence has shifted mortality patterns in adults under 50 years of age. Two decades ago, colorectal cancer was the fourth-leading cause of cancer death in younger men and women, the report says. Now, its first and second-leading causes of cancer death for men and women, respectively.
Breast cancer leads in women under 50 with 2,251 deaths in 2021.
“The continuous sharp increase in colorectal cancer in younger Americans is alarming,” said Dr. Ahmedin Jemal, senior vice president of surveillance and health equity science at the American Cancer Society.
Local oncologists are also seeing younger patients on a more frequent basis.
“We see it routinely now,” said Dr. James Ouellette, a surgical oncologist at Premier Surgical Oncology. Potential factors could include diet, obesity, environmental factors and/or some other type of exposure that people have not historically seen.
“I don’t know that we have ... a good answer,” Ouellette said.
The increased cancer diagnoses could also be a delayed outcome from other factors in the past.
“The reason is not very clear,” said Dr. Alejandro Calvo, a medical oncologist with Kettering Health. “Some of the experts that look at all this epidemiology feel that they may be related to risk factors like obesity, because a lot of that generation born in the 1950s that is showing up with this earlier diagnosis of colorectal cancer, they’ll have a high incidence of that.
When there are cancer-causing factors present, such as smoking, Calvo said there may be a 20- or 30-year delay before the incidence of cancer starts going up.
“One of the examples is tobacco. The tobacco epidemic started in the early 1900s. We did not see the high incidence of lung cancer until 20 or 30 years later,” Calvo said.
Doctors are hopeful that less invasive screening methods may encourage more people get routine screenings, particularly people with a family history of colon cancer. Up to one-third of people diagnosed before 50 have a family history or genetic predisposition and should begin screening before age 45, this new report shows.
Doctors suggest that increased screening efforts are one reason for the decline in cancer deaths. There has also been reduction in smoking in the U.S., Calvo said.
“We also have significant improvements of treatment of cancer at all stages,” Calvo said.
Treatments can include surgery, chemotherapy and radiation, as well as certain targeted immunotherapies, he said.
Doctors are also learning more about each individual cancer case to give patients more personalized medicine.
“We have a good idea of what generally works for a type of cancer, but the more we actually learn about the tumor very specifically, the better we are at trying to treat that person’s specific tumor,” Ouellette said.
Other significant findings in the American Cancer Society’s report include findings in regard to cervical cancer. Significant decreases in cervical cancer among certain groups is revealing the impact of the HPV vaccine.
“If you look at the women 30 to 44 years old, the incidence of cervical cancer was higher than expected. Whereas, if you look at the group of women between 20-25, the incidence of cervical cancer was down 65% and the only difference in those two groups other than age is that the younger group had vaccinations for HPV,” Calvo said.
Doctors are hopeful other HPV-related cancers will also continue to decrease because of the HPV vaccine.
“We’ve been adamant to get that implemented throughout the teen years. It will take many years to see the effect of that,” Ouellette said.
Additional facts and figures from the American Cancer Society can be found at cancer.org.
By the numbers
Highlights in the American Cancer Society’s newest report:
- Six of the top 10 cancers are increasing in incidence, as the projected number of new diagnoses in 2024 now tops 2 million (2,001,140) for the first time.
- Approximately 611,720 deaths from cancer are expected in the U.S. in 2024, which is about 1,675 deaths per day. Cancer is the second most common cause of death in the U.S., exceeded only by heart disease.
- The National Cancer Institute estimated that cancer-related medical costs in the U.S. were $208.9 billion in 2020.
- The list price for many prescription medicines for cancer treatment is more than $100,000 annually.
- Cancer-related costs to patients are estimated at $21.1 billion, including $16.2 billion in total out-of-pocket costs and $4.9 billion in patient time costs (travel to and from treatment, plus waiting for and receiving care).
- Cervical cancer incidence rates are decreasing steeply in women in their 20s, who were first to receive the HPV vaccine, but are increased in women 30-44 years old by 1.7% per year from 2012 through 2019.
- After decades of increase, cancer incidence in children has leveled off, although rates continue to increase among adolescents (ages 15-19 years), including a greater than 4% per year rise in thyroid cancer, much of which is likely overdiagnosis; the 15-year survival rate for thyroid cancer in adolescents is 99%.
- Mortality rates continue to increase by 2% per year for uterine corpus (endometrial) cancer, one of the few cancers with increasing mortality.
- Steeper increases in women of color are widening racial disparities for endometrial cancer, with the death rate now two times higher in Black women (9.1 per 100,000) than in white women (4.6 per 100,000).
- Cancer patients are getting younger: the proportion of diagnoses in people who are middle-aged (50-64 years) increased from 25% in 1995 to 30% in 2019-2020.
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