Cancer Death Risk Keeps Dropping, But Alarms Raised Over Rise in Prostate Cancer

The National Desk - January 18, 2023 5:25 pm

FILE - A scientist cuts thin sections from a tissue biopsy that has been preserved in wax, to be then placed on microscope slides for analysis. (Photo by Dan Kitwood/Getty Images/Cancer Research UK)

An annual report from the American Cancer Society shows both the “exciting” and “concerning” in cancer trends, while the overall cancer death rate continues its big drop from decades past.

There’s been a steep drop, 65%, in cervical cancer incidence in young women who were the first to get the human papillomavirus vaccine when it was introduced in 2006.

The American Cancer Society says the HPV vaccine has the potential to virtually eliminate cervical cancer.

“That’s very, very exciting news, because it’s just the tip of the iceberg in terms of what we expect to see both for overall cervical cancer incidence and other cancers that are caused by HPV,” said Rebecca Siegel, the lead author of the report and senior scientific director of Surveillance Research at the American Cancer Society.

Siegel said it’s important for both girls and boys to be vaccinated against HPV, which is sexually transmitted and linked to cancers of the cervix, anus and penis, along with some oral cavity cancers.

But it wasn’t all good news from this year’s report.

Siegel highlighted the “concerning trend” of more prostate cancer cases, especially advanced-stage cases.

“We found an increase in prostate cancer incidence of 3% per year since 2014, which is a pretty steep increase and a reversal in the progress that we have seen in the previous decade, where there had been declines of about 4% per year,” Siegel said.

This unwanted change stems from a drop in screenings – the prostate specific antigen, or PSA, screening.

That’s a blood test that can catch prostate cancer early.

But it also fell out of favor about a decade ago because of over diagnosis and overtreatment.

“The problem with that is … you’re treated for cancer that would never hurt you,” Siegel said. “And the (radiation) treatments for prostate cancer can have very devastating side effects, including sexual dysfunction (and) urinary dysfunction. So, it was a real problem.”

Prostate cancer is the second-leading cause of cancer deaths in men, so a drop in screenings is also a big problem.

“Although there were major issues with the way PSA testing was being done, we threw the baby out with the bathwater,” she said. “Because, indeed, we were diagnosing prostate cancers that would have been fatal.”

Another concern is the large racial disparity for prostate cancer, Siegel said. Black men are two times more likely to die from prostate cancer than white men and four times more likely to die from prostate cancer than Asian and Hispanic men.

Siegel said they’re recommending more moderated and targeted PSA screenings. That means “active surveillance or watchful waiting” for men with a certain PSA level instead of immediately starting treatment.

The hope is they can save lives while avoiding unnecessary or difficult treatments.

The overall cancer death rate has fallen 33% from its peak in 1991, according to the American Cancer Society.

That’s estimated to have saved about 3.8 million people.

The cancer death rate in males and females combined has declined by 33% since its peak in 1991. (American Cancer Society)

Still, cancer is the second most common cause of death in the U.S., after heart disease. And the American Cancer Society projects nearly 2 million new cancer cases and more than 600,000 cancer deaths in the U.S. this year.

That’s over 5,300 Americans each day finding out they have cancer.

That’s over 1,600 Americans losing their lives to cancer each day.

In 2023, a little over 1.9 million new cases of cancer are expected to be diagnosed in the United States. Prostate cancer is the most common cancer among males (29%), followed by lung (12%) and colorectal (8%) cancers. Among females, breast (31%), lung (13%), and colorectal (8%) cancers are the most common. (American Cancer Society)

Lung cancer is the leading cause of death from cancer, and much of the drop in the overall cancer death rate can be tied to a decline in lung cancer deaths.

The lung cancer death rate dropped by 58% from 1990 to 2020 in men and by 36% from 2002 to 2020 in women.

Siegel said that’s largely been driven by a reduction in smoking, which makes lung cancer one of the more preventable cancers.

But nonsmokers still get lung cancer, and Siegel said they still have a lot of work to do to “understand why those other lung cancers are occurring.”

While work continues to improve screenings and treatment, Siegel said people hold a lot of the power themselves to reduce their risks.

“I think the most important thing people can do is maintain a healthy body weight,” she said. “Don’t smoke, stay active and talk to your doctor about regular cancer screenings. Some people who have a family history of cancer can really, really reduce their risk by getting appropriate screenings earlier than other people.”


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