On the Rise Globally, Cancer Mortality Declines in U.S.

Although the U.S. death toll from cancer has declined for 2 decades, cancer deaths continue to rise globally, according to separate reports released in December that detail the latest cancer statistics.

From 2001 to 2010, the U.S. cancer death rate dropped 1.8% per year for men and 1.4% per year for women, according to the Annual Report to the Nation on the Status of Cancer, coauthored by the American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries. The lung cancer death rate declined the most, with a total decrease of 29.3% from 2001 to 2010.

Worldwide, however, cancer deaths rose from 7.6 million in 2008 to 8.2 million in 2012, according to the GLOBOCAN 2012 report from the World Health Organization's International Agency for Research on Cancer (IARC). The most common cause of death was lung cancer.

Treatment advances and decreases in smoking deserve the majority of the credit for improvements in U.S. lung cancer mortality, says Clifford A. Hudis, MD, president of the American Society of Clinical Oncology and chief of the Breast Cancer Medicine Service at Memorial Sloan-Kettering Cancer Center in New York, NY. Internationally, Hudis says, high rates of smoking are mostly to blame for the 1.8 million lung cancer diagnoses and 1.6 million deaths highlighted in IARC's report, up from 1.6 million and 1.4 million respectively in 2008.

“In many parts of the world, there's nothing like the antismoking messages here in the U.S.,” says Hudis.

Hudis expects lung cancer mortality rates in the United States to fall further as more physicians begin to screen older patients with a history of heavy smoking, based on new guidelines from the U.S. Preventive Services Task Force issued in in December.

The two reports also revealed an alarming disparity in breast cancer incidence and mortality between the United States and the rest of the world. Domestically, breast cancer incidence remained stable between 2001 and 2010, with a 15.6% decrease in mortality during that span.

Worldwide, breast cancer killed 522,000 women in 2012, up 14% from 2008. Incidence rates also rose—by more than 20%—from nearly 1.4 million cases in 2008 to 1.7 million in 2012.

Hudis suspects the explanation is fourfold. Many countries now have the resources to more accurately diagnose and report breast cancer. Populations are growing, and women around the world are living longer. “Worldwide, age remains the single greatest risk factor for breast cancer,” Hudis says.

The fourth possible reason is a global trend toward overweight and obesity. “With broad adoption of the Western lifestyle and diet, maybe we're beginning to see some impact on diseases such as breast cancer that are associated with obesity,” Hudis adds.

While incidence rates remain highest in more developed countries, the GLOBOCAN data show mortality rates are greatest in less developed countries because of lack of early detection and access to treatment.

“We can save millions of lives if we could just broadly apply what we've successfully applied in the West,” Hudis notes.