March 3, 2007

U.S. Cancer Deaths Decline For Second Straight Year, Though Mortality Rates Still Higher For Blacks Than Whites

The number of cancer deaths in the U.S. declined by 3,014 from 2003 to 2004, marking the second consecutive decline in annual cancer deaths, according to an American Cancer Society report released on Wednesday, the New York Times reports. ACS said the decline over two years indicates that the decrease in cancer deaths from 2002 to 2003 -- the first in more than 70 years -- was not a statistical fluke but potentially an emerging trend driven by smoking cessation increases and better detection and treatment of the most common types of cancers (Grady, New York Times, 1/17). For the report, ACS researchers reviewed U.S. death certificate data from 2004 compiled by the National Center for Health Statistics (Detroit Free Press, 1/18). Last year's report found that U.S. cancer deaths declined by 369 from 2002 to 2003. According to the new report, total cancer deaths in the U.S. decreased from 556,902 in 2003 to 553,888 in 2004 (Stein, Washington Post, 1/18). The cancer death rate -- the number of cancer deaths per 100,000 U.S. residents -- declined by about 2% in 2004, the same rate as in 2003, the report found. Prior to 2003, the cancer death rate had decreased about 1% annually for more than 10 years, but the total number of deaths continued to increase because of the growing and aging population (Stobbe, AP/Washington Examiner, 1/17).

The overall drop in the number of cancer deaths was driven by a decrease in deaths among men and women for three of the four most common types of cancer -- breast, prostate and colorectal -- although there was an increase in deaths from some other types of cancer, according to the report. Deaths from lung cancer, the most common cause of cancer death among both men and women, declined among men but increased among women. The report found:

  • The largest decline in death was seen in colorectal cancer, with 1,110 fewer men and 1,094 fewer women dying from the disease;

  • Women's deaths from breast cancer decreased by 666, and men's deaths from prostate cancer declined by 552;

  • Lung cancer deaths declined by 333 among men and increased by 347 among women (Washington Post, 1/18); and

  • There was an increase in deaths from some types of cancer, including esophageal cancer in men and liver cancer in men and women (New York Times, 1/18).

The report also identified racial disparities in cancer rates and deaths. Black women had a 9% lower cancer rate than white women but an 18% higher death rate. Black men had a 15% higher cancer rate and a 38% higher death rate than white men (Manning/Sternberg, USA Today, 1/18).

Common Cancers, Causes
The report also examined cancer rates by type and the causes of cancer. The report found:

  • Leukemia was the most common cause of cancer death among males younger than age 40 and females younger than age 20;

  • Lung cancer was the most common cause of cancer death among men age 40 and older and women age 60 and older;

  • Breast cancer was the most common cause of cancer death among women ages 20 to 59 (Bavley, Kansas City Star, 1/18);

  • Nearly one-third of cancer deaths are caused by tobacco use;

  • About one-third of cancer deaths are linked to obesity, poor nutrition and inactivity;

  • Five percent of cancer deaths are from hereditary causes; and

  • Other cancer deaths result from infections, sun exposure or other environmental factors (Harper, Washington Times, 1/18).

Authors' Comments
Elizabeth Ward, a managing director in epidemiology and surveillance at ACS and an author of the report, said the overall decline in deaths from cancer "really reflects the years of effort and investment in tobacco control, programs for early detection and screening, and programs in clinical and basic research." Ward said the decrease in deaths from colorectal cancer was largely driven by increased screenings, including colonoscopy and sigmoidoscopy, which can detect the disease in its earliest and most treatable stages (New York Times, 1/18). Report co-author Ahmedin Jemal, a cancer epidemiologist, said that lung cancer deaths among women have not declined because "[w]omen lag about 10 to 20 years behind men in their smoking patterns," also noting that women's lung cancer deaths could decline in future years (Washington Post, 1/18). Ward said deaths from lung cancer appear to be plateauing among women now as they did among men about 15 years ago. She said the increase in esophageal cancer in men likely was linked to obesity, which increases the risk of acid reflux that can cause the disease. The increase in liver cancer cases likely was the result of hepatitis infections, although obesity also might have played a role, Ward said (New York Times, 1/18). Ward said the higher cancer death rates among blacks than whites is concerning, adding, "[W]e have to figure out a way to make sure to reach all populations with the information they need to prevent cancer, and make sure that all populations have access to early detection and treatment ... so that 10 to 20 years from now we don't see the same big differences." (New York Times, 1/18).

Additional Comments, Funding Outlook
ACS CEO John Seffrin said, "This second consecutive drop, ... much steeper than the first, shows last year's historic drop was no fluke" (Maugh/Gellene, Los Angeles Times, 1/18). President Bush, who visited NIH on Wednesday to mark the release of the report, said funding for cancer research is "up about 25%" since 2001 (CQ HealthBeat, 1/17). Bush said of the report, "These are tangible results as a result of the research that takes place around the country" (Lite, New York Daily News, 1/18). Martin Abeloff, director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, said, "There is no doubt that there has been a substantial investment in this research." He added, "What is ironic about (the drop in cancer deaths) is that at exactly this time the federal funding is not only flat, but it's decreasing. That is something of great concern to those of us who are looking at what we can do with advances in the future" (Emery/Rockoff, Baltimore Sun, 1/18). Doug Ulman, president of the Lance Armstrong Foundation, said, "The president and the Congress have clearly not prioritized cancer during the past several years and that is a major problem," adding that Bush and Congress "must keep this nation's research momentum moving forward or we run the risk of going backwards" (Herman, Cox/Atlanta Journal-Constitution, 1/18).

The report is available online. Note: You must have Adobe Acrobat Reader to view the report.

Broadcast Coverage
Several broadcast programs reported on the report. Summaries appear below.

  • NPR's "All Things Considered": The segment includes comments from Michael Thun, who tracks data for ACS; Tim Byers, deputy director of the University of Colorado Cancer Center; and Bernard Levine, vice president for cancer prevention and population science at the M.D. Anderson Cancer Center at the University of Texas-Houston (Knox, "All Things Considered," NPR, 1/18). In addition, "All Things Considered" included an interview with Allen Lichter, executive vice president and CEO of the American Society for Clinical Oncology (Block, "All Things Considered," NPR, 1/17).

    Audio and a transcript of the first segment is available online. Audio and a transcript of the second segment also is available online.

  • PBS' "NewsHour With Jim Lehrer": The segment includes comments from Harmon Eyre, chief medical officer at ACS (Warner, NewsHour With Jim Lehrer," PBS, 1/17).

    Audio of the segment is available online.

  • NBC's "Nightly News": The segment includes comments from Eyre (Bazell, "Nightly News," NBC, 1/17).

    Video of the segment is available online.

"Reprinted with permission from You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at The Kaiser Daily Health Policy Report is published for, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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