Understanding the decline in prostate, lung, and colorectal cancer rates

Much of the overall decline in new cancer rates for men is because of the recent drop in prostate cancer diagnoses. Routine screening with the PSA blood test is no longer recommended because of concerns about high rates of over-diagnosis (finding cancers that would never need to be treated). Therefore, fewer cases of prostate cancer are now being detected.

The rate of new lung cancer cases has also continued to decline as fewer people smoke. These rates are declining about twice as fast in men as in women. The differences reflect historical patterns in tobacco use, where women began smoking in large numbers many years later than men, and were slower to quit.

Recent rapid declines in new colorectal cancer cases have been attributed in part to more people getting screened with tests such as colonoscopies, which can prevent cancer through the removal of pre-cancerous growths called polyps. Among adults ages 50 years and older, colonoscopy use has tripled, increasing from 21% in 2000 to 60% in 2015. Colorectal cancer incidence rates declined by about 3% per year in both men and women from 2004 through 2013. However, in people younger than 50 years, colorectal cancer incidence rates increased by about 2% per year from 1993 to 2013.

Continued improvement in cancer disparities, but burden remains unequal

The rates of new cancer cases and cancer deaths vary quite a bit among racial and ethnic groups, with rates generally highest among African Americans and lowest Asian Americans. However, racial disparities continue to decline. The excess risk of cancer death in black men as compared to white men has dropped from 47% in 1990 to 21% in 2014. The racial disparity has also declined in black women, from a peak of 20% in 1998 to 13% in 2014.

Although the cancer death rate remained 15% higher in blacks than in whites in 2014, increasing access to care as a result of the Patient Protection and Affordable Care Act may contribute to a further narrowing of the racial gap across all population groups. In 2015, 11% of blacks and 7% of non-Hispanic whites were uninsured, compared with 21% of blacks and 12% of non-Hispanic whites in 2010. Progress for Hispanics is similar, with the uninsured rate dropping from 31% in 2010 to 16% in 2015.

Cancer in children

Cancer is the second most common cause of death among children ages 1 to 14 years in the US, after accidents. In 2017, an estimated 10,270 children in this age group will be diagnosed with cancer and 1,190 will die from it.Leukemia accounts for almost a third (29%) of all childhood cancers, followed by brain and other nervous system tumors (26%).

Cancer incidence rates increased in children and adolescents by 0.6% per year from 1975 through 2013. However, death rates have declined continuously. The 5-year relative survival rate for all cancer sites combined improved from 58% for children diagnosed during 1975 to 1977 to 83% for those diagnosed during 2006 to 2012.


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