The death rate from cancer in the US has fallen steadily over the past 20 years, according to the American Cancer Society's latest annual figures, which were published online this week in CA: A Cancer Journal for Clinicians.
The report shows that the cancer death rate for American men and women combined fell 20% from a peak of 215.1 per 100,000 in 1991 to 171.8 per 100,000 in 2010, the most recent year for which full data exists.
Over the period, this 20% fall equates to some 1,340,400 cancer deaths avoided.
Although the steepest fall in deaths to cancer in the last 20 years is among middle-aged black men, the rate of cancer deaths for black males is still higher than for white males.
Dr. John R. Seffrin, chief executive officer of the American Cancer Society, says:
"The progress we are seeing is good, even remarkable, but we can and must do even better."
The report also estimates there will be 1,665,540 new cancer cases and 585,720 deaths from cancer in the US in 2014.
Cancer rates and deaths vary considerably by race and ethnicity
The report authors write that the rates of new cancer cases and cancer deaths vary considerably among racial and ethnic groups:
"The magnitude of the decline in cancer death rates from 1991 to 2010 varies substantially by age, race, and sex, ranging from no decline among white women aged 80 years and older to a 55% decline among black men aged 40 years to 49 years."
Asian Americans have the lowest rate of cancer deaths, while black men continue to have the highest rates of cancer deaths of all ethnic groups in the US, despite the steepest fall being among black men.
Dr. Seffrin says while it is good news that cancer deaths among middle-aged black men have halved in only two decades, this is "immediately tempered" by the fact that for every major cancer and for all cancers combined, deaths among black American men are still higher than among white men.
The report says progress against cancer could be speeded up if knowledge about fighting the disease was applied across all parts of the population, especially the poorest groups.
Lung, colon, prostate and breast cancers continue to be the biggest killers
The most common causes of death from cancer continue to be lung, colon, prostate, and breast cancers. Nearly half of all cancer deaths among men and women in the US are due to these four diseases. The biggest killer continues to be lung cancer, accounting for more than 1 in 4 cancer deaths.
Looking ahead to 2014, the authors estimate that prostate, lung, and colon cancer will account for around half of new cancer cases among American men, with prostate cancer accounting for around 1 in 4.
Among American women, 2014 will see breast, lung, and colon cancer featuring as the most common cancers. Together they will account for around half of all cancers among US females, with breast cancer accounting for 29% of all new cases.
Rates of new colon and lung cancer cases falling rapidly
In recent years, rates of newly diagnosed colon cancer have fallen rapidly, by more than 4% a year from 2008 to 2010. The report suggests this is partly due to increased numbers of people having colonoscopy exams, which by removing pre-cancerous polyps, can avert the full-blown disease.
New cases of lung cancer in the US have also fallen, in line with falling numbers of smokers. The decline started around the mid-1980s in men and in the late 1990s in women, reflecting the fact American women started smoking in larger numbers about 20 years after men.
In the meantime, a recent study of nearly 20,000 men with advanced prostate cancer finds that deaths from metastatic prostate cancer have changed little in the last 25 years.