U.S. cancer deaths declined 27% overall in a period of 25 years – from 1991 to 2016. Good news for many, but this statistic reverses in some counties where there is a great deal of social and economic difference.
Why does the cancer death rate vary between counties?
The positive: In those 25 years, almost 2.6 million fewer people died due to cancer. This is primarily due to:
– Smoking reduction
– Earlier detection
– Improved treatments
– Environmental factors
Common cancers, such as breast, colon, lung, and prostate benefitted the most with a percentage decrease of 40%-breast, 53%-colon, 48%-lung, and 51%-prostate. So, why have some counties actually shown an increase in these cancers over the same length of time?
The negative: Rebecca Siegel, lead researcher and scientific director of surveillance research at the American Cancer Society (ACS), suggests, “The largest gaps are for the most preventable cancers. For example, in the early 1970s colon cancer death rates were 20 percent lower in poor counties, and today they are 35 percent higher, when compared with people living in richer counties.”
Siegel also said, “Differences in wealth lead to differences in risk factors and less access to high-quality care for prevention, early detection and treatment.” Predictably, people in lower economic areas are less likely to go to a doctor as frequently for screening, which leads to cancer diagnoses at a more advanced stage.
“Health literacy is an issue”, stated Siegel. Where people of lower economic levels have access to screening, the cancer percentages per county even out with those of more wealth, but only if residents also are educated on how they can lower their cancer risks.
Environmental factors are important as well. Beginning in the early 1970s, many of the first environmental regulations were passed – aiming to curb public exposure to a myriad of industrial toxins. Additionally, geographic areas with heavy industry often tend to have a higher incidence of cancer rates.
Not all cancer deaths declined
Though the report is good news overall, other cancer deaths rose, such as liver cancer, pancreatic cancer, brain cancer, soft-tissue cancers, and oral cancers related to the human papillomavirus (HPV).
Siegel reminded that, even though lung cancer deaths decreased, “lung cancer still kills more Americans than breast, prostate and colon cancer combined.” Another disease is malignant mesothelioma, a fatal disease across all economic groups that currently has no cure. Mesothelioma is actually a cancer of the lining of the lung caused by asbestos exposure. There are also several variants of lung cancer which can also be asbestos-related.
Great strides are being made, but cancer remains the second leading cause of death after heart disease. For some areas, as well with Hispanic, Asian American, and people under 80, cancer is still the primary cause of death. While the gap in cancer deaths has reduced between black and white populations, there is a growing gap based on wealthy versus poor counties.
What is next?
Obviously additional research and studies on more that the common cancers is necessary. There must be increased education initiatives in poor communities and communities in general.
Cancer deaths currently drop at 2% a year, but with increased availability of screening, health education within all communities, and ongoing research, this 2% could increase a great deal and cancer deaths become fewer with each year.
Dr. Harold Burstein, professor of medicine at Harvard Medical School and physician with the Dana-Farber Cancer Institute in Boston, stated this report shows “tremendous improvements” in therapeutic treatments for cancer.
Though there is still work to do, Burstein professes the medical researchers have made tremendous progress treating the disease. “For a long time, there was a nihilism that we are not winning the war of cancer,” he said. “We are winning the war.”