Managed Care Outlook

Progress made, but still not enough in America’s long war on cancer

The war on cancer was declared in 1971 with passage of the National Cancer Act. We were putting men on the moon so beating cancer forever in a relatively short time seemed plausible. Though fantastic strides have been made, that’s not quite how things worked out.

Consider a study in the July issue of Preventing Chronic Disease, a peer-reviewed journal published by the CDC. The researchers, led by Hannah Weir of the CDC, used trends from 1975 to 2009 to project deaths and death rates from cancer through 2020.

Observed (2007) and predicted (2020) age-standardized death rates per 100,000 population

Source: Weir HK et al., Preventing Chronic Disease, July 2015

By their reckoning, the total number of cancer deaths will increase by more than 10% among men and black women between 2007 and 2020, but level off to an increase of 4.4% among white women partly because of declines in breast, cervical, and colorectal cancer deaths. If their predictions prove to be accurate, more than 335,000 American men will die of cancer in 2020 and more than 290,000 American women.

That war on cancer—it’s hardly won.

The increase in total deaths from cancer is partly explained by demographics, particularly an aging population. When Weir and her colleagues calculated age-standardized cancer death rates, the picture brightens. Between 2007 and 2020, they figure Americans will see declines in the rates for lung and bronchus (21.3%), female breast (19.6%), cervix uteri (12.5%), colon and rectum (22.5%), oral cavity and pharynx (16.0%), prostate (26.4%), and melanoma (7.4%). The rate for those seven sites combined is projected to decrease by 15.6%. In fact, the pitch of the declines for the individual cancer sites is steep enough that, with the exception of melanoma, goals set in the federal government’s Healthy People 2020, a health planning document, are likely to be met.

Explanations for declining rates vary with the cancer. Lung cancer rates are going down because lung cancer incidence is decreasing, a reflection of declining smoking rates. Screening—and to a lesser extent risk factor reduction—explain the favorable trends in the death rate from colon cancer.