Cancer deaths have been falling since 1990

A new study suggests that cancer deaths for people under age 75 have been on the decline since 1990 and are now at levels lower than when the War on Cancer began in 1971. But rather than amazing new treatments, the big key seems to be prevention—both through an increase in screening, and a decrease in risky behaviors, especially smoking.

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  1. And that’s for all people under 75–unfortunately survival rates for young adults haven’t budged, because a) young adults are a smaller subset of cancer patients and not as profitable research-wise and b) at least in the U.S., the current insurance system disincentivizes a young person from seeking preventive care and early detection.

  2. …and early incidental detection. We are doing way too many CT scans on people for nebulous and vague symptoms, and this increase in radiation exposure is a worry in and of itself, but as a consequence we are getting more incidentally discovered cancers, like kidney cancer, that can be treated earlier.

    But on the other hand, many of the screen detected cancers that might plump up the denominator in this equation may have been cancers that never needed treatment in the first place. The prime example here is prostate cancer – screening for prostate cancer with PSA and DRE (no not that Dr Dre, something far less pleasant) is standard-of-care in the US, but not really anywhere else in the world because it detects prostate cancers that will ultimately never kill the patient.

  3. I really, really, dislike it when screening is equated with “prevention”. Screening is detection; it may prevent your death, but it doesn’t prevent the cancer. Quitting smoking, wearing sunscreen–these things help prevent cancer. Mammograms, colonoscopy–these do not prevent cancer.

    (Strangely, the pap smear may prevent cervical cancer, as the minor trauma of scraping may cause the cervix to shed precancerous cells–but I can’t find the study at the moment. And I suppose you could discuss whether finding a precancerous mole or lesion and getting it removed “prevents” skin cancer.)

    1. But this study is discussing cancer deaths, not incidences of cancer. Screening does apparently decrease cancer death; I’m not sure where you got the idea that it was saying that screening reduced the incidences of cancer.

      1. “the big key seems to be prevention—both through an increase in screening…”

        I suppose you could interpret that as either the prevention of death or the prevention of cancer. Only one is (possibly) correct. And there’s a lot of evidence to suggest that most screening does more harm than good.

    2. Actually, colonoscopy can prevent cancer, by removing precancerous growths (polyps) before they turn into cancer. Ditto for pap tests, which can find precancerous changes to cervical cells. Those cells are removed when they’re found, which prevents them from growing into cancer. You are absolutely right about mammograms, and about how people often do lump “early detection” into “prevention.”

  4. The cigarette companies know this, and it’s one reason why they fund so many of the ‘pink ribbon’ events. They sponsor the programs, and the programs are not allowed to talk about prevention, but only ‘the search for the cure’. I was checking out of a store recently and noticed that the cartons of Camel cigarettes were printed in pink. While I knew about the cigarette companies manipulating media, I had no idea they had stooped this low and it made me sick. While smoking has decreased among males, it has increased among females, and breast cancer is still on the rise instead of decreasing like other cancers.

  5. Yeah, decrease in risky behaviors has only really effected lung cancer death. The study gave equal weight to screening (which requires subsequent treatment) and medical/surgical intervention (especially leukemia, lymphoma and testicular cancer). It should be worth noting that current screening standards that the article references are being questioned by the US preventive task force.

    @akwhitacre: The article mentioned that the reduction in death was seen across all age groups and ethnicities. This makes sense; some of the few cancers that have been outright cured by chemotherapy are the pediatric neoplasms (AML and ALL come to mind).

    It seems like a lot of people are reading this as a repudiation against basic science and unequivocal support for public health. If anything, the lesson learned is that the war against cancer has to be fought on multiple fronts, not just one.

  6. Nobody dies from cancer anymore, now it’s all about obesity due to their diabetes, lead in your Chinese toys, or crashing your out of control Toyota on the way to the mall.

  7. whilst I cannot argue for a moment that there are some cancers that might not need treatment, screening does increase the chances of finding a tumor that might not need treatment RIGHT THIS MINUTE…but will need treatment before it endangers the person’s life.

    It’s kind of a big deal to me…my sister and I both have had pre-cancerous growths removed. Both of us had outpatient surgeries and were home with our kids that night.

    Without screening that led to the discovery of those growths, there’s a good chance that at minimum our kids would have had to watch their moms go through major invasive surgery, chemo, radiation therapy and all the fun physical changes that accompany that…and that’s if we were lucky enough to come home to them at all.

    All things in moderation, of course…but I’m pretty happy that I went (and still go) for regular screenings.

  8. Sorry, Xenu. Deaths from out-of-control Toyotas number far fewer than deaths from lightning strikes.

    Cancer deaths are #2 behind heart disease. Lead in your toys isn’t going to kill you, but it will make you stupid.

  9. “Nobody dies from cancer anymore”

    Wow, my dad and sister would love to know that (if they were still alive, anyway.)

  10. “Nobody dies from cancer anymore”

    Wow, my dad and sister would love to know that (if they were still alive, anyway.)

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