【CA】The United States released the latest annual cancer report, and deaths from new crown infections accounted for two-thirds of the increase!

The American Cancer Society (ACS) publishes Cancer Statistics 2023, the organization's annual report
on cancer facts and trends.
According to the report, overall cancer mortality has fallen by 33% since 1991, with an estimated 3.
8 million cancer deaths
averted.
According to ACS data, by 2023, 1958310 new cancer cases and 609,820 cancer deaths
are expected in the United States.
These key findings were published in CA: The Journal of Cancer in Clinicians
.

This article is the original of Translational Medicine Network, please indicate the source for reprinting

Author: kope

Each year, the American Cancer Society estimates new cases and deaths from cancer in the United States, a major public health problem worldwide and the second leading cause of
death in the United States.
The coronavirus disease 2019 (COVID-19) pandemic has delayed cancer diagnosis and treatment due to healthcare facility closures, disruptions to employment and health insurance, and fear
of exposure to COVID-19.
Although the COVID-19 peak in mid-2020 had the greatest impact, healthcare delivery has yet to fully rebound
.
Increasingly, this progress reflects advances in
treatment.

Trends in cancer incidence

 01 

The surge in the incidence of men in the early 1990s reflected a surge
in the detection of asymptomatic prostate cancer due to the widespread and rapid acceptance of prostate-specific antigen (PSA) testing in previously unscreened men.
Since then, cancer rates have generally declined in men until around 2013 and then stabilized
in 2019.
Among women, the rate was fairly stable until the mid-1980s, but has slowly increased by < 0.
5 per cent
per year since then.
As a result, the gender gap is slowly narrowing, with the male-to-female incidence ratio falling from 1.
59 in 1992 to 1.
14
in 2019.
However, risk differences vary
by age.
For example, the incidence is about 80% higher in women than men in people aged 20-49 years, and nearly 50%
higher in men aged 75 years and older.

Two of the most critical findings have been driven by significant changes in cancer prevention and screening over the past decade
.
First, after the introduction of the human tumor virus (HPV) vaccine, the incidence of cervical cancer in women aged 20-24 years decreased by an astonishing 65%
from 2012 to 2019.
This is clear population-level evidence that vaccination can reduce cancer incidence and provides optimism for scaling up research to develop other cancer prevention vaccines
.
Since 2011, diagnoses of advanced prostate cancer have increased by 4 to 5 percent annually, and the proportion of men diagnosed with long-term disease has doubled
.
This finding underscores the importance of
understanding and reducing this trend.

Cancer survival rate

 02 

The 5-year relative survival rate for all cancers increased from 49% in the mid-1970s to 68%
between 2012 and 2018.
Thyroid cancer (98%), prostate cancer (97%), testicular cancer (95%) and melanoma (94%) have the highest survival rates, and pancreatic cancer (12%), liver cancer and esophageal cancer (21%) have the lowest
survival rates.
Screening affects the explanation for improved survival in breast and prostate cancer, because of lead time bias and detection of indolent cancers, which may also be a factor in thyroid and other cancers, can be detected
incidentally by imaging.

Survival rates for hematopoietic and lymphoid malignancies have improved particularly rapidly
due to improved treatment regimens, including the development of targeted therapies.
For example, the 5-year relative survival rate for chronic myeloid leukemia increased from 22% in the mid-1970s to 70% diagnosed between 2012 and 2018, and most patients treated with tyrosine kinase inhibitors had a near-normal
life expectancy.
Unlike most common cancers, survival rates for women with uterine malignancies have not improved over the past 40 years, largely reflecting a lack of significant treatment progress
.

Mortality trends

 03 

Mortality is a better indicator of cancer progression than morbidity or survival because they are less
affected by bias due to changes in testing practice.
For most of the 20th century, cancer mortality rates rose, largely because of the rapid increase
in lung cancer deaths among men due to the tobacco epidemic.
However, reductions in smoking and improvements in early detection and treatment of certain cancers have led to a steady decline
in cancer mortality since peaking at 215.
1 cases per 100,000 in 1991.
With an overall decrease of 33% by 2020 (143.
8 per 100,000 people), twice as many men avoided death as women, as mortality peaked higher and fell faster
for men.

The rate of decline in cancer mortality has slowly accelerated from about 1 percent per year in the 1990s, to 1.
5 percent per year in the 2000s, and to 2 percent
per year from 2015 to 2020.
Overall mortality trends are primarily driven by lung cancer, and in recent years, lung cancer has declined similarly
in men and women due to treatment advances that have prolonged survival, as well as early detection.
For example, the annual decline in lung cancer mortality accelerated from 3.
1% in 2005-2014 to 5.
3% in 2014-2020 and from 1.
8% to 4.
3%
in women.
Overall, lung cancer mortality declined by 58% in men from 1990 to 2020, and by 36% in women from 2002 to 2020
.

The impact of the coronavirus is far-reaching

 04 

In 2020, a total of 3383729 deaths were recorded in the United States, an increase of 528891 deaths from 2019; This is 34 times
higher than the increase in 2018-2019.
COVID-19 infections were the underlying cause of death, accounting for two-thirds of the increase, highlighting the substantial excess burden
from other causes in 2020.
Most notably, the increase in deaths from heart disease in 2019 to 2020 was 10 times
higher than in 2018 to 2019.

Of all the major causes, only chronic lower respiratory diseases experienced a decline in deaths between 2019 and 2020, with an age-standardized mortality rate of 4.
7%; Cancer was the only other cause of the decline in mortality (1.
5% decline).

The impact of the pandemic on mortality will continue to be felt for many years and may parallelize
the disproportionate COVID-19 burden in the United States compared to other countries.
For example, a recent study found that life expectancy in the United States continued to decline
between 2020 and 2021.

In 2020, cancer accounted for 18% of all deaths and remains the second leading cause
of death after heart disease.
However, it is the leading cause
of death for women aged 40-79 and men aged 60-79.
Brain and other neurological tumors are the leading cause of cancer death in children and adolescents under the age of
20.
However, CRC has surpassed brain tumors in men aged 20-39 and is the leading cause of cancer death in men aged 20-49, while breast cancer leads
women in this age group.
Lung cancer is the leading cause of cancer death in men and women aged 50 and older, causing far more deaths than breast cancer, prostate cancer and CRC combined
.

Reduce inequality

 05 

Errors in reporting race and ethnicity in medical records and death certificates lead to an underestimation of cancer incidence and mortality
rates among non-whites, especially Native Americans.
Although racial misclassification of Native American mortality data has eased thanks to new adjustment factors published by NCHS researchers, these factors currently only apply to all cancers combined
.
It is also important to note that cancer data in the United States are primarily reported for broad, heterogeneous racial and ethnic groups, masking important differences
in cancer burden in these populations.

Overall, cancer mortality has continued to decline since 1991, with an overall decline of 33 percent, averting about 3.
8 million cancer deaths
.
This steady progress is due to a decrease in smoking; Get screened for breast, colorectal and prostate cancer; Treatment breakthroughs have particularly improved the management of some difficult-to-treat cancers, such as non-small cell lung cancer and metastatic melanoma
.
Of concern is the rising incidence of breast, prostate and body cancer, all of which have large ethnic disparities in mortality and are easy to detect
early.
Expanding access to care and increasing investment to widely scale up existing cancer control interventions, as well as conducting research to advance treatment options and developing successful interventions to reduce inequalities, will help close gaps and accelerate progress
in the fight against cancer.

Resources:

https://doi.
org/10.
3322/caac.
21763

https://acsjournals.
onlinelibrary.
wiley.
com/doi/10.
3322/caac.
21763

Note: This article is intended to introduce the progress of medical research and cannot be used as a reference
for treatment options.
If you need health guidance, please go to a regular hospital
.