Cancer Death Rates in the U.S. Have Declined Significantly

Over the past 35 years, cancer death rates in the United States have decreased remarkably, plummeting by 35%, as highlighted in a report released by the American Association for Cancer Research. This reduction means nearly 5 million fewer cancer-related deaths since 1991, largely attributed to better screening practices and advancements in treatments.

However, this progress isn’t evenly distributed across different regions. “African American communities and American Indian and Alaska Native populations experience the highest cancer death rates in the U.S.,” remarked Mariana Stern, the report’s chair and a professor at the Keck School of Medicine. This disparity translates to increased incidence and mortality rates for various cancers within these groups.

Historically, Black Americans have had higher cancer death rates compared to white Americans, though the gap has somewhat narrowed. That said, Black individuals are still almost twice as likely to die from cancers such as multiple myeloma, stomach, prostate, and gallbladder cancers, compared to their white counterparts. Particularly, breast cancer mortality rates are 35% higher among Black women than for white women.

Colorectal cancer — which is becoming more common in individuals under 50 — also shows higher mortality among Black and American Indian/Alaska Native populations compared to white individuals. The report indicates that increased screenings are linked to 79% of the colorectal cancer deaths that were averted. During colonoscopies, doctors can remove precancerous polyps before they develop into cancer. It’s generally recommended that those at average risk start screening at the age of 45.

Despite these guidelines, screening rates lag behind for non-white populations. In 2023, only 53% of Hispanic individuals and 57% of Asian and American Indian/Alaska Native groups kept up with their colonoscopies, while 67% of white individuals were up to date. Alarmingly, the Hispanic community has noted the steepest rise in early-onset colorectal cancer, with annual increases of 4.7% for women and 3.7% for men.

Alex Valdez, 40, was diagnosed with colorectal cancer at age 38 during a routine colonoscopy meant to monitor his ulcerative colitis and Crohn’s disease. “The pathology report revealed a 7-centimeter tumor I had likely lived with for one-and-a-half to two years without knowing,” he shared. “Many people believe colonoscopies aren’t necessary until their mid-40s, but my experience shows that isn’t true.”

Experts underscore the importance of screenings in mitigating cancer’s toll, as early detection can greatly improve treatment outcomes. Still, access remains a concern. The report found cervical cancer screening rates are consistently lower among Asian and Hispanic women compared to white women. Women in poorer regions are also less likely to receive regular screenings.

“Cervical cancer continues to be an issue,” noted Dr. Sarah Kim, a gynecologic surgeon. “Especially for those who lack consistent access to care, including people in unstable jobs or inadequate healthcare.” The report highlights that cervical cancer rates are 32% higher among women in low-income areas and death rates are 49% higher in these populations.

This is particularly alarming given that cervical cancer is preventable with the HPV vaccine. “This vaccine has no side effects and only benefits, preventing women from developing cervical cancer,” Kim explained, noting it’s readily available without needing a prescription.

The findings reveal that disparities in cancer diagnoses and mortality stem from multiple intertwined factors, including systemic racism and the socio-economic conditions affecting health and well-being. These issues impact not just screenings but treatment quality as well.

Patients from racial and ethnic minority backgrounds and those in economically disadvantaged situations often do not receive the same quality of care, even though significant advancements in cancer treatments have been made.

Additionally, practical challenges such as finding time and resources for adequate care hinder many Americans’ ability to seek treatment. A report indicates that over the past year, more than 5 million people have dropped out of Medicaid and the Affordable Care Act programs.

Resources do exist at many hospitals to assist patients in navigating their cancer care effectively. “One strategy that has proven successful in various studies is employing patient navigators,” Stern pointed out. Patient navigators help individuals bypass obstacles to receive the necessary care. Kim recounted her experiences with navigators during her residency, emphasizing the importance of keeping patients scheduled for their surveillance appointments.

Future funding for these crucial programs, however, is uncertain. Stern raised concerns about potential cuts to the NIH budget and the elimination of the National Institute of Minority and Health Disparities, suggesting that these decisions could threaten the progress made in addressing cancer disparities.