Latest ACS Cancer Statistics Report Highlights Alarming Trends ... - AJMC.com Managed Markets Network

The American Cancer Society (ACS) today released its annual report on cancer statistics. The report showed an overall reduction in cancer mortality and a substantial drop in cervical cancer incidence. However, a concerning uptick in prostate cancer incidence and significant disparities prompted the launch of a new ACS initiative to improve prostate cancer outcomes.

The report, which was published in CA: A Cancer Journal for Clinicians, is based on population-level cancer incidence and outcomes data from the National Center for Health Statistics. Overall cancer mortality showed improvement, dropping by 33% since 1991. Based on the most recent available incidence and mortality data, the report projects 1,958,310 new cancer cases and 609,820 cancer deaths in the United States in 2023. Lung, prostate, and colorectum cancers are attributed to the greatest number of deaths in men, whereas lung, breast, and colorectum cancers account for the highest number of deaths in women.

The overall trends in mortality were largely due to declines in lung cancer in both men and women in the wake of treatment advances and earlier detection. In men, the lung cancer death rate dropped by 58% from 1990 to 2020. In women, it dropped by 36% from 2002 to 2020.

The report also found that rates of cervical cancer dropped 65% in women aged 20 to 24 years from 2012 through 2019. This finding is particularly exciting, as this population was the first to receive the human papillomavirus (HPV) vaccine. This suggests that HPV vaccination may have a profound effect on the incidence of cervical cancer and other HPV-associated cancers.

These findings also have implications for other infection-related cancers in general. "Increased investment in strategies to harness the immune system in cancer prevention is warranted," Ahmedin Jemal, DVM, PhD, study author and senior vice president of surveillance and health equity science at ACS, said in a press release.

Despite the improvement in overall cancer rates and mortality, certain cancer types saw negative trends. Most notably, the incidence rate of prostate cancer, the most diagnosed and second most deadly cancer among men in the US, rose by 3% per year from 2014 to 2019. This alarming trend follows a 2-decade decline in prostate cancer incidence and was spurred by increases in advanced-stage diagnoses, according to the report. For localized prostate cancer, the 5-year survival rate is 99% due to the efficacy of surgical intervention and radiation therapy. For metastatic prostate cancer, 5-year survival is just 32%.

"The increasing percentage of men presenting with advanced prostate cancer, which is much more difficult to treat and often incurable, is highly discouraging," Karen E. Knudsen, PhD, MBA, CEO of the ACS, said. "In order to end cancer as we know it, for everyone, it is imperative for us to focus on cancers where trends for incidence and mortality are going in the wrong direction."

Substantial disparities were also identified: The incidence rate of prostate cancer was 70% higher among Black men than White men, and mortality was 2 to 4 times higher in Black men than other ethnic groups.

In light of the uptick in prostate cancer incidence as well as the disparities seen in the report, the ACS announced the launch of Improving Mortality from Prostate Cancer Together (IMPACT), an initiative that will include advocacy, patient support, and research strategies to improve outcomes. The goal of the program is to reduce mortality for all men with prostate cancer, placing an emphasis on those disproportionately affected.

"IMPACT will fund bold new cancer research programs that connect the laboratory, the clinic, and the community," said William Dahut, MD, chief scientific officer for the ACS. "These studies will help discern who is most at risk for prostate cancer, and how to prevent it."

To facilitate earlier diagnosis, the ACS is also revising its own screening guidelines for prostate cancer using the best possible evidence, Knudsen said during a news conference. The organization aims to guide men, their primary care physicians, and urologists toward the most appropriate screening strategies based not just on age, but also family history, clinical history, and any known genetic risk.

The 2023 report does not account for known delays in screening and treatment throughout the COVID-19 pandemic, but next year's report will have early insights into the impact of the pandemic on cancer incidence and mortality, Knudsen noted during the news conference.

Reference

Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA
Cancer J Clin. Published online January 12, 2023. doi:10.3322/caac.21763