The American Cancer Society (ACS) has published its latest annual report on cancer incidence and mortality, and the news is good. Cancer death rates have declined 20% over the past two decades.

The overall cancer death rate peaked at 215.1 per 100,000 population in 1991; however, advances in prevention, early detection, and treatment, plus a significant trend toward smoking cessation brought that number down to 171.8 per 100,000 population in 2010.

ACS estimates are based on the most recent data on cancer incidence, mortality, and survival from the National Cancer Institute (NCI) and the Centers for Disease Control and Prevention (CDC). Mortality data is culled from the National Center for Health Statistics. The report is published as “Cancer Statistics, 2014” in CA: A Cancer Journal for Clinicians (2014;64[1]:9-29) and its companion article, “Cancer Facts & Figures.”

The report estimates 1,665,540 new cancer cases and 585,720 deaths in the United States in 2014. Prostate, lung, and colon cancers will account for approximately half of newly diagnosed cancers in men, with prostate cancer alone accounting for 27% of cases; breast, lung, and colon cancers will account for approximately 50% of all cases among women, with breast cancer comprising 29% of new cancers.

The four most prevalent cancers in both men and women—lung, colon, prostate, and breast cancers—account for approximately half of the total cancer deaths, with more than one quarter due to lung cancer.

Trends in incidence Cancer incidence is 23% lower among women compared with men. But, the most recent 5-year period for which data are available (2006-2010) shows a decrease in cancer death rates for both sexes. Although incidence rates were stable in women, a decrease of 0.6% per year was seen in men.

Improvements in cancer control and prevention contribute to the decline in incidence. For example, a decline of greater than 4% per year from 2008 to 2010 is attributed to increased use of colonoscopy, as the procedure also allows for removal of precancerous polyps.

Despite the positive trends for the most common cancers, incidence rates for melanoma; esophageal cancer; cancers of the kidney, anus, and pancreas; and human papillomavirus-positive oropharyngeal cancers are increasing. The largest annual increases in both men and women are in cancers of the thyroid and liver.

Trends in mortality An estimated 1,340,400 cancer deaths have been averted as a result of the decline in cancer deaths over the past 20 years. The largest declines in deaths were among middle-age men and women, with black men age 30 to 59 years showing the sharpest decline (44%-55%). Tobacco use in older generations is a factor in the smaller declines seen in older persons.

The decline in cancer death rates varied substantially by race and ethnic groups. Cancer incidence and death rates are highest in black men compared with white men and non-Hispanic white, Asian American/Pacific Island, American Indian/Alaska Native, and Hispanic men and women.

The researchers conclude that expanding existing cancer control knowledge across all populations will lead to further decreases in cancer incidence and death rates.