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Medicine

Cancer Deaths Are Falling, but There May Be an Asterisk (nytimes.com) 29

Posted by msmash from the closer-look dept.
Cancer deaths in the United States are falling, with four million deaths prevented since 1991, according to the American Cancer Society's annual report. At the same time, the society reported that the number of new cancer cases had ticked up to more than two million in 2023, from 1.9 million in 2022. The New York Times: Cancer remains the second leading cause of death in the United States, after heart disease. Doctors believe that it is urgent to understand changes in the death rate, as well as changes in cancer diagnoses. The cancer society highlighted three chief factors in reduced cancer deaths: declines in smoking, early detection and greatly improved treatments. Breast cancer mortality is one area where treatment had a significant impact. In the 1980s and 1990s, metastatic breast cancer "was regarded as a death sentence," said Donald Berry, a statistician at the University of Texas MD Anderson Cancer Center and an author of a new paper on breast cancer with Sylvia K. Plevritis of Stanford University and other researchers (several authors of the paper reported receiving payments from companies involved in cancer therapies).

The paper, published Tuesday in JAMA, found that the death rate from breast cancer had fallen to 27 per 100,000 women in 2019 from 48 per 100,000 in 1975. That includes metastatic cancer, which counted for nearly 30 percent of the reduction in the breast cancer death rate. Breast cancer treatment has improved so much that it has become a bigger factor than screening in saving lives, said Ruth Etzioni, a biostatistician at the Fred Hutchinson Cancer Center. Death rates have even declined among women in their 40s, who generally did not have regular mammograms, said Dr. Mette Kalager, a professor of medicine at the University of Oslo and Oslo University Hospital, "indicating a substantial effect of treatment," she said.
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Cancer Deaths Are Falling, but There May Be an Asterisk More

Cancer Deaths Are Falling, but There May Be an Asterisk

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  • It's not that surprising. Our medical knowledge and ability to cure diseases continues to improve and in ten years it's going to be even better. I expect that the lifestyle choices that our population makes will grow worse. Our diets will be worse, we'll be more sedentary, and we won't have dropped the bad habits we ought to kick. The only way those things will get better is if someone figures out how to make a pill for that.

  • If we are getting better at curing cancer, or at least prolonging the life of those with cancer, I'm curious if the reason cancer cases are increasing is because people are getting cancer for a second time. Those individuals would have died the first time if not for our better treatment options, but now they are alive to increase the number of total cancer cases.

    I'm not sure if the article takes this into account considering it is behind a paywall.

    • Re:Is recurring cancer the cause of increased case (Score:4, Informative)

      by quonset ( 4839537 ) on Wednesday January 17, 2024 @07:17PM (#64168637)

      I'm curious if the reason cancer cases are increasing is because people are getting cancer for a second time.

      No. These are young(er) people having cancer for the first time. This article [harvard.edu] from last year explains a possible reason this way:

      "From our data, we observed something called the birth cohort effect. This effect shows that each successive group of people born at a later time — e.g., a decade later — have a higher risk of developing cancer later in life, likely due to risk factors they were exposed to at a young age,” said Shuji Ogino, a professor at Harvard Chan School and Harvard Medical School and a physician-scientist in the Department of Pathology at the Brigham. “We found that this risk is increasing with each generation. For instance, people born in 1960 experienced higher cancer risk before they turn 50 than people born in 1950, and we predict that this risk level will continue to climb in successive generations.”

      This non-paywalled article [cnn.com] says essentially the same thing, and it's from today.

      Among adults 65 and older, adults 50 to 64 and those younger than 50, “people aged younger than 50 years were the only one of these three age groups to experience an increase in overall cancer incidence” from 1995 to 2020, says the report, which was published in CA: A Cancer Journal for Clinicians.

      Even though the overall US population is aging, “we’re seeing a movement of cancer diagnosis into younger folks, despite the fact that there are more people that are in the older populations,” said Dr. William Dahut, chief scientific officer for the American Cancer Society.

      “So cancer diagnoses are shifting earlier,” he said. “There’s something going on here.”

      • The basic direction of the previous post's thinking could still hold true.
        We will never have any data on all the humans who didn't make it to 50, or didn't even get born. We will never know how many sperm failed to swim upstream, eggs failed to release, zygotes failed to implant, fetuses miscarried, stillbirths, SIDS cases and other things happened due to health of the mother, environmental conditions, nutrition, prenatal care, etc. We will never have any data on nature's built-in weeding process before th

        • I've wondered about this too. Essentially by our efforts to thwart darwin by allowing an infant to survive that otherwise would have died, now that infant grows up and may be weaker or have weaker children. Not suggesting we stop, but it could become a game of whack-a-mole. Not the same of course, but in the dog world, breeding makes it almost necessary for bulldogs to be delivered by C-section. Imagine that happening in a true Darwin world.
          • We do not really know what causes most types of cancer. HPV is a major cause and there is a vaccine now, but as for the rest, much is unknown. So once you had some kind of cancer, it can always recur, as the root cause was not fixed.
            • From what I understand, cancer is about 50% environment, 50% genetic. Certainly breast cancer tends to the genetic. So much so I think it is the brac-4(sp?) gene that results in almost certain cancer. So much so I recall a case of a woman getting a full removal of both breasts because her mother had the gene and cancer, and so did her siblings. As the other commenter to me, Eugenics experiments almost makes this a off limits topic. But it is basic Darwinism at play.

          • Re: (Score:2)

            by gweihir ( 88907 )

            Indeed. Too many people that genetically should not have children try anyways. That makes things even worse for the offspring they produce. Due to the history of fascist (and other) Eugenics, we tend to not even talk about that as a society, but it is a factor until these problems can be fixed.

      • Re: (Score:2)

        by gweihir ( 88907 )

        Interesting. So more carcinogenic chemicals in the environment or something like that?

    • Figures are also skewed by improved detection. If you detect prostate cancer 2 years earlier, then the patient eventually appears to live 2 years longer without anything else being done differently with the cancer treatment.

    • Re: (Score:2)

      by gweihir ( 88907 )

      That is probably a factor. A side-effect of many cancer therapies is cancer. Radiotherapy and chemotherapy in particular are something that would never be used for a not life threatening condition.

  • Prediction: while cancer rates are only up a small amount this past year, they'll continue to climb. Those new deaths are due to, in all likelihood, fairly recent diagnosis's.

    I'm sure we've all heard of widespread cases of new "turbo cancers". I know I certainly have - people getting cancer and dying within months. That was unheard of until recently.

    Remember in 2020 when the "healthcare professional" talking heads were talking about how covid/lockdowns would cause an increase in cancer deaths?

    This is probab

    • Some cancers are very slow growing, like prostate, breast and lung cancer. These are also the most common. With these types, Covid disruptions probably didn’t make much difference in the greater scheme of things. With rapidly growing cancers, the Covid disruptions probably killed many patients, but they are gone already and we will never know. Disclaimer: I am a Covid prostate cancer survivor, so I am an official armchair expert on it.
  • Per NPR, "Medical Errors Are No. 3 Cause Of U.S Deaths" https://www.npr.org/sections/h... [npr.org]

  • An asterisk? (Score:4, Funny)

    by YetAnotherDrew ( 664604 ) on Wednesday January 17, 2024 @09:14PM (#64168825)

    PATIENT: So it's not cancer?

    DOCTOR: Definitely not cancer . . .

    PATIENT: What? What is it?

    DOCTOR: We've found an asterisk in your colon. We'd like a biopsy as soon as possible.

    DOCTOR: Or an editor.

    • The advantage of Python and FORTRAN is that they don’t use colons. So there are ways to avoid half the problem.

      • The advantage of Python and FORTRAN is that they don’t use colons. So there are ways to avoid half the problem.

        My recent Python experience tells me it's colons galore, though they blush at the amount of indent going on.

        Maybe you're thinking of semicolons, optionally used for ending statements (say you want a one liner . . .). Still not really unused, though!

        Note: Same goes for Fortran (the language formerly known as "FORTRAN!!!1!!bangbang!!").

    • Re: (Score:1)

      by Tablizer ( 95088 )

      "You will only lose half your colon, so you will have a semicolon, but your ass is at risk. Thus, you have Assterisk Syndrome."

  • https://www.npr.org/sections/h... [npr.org]

    If you think you're too young to get colorectal cancer, consider this: About 20,000 people in the U.S. under the age of 50 will be diagnosed this year. And an estimated 3,750 young adults will die [ascopost.com].

    "Colorectal cancer is rapidly shifting to diagnosis at a younger age," conclude the authors of an American Cancer Society report released this month [wiley.com]. Since the mid-'90s, cases among people under 50 have increased by about 50%. It's one of the deadliest cancers [jamanetwork.com] in this age group.

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