Annual Report to the Nation: Cancer death rates continue to decline

Increase in liver cancer deaths cause for concern

Logos: Centers for Disease Control and Prevention, National Cancer Institute, American Cancer Society, North American Association of Central Cancer Registries

The Report to the Nation on the Status of Cancer (1975-2012) shows that death rates continued to decline for all cancers combined, as well as for most cancer sites for men and women of all major racial and ethnic populations. The overall cancer death rates for both sexes combined decreased by 1.5 percent per year from 2003 to 2012. Incidence rates—new cancer cases that are diagnosed per 100,000 people in the U.S.—decreased among men and remained stable for women between 2003 and 2012.

The ongoing drop in cancer incidence in most racial and ethnic groups is due, in large part, to progress in prevention and early detection. Fewer deaths from cancer in those same groups may also reflect better treatments. Tobacco control efforts have contributed to lower rates of lung cancer, the leading cause of cancer death in both men and women, as well as many other types of cancer.

The report also examines trends in liver cancer. In contrast to the trends for most other cancers among both men and women, death rates due to liver cancer have increased the most compared with all cancer sites, and liver cancer incidence rates have also increased sharply.

“The latest data show many cancer prevention programs are working and saving lives,” said CDC Director Tom Frieden, MD, MPH. “But the growing burden of liver cancer is troublesome. We need to do more work promoting hepatitis testing, treatment, and vaccination.”

Key findings on liver cancer:

• From 2008 to 2012, liver cancer incidence increased an average of 2.3 percent per year overall, and the liver cancer-related death rate increased by an average of 2.8 percent per year among men and 3.4 percent per year among women.
• In all racial and ethnic populations, about twice as many men as women were diagnosed with liver cancer.
• Between 2008 and 2012, liver cancer incidence rates were highest among non-Hispanic American Indian/Alaska Native men followed by non-Hispanic Asian/Pacific Islander men.
• Hepatitis C and liver cancer-associated death rates were highest among those born in 1945-1965; these also represent the majority of Americans with hepatitis C infection.

“Research over the past decades has led to the development of several vaccines that, given at the appropriate ages, can reduce the risk of some cancers, including liver cancer,” said Douglas Lowy, M.D., acting director of the National Cancer Institute. “Determining which cancers can be effectively prevented by vaccines and other methods is one of our top priorities at NCI and one which we believe will truly make a difference in cancer incidence and mortality trends.”

The authors noted that, in the United States, a major contributing factor to liver cancer is hepatitis C virus (HCV) infection. A little more than 20 percent of the most common liver cancers are attributed to HCV infection. Compared with other adults, people born during 1945-1965 have a six times greater risk of HCV infection. CDC recommends all people born during 1945-1965 receive a one-time test for HCV.  Diagnosis of HCV, followed by treatment, can greatly reduce the risk of liver cancer.

“We have the knowledge and tools available to slow the epidemic of liver cancer in the U.S., including testing and treatment for HCV, hepatitis B vaccination, and lowering obesity rates,” said Otis W. Brawley, M.D., chief medical officer of the American Cancer Society. “We hope that this report will help focus needed attention and resources on liver cancer.”

Hepatitis B virus (HBV) infection also increases the risk for liver cancer. HBV is a common risk factor for liver cancer for Asian/Pacific Islander populations, especially among Asians not born in the United States, and CDC recommends universal HBV testing for this population. Fortunately, rates of HBV infection are declining worldwide due to increases in hepatitis B vaccination of children beginning at birth.

Obesity and type 2 diabetes can cause cirrhosis, or scarring of the liver, which can progress to liver cancer and is associated with excessive alcohol use; from 8 to 16 percent of liver cancer deaths are attributed to excessive alcohol use.

“Collecting and analyzing high-quality cancer surveillance data is essential for tracking the benefits of screening and other prevention efforts,” said Betsy Kohler, executive director, North American Association of Central Cancer Registries. “Data from an estimated 97 percent of all newly diagnosed cancer cases in the US are used in this report.”

The Report to the Nation is released each year in a collaborative effort by the American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries.

To view the full Report, go to http://onlinelibrary.wiley.com/doi/10.1002/cncr.29936/full

For a Q&A on this Report, go to http://www.cdc.gov/cancer/dcpc/research/articles/arn_7512.htm

For Spanish translation of this press release, go to http://www.cdc.gov/Spanish/MediosdeComunicacion/comunicados/p_informe_anual_tasas_mortalidad_cancer_0300916.html

To learn more about hepatitis, go to www.cdc.gov/hepatitis

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES