Annual Report Cites Continued Decline in Most Cancer Mortality but Trends Toward Increased Liver Cancer Incidence, Mortality


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Earlier this month, experts from four major institutions issued the annual Report to the Nation on the Status of Cancer (1975–2012). This year’s report showed 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% per year from 2003 to 2012. Incidence rates decreased among men and remained stable for women between 2003 and 2012.

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

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 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. “But the growing burden of liver cancer is troublesome. We need to do more work promoting hepatitis testing, treatment, and vaccination.”

Vaccination Key to Prevention

“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, MD, Acting Director of the NCI. “Determining which cancers can be effectively prevented by vaccines and other methods is one of our top priorities at NCI and one 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% 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. The 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 United States, including testing and treatment for HCV, hepatitis B vaccination, and lowering obesity rates,” said Otis W. Brawley, MD, 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. 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% 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% of all newly diagnosed cancer cases in the United States are used in this report.”

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

See ASCO Issues Report on State of Cancer Care in America: 2016 in this issue of The ASCO Post for more on the status of cancer in the United States, including news of ASCO’s State of Cancer Care Report released earlier this month.

Corrections were made to this article on March 25, 2016.


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