Annual cancer report shows decline in mortality rates, analyzes breast cancer subtypes

Overall rates for cancer deaths are decreasing among all demographics nationwide, according to “The Annual Report to the Nation on the Status of Cancer, 1975-2011,” published in the Journal of the National Cancer Institute.

The report, co-authored by the North American Association of Central Cancer Registries (NAACCR), the American Cancer Society, the Centers for Disease Control and Prevention and the National Cancer Institute (NCI), shows a consistent decline in overall cancer mortality rates since the early 1990s. From 2002 to 2011, mortality rates decreased by approximately 1.8 percent per year among men and by 1.4 percent per year among women. The report also showed that pediatric cancer mortality rates have decreased since 1975 after rising from the years 1998 to 2003.

“Overall cancer death rates continue to decrease in the United States,” wrote lead author Betsy Kohler, MPH, CTR, of the NAACCR, and colleagues, “and this favorable trend includes men and women, children, all major racial and ethnic groups, and all four of the most common cancers (lung, colorectal, female breast, and prostate) and many other cancers.”

While the results outlined in the report are promising, they should not be taken as a signal to relax anti-cancer efforts, cautions CDC Director Tom Frieden, MD “The continued decline in cancer death rates among men, women, and children is encouraging, and it reflects progress we are making in cancer prevention, early detection, and treatment,” Frieden said in a release. “However, the continuing high burden of preventable cancer, and disparities in death rates among races and ethnicities, show that we still have a long way to go.”

The report also included a comprehensive analysis of the four breast cancer molecular subtypes: Luminal A (HR+/HER2-), Luminal B (HR+/HER2+), HER2-enriched (HR-/HER2+), and triple negative (HR-/HER2-). The subtypes were analyzed for the first time ever, as U.S. cancer registries are now differentiating among them in their records. This allows statisticians to better examine and analyze cancer rates based on clinically meaningful subtypes.

The researchers found unique patterns with racial/ethnic group according to age, socioeconomic status, geography, and specific tumor characteristics. “Rates of HR+/HER2- breast cancer, the least aggressive subtype, were highest among non-Hispanic whites, aligning with previously reported findings,” the NCI stated in a release. “Rates of HR+/HER2- breast cancer decreased with increasing levels of poverty for every racial and ethnic group. Also consistent with prior studies, non-Hispanic blacks had higher incidence rates of the most aggressive breast cancer subtype, triple negative, than other racial/ethnic groups.”

Because different subtypes require specific medications and courses of treatment, this first-of-its-kind information will go a long way toward improving patient care and cancer management, according to the NCI. “As women with breast cancer become more familiar with the concept of breast cancer subtypes, they will be better able to understand what is guiding their treatment and the implications for their health outcomes based on their breast cancer subtype.”

(Check out the NCI infographic on breast cancer subtypes below, or click here to read the full cancer report.)

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