Estimates indicate that cancer will become the number one leading cause of death in the United States over the next five to 10 years. But, as one expert argued in a policy roundtable, there are ways to significantly decrease that rate.
Behind heart disease, cancer is the second leading cause of death in the United States. However, it is on track to surpass heart disease and become the leading cause of death in the U.S. within the next five to 10 years, according to one expert.
“Over the next five years or so with the dramatic declines in heart disease death rates, actually faster than the declines in cancer death rates, we will see cancer become the number one killer in the United States,” Dr. Otis Brawley, a professor of oncology at Johns Hopkins University School of Medicine, said during a policy roundtable hosted by the National Coalition for Cancer Survivorship.
During the discussion titled, “Cancer in the Next Decade”, Brawley broke down various statistics and trends over the last several decades across multiple cancer types and offered insight into how that mortality trend could be significantly reduced by 2035.
Behind the Decline
Over a 26-year period ending in 2017, there was a 29% decline in cancer deaths, but that rate is nowhere near what it was in 1900, explained Brawley. A significant factor in that 29% decline is what he refers to as wise early detection, especially the early detection of colorectal, breast and cervical cancers.
“I say wise early detection because there is unwise screening out there in which people actually get hurt,” he said referencing what can happen when people receive unnecessary screenings. “And then there’s good prevention especially tobacco control as well as improvements in cancer treatments.”
As an example, he mentioned that 40% to 50% of the decline in breast cancer deaths can be attributed to screening and early detection, and 50% to 60% of the decline is as a result of improvements in the ability to treat the disease.
Potentials for Prevention
In paying attention to known risk factors cancer deaths can be reduced by 60%, Brawley noted during the presentation. For instance, 33% of cancers are attributed to smoking which correlates to 188,744 cancer-related deaths. Additionally, 20% of cancers are caused by overweight and obesity leading to 114,390 deaths.
Although smoking is currently the number one known risk factor for cancer, Brawley explained that as the prevalence of smoking continues to decline the focus needs to shift to what he refers to as energy balance.
“Energy balance is how I prefer to look at the problem of overweight, obesity, too many calories and lack of exercise,” he said. “Think of it as a three-legged stool, it is not just obesity, it is the combination of too many calories, not burning those calories (off) through exercise and then storing those calories.”
Fifteen percent of Americans were obese in 1970, but today that number has increased to 35% subsequently resulting in an expected 30% to 40% increase of weight-related cancers over the next decade or more.
“With the decline in tobacco use, energy balance will become the leading cause of cancer death in the United States within the next five to 10 years,” Brawley said.
Applying Facts to Reduce Mortality
There are estimates, according to Brawley, that approximately 600,000 Americans will die of cancer in 2020. That number would reduce by 22%, however, if everyone had a college education. Meaning, more than one in five cancer deaths would not occur.
Additionally, at least 132,000 of those deaths could be prevented if Americans received known medical prevention and treatment.
“That’s more powerful than any drug that we have,” Brawley said. “There’s no breakthrough treatment, no breakthrough drug, no breakthrough screening that is as powerful as simply getting to all human beings the technologies, risk reduction, screening, prevention diagnosis and treatment that we already have. Keep in mind some of these risk reductions technologies involve preventing teenagers from smoking, therefore they won’t die when they are in their 50's and 60's. Again, this is the 29% decline that we have had over the last 26 years.”
If the current path of screening and treatment is continued with no changes, the belief is that by 2035 there will have been a 26% decline in cancer mortality from 2015. However, if things were done to ensure all Americans received the necessary care, cancer mortality would decline 38% by 2035.
“Essentially what I'm saying is that we are literally at a point in time where our options are, we can have about a 50% decline from 1991 and 2035 or we could have close to a 65% decline in cancer death rates from 1991 to 2035,” Brawley said. “If we were to do what we should do as a society, by 2035 we would actually get the cancer death rate back down very close to the cancer death rates that we had about 1900. So that is really the bottom line of this talk, trying to get everyone adequate care be it preventative, risk reduction or therapeutic, if we could try to do that to everyone, it's much more powerful than any research has ever given us in terms of a therapy.”