The American Cancer Society (ACS) has released its annual report on cancer facts and trends. The findings trumpet a victory over cervical cancer — and sound a call-to-arms for fighting prostate cancer.
Cancer mortality has fallen 33% since 1991. That’s a reduction of around 3.8 million deaths.
But perhaps the report’s most encouraging finding was a reported 65% drop in cervical cancer rates among 20- to 24-year-old women from 2012-2019.
“There’s really astounding, important news showing that the efforts that our children went through over the last 20 years or so to go through vaccinations have actually saved lives,” said ACS’s chief science officer, Dr. William Dahut.
Cervical cancer numbers have fallen since the screening boom of the 1970s, but at a shallower rate of around 20%-30% over a decade. This steepening shift could offer new hope for preventing other HPV- and infection-related cancers.
“We know of Merkel cell cancers; we have hepatitis and others,” said Dahut. “There's real potential for impact in saving lives.”
Research links HPV (human papillomavirus) to genital cancers, anal cancers and cancers of the oral cavity, throat and tongue. Lead author Rebecca Siegel is the senior scientific director of surveillance research at ACS. She says she has seen case rates and deaths for such cancers rise among both men and women.
“What we'll be looking for is to see a downturn in those trends in the future,” she said.
In less encouraging news, following a two-decade decline, prostate cancer grew 3% per year from 2014-2019. Worse, the increase mainly involved advanced-stage cases, which are hard to treat and often incurable.
“When we do see the shift to diagnosis of more advanced disease, it gives us a concern about what the subsequent years will look like for mortality rates,” said ACS CEO Karen Knudsen. “This is why it's so important for us to act now.”
The report also finds that the impacts of prostate cancer vary along geographic and racial lines. The disease occurs 70% more in Black men than White men and kills around two to four times as many Black men as men in every other racial and ethnic group.
In response to these alarming trends, ACS is launching IMPACT (Improving Mortality from Prostate Cancer Together), an initiative to fund new cancer research and improve screening and prevention.
That’s important, because catching cancer before it leaves the prostate can make a huge difference in prognosis. Knudsen said people diagnosed with localized prostate cancer can hope for five-year survival rates upwards of 99%.
Moreover, she said, the field of prostate cancer detection and diagnosis has advanced in the past three decades and offers options that are more personal and nuanced, including improved imaging.
“This is not the 1990s, where a rising PSA would trigger potentially premature strategies for prostate removal,” said Knudsen. “We have moved so far beyond that as a field.”
A PSA, or prostate-specific antigen (PSA) test, is a blood test that screens for prostate cancer by looking for abnormally high levels of a certain protein. Shifts in guidelines regarding PSA tests have contributed to confusion and mistrust of the procedure.
In 2012, the U.S. Preventive Services Task Force (USPSTF) recommended against its use on the grounds that its potential harms outweighed its benefits. In April 2017, due in part to a rise in later-stage prostate cancer cases, the agency reversed that guidance and recommended men 55-69 years old undergo periodic PSA screening, but take into account individual risks, benefits and uncertainties before deciding on a treatment plan.
Just when ACS will release its new cancer standards remains unclear. Dahut said he hopes to be “fairly far along” by year’s end, but such a collaborative scientific process resists strict timelines.
He added that updates will come more frequently in future.
“These will be living documents,” he said. “We're not going to wait 10 years to update our documents on screening guidelines if new information is available.”
Arizona’s prostate and cervical cancer rates have trended downward over the past two decades, but available data is too old to capture some of the changes described in the report. Cancer rates in the state vary significantly from county to county.