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U.S. cancer death rate has dropped by a third since 1991

wsj.com

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Re: U.S. cancer death rate has dropped by a third since 1991

#41

Post by Gatsky »

This is great progress.

Important to note this is not an average effect across all cancers. Some cancers still have terrible outcomes eg pancreatic cancer, GBM, small cell lung cancer, stomach and esophageal cancer, certain types of breast cancer. Advanced colorectal cancer also not great.

The other aspect of this is that death can often be replaced with multiple years of a highly medicalised and sallow existence while receiving cancer therapy.

Point being, we don’t want to lose site of the ultimate goal, which is preventing cancer as much as possible.

Re: U.S. cancer death rate has dropped by a third since 1991

#42

Post by vikingerik »

paulpauper wrote: post #3

The problem is this is mostly due to screening, not progress at treating advanced cancer, although that has improved too.

Avoiding cancer in the first place matters too. Lung cancer is a lot less common, now that nobody smokes any more. The rate of lung cancer deaths for men has halved since 1991, which itself accounts for half of the overall decline.

Re: U.S. cancer death rate has dropped by a third since 1991

#43

Post by docdendrite »

wahern wrote: post #24
docdendrite wrote: post #13

Earlier quoted context omitted.

That is a dubious claim. While links between HPV and cervical cancer are quite strong and well-defined, the associations with the other viruses you cite are only correlative. Also, Hep C, HIV and herpes have no vaccine, so unclear what your statement is referring to anyway? What has contributed to a drop in cancer mortality would be advances in treatment (like targeted therapies and immunoncology), better image/blood…

> While links between HPV and cervical cancer are quite strong and well-defined, the associations with the other viruses you cite are only correlative. HPV is merely correlative, as well. That's basically how all endogenous cancers work. With Epstein-Barr Virus the association is quite strong, though the incidence of EBV-induced cancers doesn't seem to be quite as large as HPV--~1% vs 2-3%.

HPV isn't correlative, it's causative. Additional co-transformation factors may be required, but it is well understood that E6 and E7 proteins directly lead to tumorigenesis. EBV pathogenic mechanisms are more autocrine and therefore a muddier picture, hence correlative.

Re: U.S. cancer death rate has dropped by a third since 1991

#44

Post by chimeracoder »

TylerE wrote: post #39
chimeracoder wrote: post #32

Earlier quoted context omitted.

> Or it could simply mean that another cause of death has increased. Like heart disease/diabetes from ever increasing obesity rates. You could hardly have picked a worse counterexample. Deaths from heart disease have fallen dramatically over that time period, even faster than cancer deaths have dropped. Deaths from strokes - which at one point equalled deaths from all cancers combined - have fallen as well, although…

Diabetes is almost never the direct cause of death, but it’s damn hard in the body. Hurts circulation, hurts your nerves, hurts your organs… and it can flare badly in reaction to some medications. So, the cause of death won’t be “diabetes”, it’ll be heart attack, stroke, chronic infection, something like that. Similar to AIDS in that it doesn’t kill you directly (not that we know that juvenile diabetes is a thing, an…

> Diabetes is almost never the direct cause of death, but it’s damn hard in the body. Hurts circulation, hurts your nerves, hurts your organs… and it can flare badly in reaction to some medications. So, the cause of death won’t be “diabetes”, it’ll be heart attack, stroke, chronic infection, something like that.

It's not like the CDC doesn't know this. They understand how diabetes works; that's reflected in the tabulation of data. It's still incorrect to say that the drop in cancer deaths is explainable by the increase in diabetes deaths, not the least because age-adjusted diabetes deaths decreased during most of that interval.

Re: U.S. cancer death rate has dropped by a third since 1991

#46

Post by chasil »

docdendrite wrote: post #13
myroon5 wrote: post #5

More vaccines seems like one of the most straightforward future mitigations since viruses like Hepatitis/HPV/mono/HIV/herpes/etc cause almost a fifth of cancer cases: https://en.wikipedia.org/wiki/Oncovirus

That is a dubious claim. While links between HPV and cervical cancer are quite strong and well-defined, the associations with the other viruses you cite are only correlative. Also, Hep C, HIV and herpes have no vaccine, so unclear what your statement is referring to anyway? What has contributed to a drop in cancer mortality would be advances in treatment (like targeted therapies and immunoncology), better image/blood…

This particular virus has a solid link to various forms of cancer:

"[Epstein–Barr virus] has also been implicated in several other diseases, including Burkitt's lymphoma, hemophagocytic lymphohistiocytosis, Hodgkin's lymphoma, stomach cancer, nasopharyngeal carcinoma, multiple sclerosis, and lymphomatoid granulomatosis.".

https://en.wikipedia.org/wiki/Epstein%E2%80%93Barr_virus#Rol...

Re: U.S. cancer death rate has dropped by a third since 1991

#47

Post by stjohnswarts »

londons_explore wrote: post #25
timerol wrote: post #11

Earlier quoted context omitted.

The "US Cancer Death Rate" talked about in the article is measured in deaths per 100,000 population, not deaths per detected cancer. So we are comparing apples to apples, but finding and treating cancers earlier could be helping to result in fewer deaths.

Or it could simply mean that another cause of death has increased. Like heart disease/diabetes from ever increasing obesity rates. A person can't die twice, so if heart disease gets them first, then they won't die of cancer.

You have to got to decide a parameter at some point. It will never be 100% descriptive in reality, biology is a messy science.

Re: U.S. cancer death rate has dropped by a third since 1991

#48

Post by HWR_14 »

kragen wrote: post #15
pasquinelli wrote: post #9

Earlier quoted context omitted.

> If our testing were perfect such that we could detect all cancers early enough to stop, that would functionally be a cure, no? no. being able to detect cancer doesn't mean people are getting tested twice a year for their whole life. for example, you wouldn't have routine cancer screenings for children, but sometimes they get cancer, and on those occasions it'd be nice to have better treatment options.

if cancer screenings for children were painless, lower risk than the cancer, and cost five dollars, you would totally have routine cancer screenings for children i mean maybe not in the usa but in sane places

They would have them in the US as well, but only for people in the Gold tier of insurance

Re: U.S. cancer death rate has dropped by a third since 1991

#50

Post by caeril »

cokeandpepsi wrote: post #20
JKCalhoun wrote: post #17

Earlier quoted context omitted.

> The decline in smoking rates in the U.S., better early detection and innovative treatments including immunotherapy drugs have driven a drop in death rates since 1991, the report said, averting an estimated 3.8 million cancer deaths in that time. Yes. I expected to find that the decline in smoking has also lead to the decline in fatal cancer — and there it is. Still a good thing.

it's crazy how fast smoking died out in the US even 10 years ago it felt people were puffing away all over the place

Indeed. Now we just need to do the same for overeating.
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