Changing future trends in cancer incidence and mortality.

Abstract

In 2040, cancer incidence and mortality in the United States will be different than they are now, with more patients being diagnosed with melanoma and dying of pancreatic and liver cancer. “Although death rates will decline for the majority of cancer types, a significant increase in deaths from pancreatic cancer and liver cancers is estimated to continue,” says Lola Rahib, PhD, director of scientific and clinical affairs at Cancer Commons in Mountain View, California, and lead author of a study published in JAMA Network Open that estimated projections of US cancer incidence and mortality in the year 2040.1 In the cross-sectional study, Dr. Rahib and her colleagues used US Census Bureau population growth projections and current population-based cancer incidence and death rates to calculate cancer incidence and deaths in the year 2040. The study found that lung cancer will continue to be the leading cause of cancer-related deaths (at an estimated 63,000 cases), but deaths from pancreatic cancer and liver and intrahepatic bile duct cancers (41,000 cases total) will surpass colorectal cancer deaths (34,000 cases). The study also found that breast cancer will be the most common cancer type (at an estimated 364,000 cases), and that it will be followed by melanoma (219,000 cases), lung cancer (208,000 cases), and colorectal cancer (147,000 cases). Electra D. Paskett, PhD, the Marion N. Rowley Professor of Cancer Research at The Ohio State University in Columbus, says that the increase in the incidence of melanoma and the mortality figures for pancreatic and liver cancers surpassing those for colorectal cancers were unexpected, and it was disheartening to see the continual rise in and death from preventable cancers. The findings suggest to her the need to maximize the use of screening tests for these types of cancers. “Prevention needs to be pushed more for melanoma, lung, and colorectal cancers, and new prevention, screening, and treatment strategies need to be implemented for pancreatic and liver cancers,” says Dr. Paskett. She also emphasizes the need to expand access to and options for treatment, particularly the use of immunotherapy for lung cancer, which is greatly improving survival rates. Dr. Rahib also underscores the need to invest in screening programs to alter the burden of cancer in the future. “A central challenge in early detection is the inability to distinguish between cancers that will turn aggressive and need to be treated and those that are indolent and will not cause harm if left untreated,” she says. Dr. Rahib emphasizes the need to address disparities in cancer screening and care, which, she says, “can further prevent deaths substantially in some cancers with already existing screening programs, such as colorectal and breast cancer.” The findings of this study, she says, can help to inform efforts to improve detection of and treatment for many cancer types.