Cancer death rates down, but other ‘hurdles’ must be faced

January 7, 2013 | by

Overall, cancer death rates in the U.S. are falling among men, women and children – and across all major ethnic groups. That’s the broad message from the latest Annual Report to the Nation on the Status of Cancer.

Human papillomavirus

Cancer death rates are down in the U.S., but many hurdles remain, a new report says. Among them, increasing vaccinations against the human papillomavirus (shown).

Then the numbers become more nuanced. Overall cancer incidence rates are also falling – but only for men; for women, they’re holding steady, and for children, they’ve ticked up. Similarly, while death rates for most common cancer sites – lung, colon and rectum, breast (for women) and prostate – are down, death rates are up for melanoma (among men) and for liver, pancreatic and uterine cancers.

“The continuing drop in cancer mortality over the past two decades is reason to cheer,” John R. Seffrin, chief executive of the American Cancer Society, said in a statement. “The challenge we now face is how to continue those gains in the face of new obstacles, like obesity and HPV infections. We must face these hurdles head on, without distraction, and without delay, by expanding access to proven strategies to prevent and control cancer.”

The report was co-written by researchers from the American Cancer Society, the federal Centers for Disease Control and Prevention, the National Cancer Institute and the North American Assn. of Central Cancer Registries. It was published online in the Journal of the National Cancer Institute on Monday and will be published later in print.

The traditional special-feature section of the report focused this year on cancers linked to the human papillomavirus and on HPV vaccination rates among adolescent girls. Among the cancers linked to the virus are most cervical and anal cancers, and some oropharyngeal, vaginal, vulvar and penile cancers. The report highlighted increasing rates for oropharyngeal (part of the throat) and anal cancers – and the low vaccination rates among girls.

“While this report shows that we are making progress in the fight against cancer on some fronts, we still have much work to do, particularly when it comes to preventing cancer,” said CDC Director Thomas R. Frieden, M.D., in a statement. “For example, vaccinating against HPV can prevent cervical cancer, but, tragically, far too many girls are growing into adulthood vulnerable to cervical cancer because they are not vaccinated.”

As Joel Epstein, D.M.D., M.S.D., director of oral medicine at City of Hope, noted last year: “From an epidemiological perspective, it makes sense to vaccinate the population during their childhood, but there are cost issues that need to be considered as well. We don’t know if HPV infection is an epidemic in the starting stages or if HPV-related cancers will remain relatively rare in comparison to other cancers.”

And in their conclusion, the researchers wrote:

"Previous studies have found that health-care provider recommendation is the most important predictor of vaccine acceptance.... Barriers to not “strongly or always” recommending vaccination included the need to discuss sexuality before recommending the vaccine; the high cost of the vaccine (approximately $390 for the three-dose series) and reimbursement concerns; parental refusal because of vaccine safety concerns, religious, or philosophical concerns; and lack of understanding of the HPV vaccine."