A recent report by the National Cancer Institute, and reported in USA Today, has stated that cancer death rates have been falling for at least 25 years. Cancer is the second leading cause of death in America behind cardiovascular disease. This sounds like good news, but let’s unpack what lies behind the headlines. Does this represent the big picture?

    Lower smoking rates are translating into fewer lung cancer deaths. Lung cancer is the leading cause of cancer death in America. Early detection has also helped reduce deaths due to lung cancer. In USA Today headline, the most important factor in helping lower the death rate was stopping the leading cause of our most deadly cancer. Intuitively, getting at the cause is what is lowering cancer rates, specifically lung cancer. 

    In 2017, increasing death rates were reported in 7 of the 10 leading causes of death. Is cancer really a bright spot? Why is the rate of lung cancer still high in some states? Is the rate of cancer dropping? What about the other types of cancer?

    Dr. Rob Headrick, one of my partners and chief of thoracic surgery at Memorial Hospital, shared this on lung cancer with our group in Tennessee:  “We’ve got a terrible cancer death issue in our state, and people in our communities are hurting worse than others in the rest of the country.” Smoking prevention would help Tennessee catch up with the rest of America.

    Many types of cancer have increasing death rates. These include the cancers associated with obesity. Obesity is associated with many physiologic changes increasing the cancer risk. Pancreatic, uterine, liver, and breast cancer have links to obesity. It may take decades to see the full effects of obesity on cancer.

    The take home is that cancer death rates will improve as we find ways to lower the stressors that trigger the mutations of cancer. We have helped lung cancer rates with lower cigarette rates. More treatment is not the solution in lowering death rates from cancer. We must find ways to lower the cause, whether that be losing weight, being smart about sun exposure, lowering substances that trigger colon cancer, increasing fiber, and the list goes on. One report does not give a complete picture.