Cancer, as a disease, is believed to have been around since 1600 B.C. where human bone cancers were found in Egyptian mummies and were documented in very early manuscripts from that time. The term “cancer” is from the Greek word karkinos which is related to a crab; the Greek saw cancer like a crab where it grabbed hold and would not let go as well as having multiple arms to spread out within an animal. Carcinomas were originally described by Hippocrates around 400 B.C. This brief history is provided simply to illustrate that this is a very old disease, although it seems like we didn’t start noticing it until well into the 1900s.
While the disease itself may be old, the data collected is less so. Cancer control data has been documented since the early 1900s where providers of that time looked to detect cancer early via physical signs or symptoms and proceeded with surgical interventions. Cancer control, as an academic science field was not recognized until the mid-twentieth century when more consistent early screening tests became more widely accepted. Cancer control, as a subspecialty, is focused on providing education and information to the public and clinical providers to reduce the cancer burden on society. Their practices include prevention strategies, early detection, and treatment interventions.
The American Cancer Society is providing current literature on their analysis of the National Center for Health Statistics data on cancer mortality trends and concerns for the future and the first article published in CA: A Cancer Journal for Clinicians outlines where we have come in thwarting this very old disease.
The three metrics often used in analyses of cancer control progress are incidence rates, survival rates, and death rates. The group that authored the aforementioned article chose to evaluate our outcomes based on mortality rates because these are less affected by the multitude of interventions that have been developed in the last two to three decades. In analyzing data from 1930 to 2015, the peak mortality rate occurred in 1991 where 215 individuals out of 100,000 were dying of cancer. Those numbers have declined dramatically at a rate of 26% in the past 24 years overall. The four big cancers that account for nearly half of all cancer deaths, namely lung, colorectal, breast, and prostate, have decreased their mortality rates which collectively lowered the overall rate in dramatic fashion (36% decline for these 4 cancers from 1991 to 2015). The reasoning for this decline includes the work being done on cancer prevention including significant decreases in smoking and the recognition and removal of pre-cancerous colorectal or cervical lesions, thus affecting the incidence rates. In fact, the increase and enhancement of screening techniques may have increased the incidence rates, but the mortality rate declined because cancers are being detected and treated earlier, leading to higher remission rates. Lastly, these numbers are attributed to improvements in surgical interventions leading to fewer surgical complications and death as well as better therapeutic approaches and management of those approaches.
There are still opportunities to improve these numbers in the next 20 years, however. Lung cancer remains the leading cause of cancer deaths and while there is a decline in smoking and cancer related deaths since the 55% mortality rate peak in 1991 for this particular disease, there are still areas or populations that maintain smoking habits which will continue to affect cancer rates. Additional opportunities with cervical cancer lie in education and awareness that in the United States in 2016, less than 1 in 2 females utilized the human papillomavirus vaccine which has been proven to severely minimize the potential for cervical cancer development. This one change could eliminate cervical cancer which is still considered a major cause of morbidity and mortality. In addition, there are opportunities to better educate on the differences in prevalence and cancer rates based on race and ethnicity of individuals. Lastly, there are continued opportunities to mitigate health disparities brought about by differences in access to health care. These pieces are critical to continuing to effect positive change on cancer death rates, driving innovative and effective therapies, and reducing the cancer burden for the public.
Source: CA: A Cancer Journal for Clinicians,