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The cancer death rate has fallen 33% since 1991, according to a new study from the American Cancer Society. The report, published in CA: A Cancer Journal for Clinicians, estimates 3.8 million deaths were prevented over the past three decades. In the most recent year for which data is available, between 2019 and 2020, the death rate shrunk by 1.5%.

The report’s authors credit improvements in cancer treatment, increases in early detection and a decline in smoking for the lower death rates. Researchers also pointed to HPV vaccinations as a direct link to reduced cancer deaths.  HPV, or human papillomavirus, is known to cause cervical, anal and head and neck cancers.

Dr. Monica Avila, gynecologic oncologist

Dr. Monica Avila, gynecologic oncologist

“Over the last 30 years we’ve seen a significant decline in the United States in cervical cancer mortality,” said Dr. Monica Avila, a gynecologic oncologist in the Gynecologic Oncology Program at Moffitt Cancer Center.  “We’ve seen more than a 50% decline in that time, and based on the data we have, it seems that that decline is directly linked to HPV vaccination.”

“This is especially true in the Hispanic and the Black communities,” Avila said. “It’s interesting because data suggests that Hispanic patients are the most likely to have a diagnosis of cervical cancer while Black patients are most likely to die from the disease. Thankfully, with the efforts to vaccinate these populations against HPV, we’ve seen a huge decline in deaths rates.”

In all cancers combined, the report found that the five-year survival rate has increased from 49% in the mid-1970s to 68% during 2012-18. Researchers point to a decline in smoking as a big reason for the improved survival rates.

The report was not all good news, however. The study showed that more men are being diagnosed with advanced prostate cancer that is less likely to respond to treatments. Prostate cancer diagnoses rose by 3% each year from 2014 to 2019. The increase was mostly driven by new advanced disease cases, which has grown by 4% to 5% annually since 2011.

According to the American Cancer Society, nearly 290,000 men will be diagnosed with prostate cancer in the United States in 2023. About 34,700 will die from the disease. Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer.

In 2012, the U.S. Preventive Services Task Force recommended against PSA screening for men 75 and older. Researchers believe this could be linked to the rise. In 2018, the task force recommended a discussion regarding risks and benefits of screening. The concern with screening is the overdiagnosis and overtreatment of cancers that will not spread or affect the life expectancy of many men.

Dr. Julio Pow-Sang, Genitourinary Oncology Program

Dr. Julio Pow-Sang, Genitourinary Oncology Program

“For several years, fewer men had prostate cancer screenings, and this might have led to diagnosing cancers at a more advanced stage. Also, the reality is that it’s very difficult for health care providers to have thorough discussions with men regarding the risks and benefits of prostate cancer screening,” said Dr. Julio Pow-Sang, chair of the Genitourinary Oncology Program at Moffitt. “Without these PSA tests happening, we’re not able to catch significant cancers at an early stage and until men develop symptoms potentially a few years down the road.”