(National Cancer Institute/Unplash)
By 2040, more people will die of skin, pancreatic and liver cancer than they do today, but fewer will succumb to breast and prostate cancer.
That’s according to an analysis published Wednesday in Journal of the American Medical Association. Lola Rahib of Mountain View, Calif., led the original investigation. She practices at Cancer Commons and represents Pancreatic Cancer Action Network of Manhattan Beach, Calif.
“This study estimated that the most common cancers in 2040 will be breast (364,000 cases) with melanoma (219,000) becoming the second most common cancer; lung, third (208,000); colorectal remaining fourth (147,000); and prostate cancer dropping to the fourteenth most common cancer (66,000 cases),” the authors tabulated.
“Lung cancer (63,000 deaths) was estimated to continue as the leading cause of cancer-related death in 2040, with pancreatic cancer (46,000 deaths) and liver and intrahepatic bile duct cancer (41,000 deaths) surpassing colorectal cancer (34,000 deaths) to become the second and third most common causes of cancer-related death, respectively. Breast cancer (30,000 deaths) was estimated to decrease to the fifth most common cause of cancer death.”
‘Marked changes in the landscape of cancer incidence,’ deaths
The authors said their findings “suggest that there will be marked changes in the landscape of cancer incidence and deaths by 2040.”
They offered a snapshot of today’s cancer impact in this country. “There were an estimated 1.8 million diagnoses and more than 600,000 deaths from cancer in the U.S. in 2020. Malignant neoplasms are the leading cause of death in individuals aged 45 to 64 years, and a substantial proportion of health care spending is attributed to cancer.
“Coping with the burden of cancer requires an in-depth understanding of trends in cancer incidence and death by all stakeholders. As incidence and death rates for many cancer types vary by age, sex, and ethnicity, the changing demographic characteristics of the U.S. must be considered.”
When projecting which killer cancers will emerge more powerful in the next 20 years, the authors used this math:
“To determine the most accurate estimated projections, we integrate changing cancer incidence and death rates with updated demographic data from the 2016 population estimates based on 2010 U.S. Census data to estimate cancer incidences and deaths to 2040.”
Other than to satisfy curiosity, what purpose does knowing which cancers will emerge deadliest serve? “These estimated projections are important to guide future research funding allocations, health care planning, and health policy efforts,” the authors wrote.
Lung cancer incidence down
The authors explained why incidence of lung cancer is trending down. “A large portion of the decrease in lung cancer death rates are secondary to decreased tobacco use,” they wrote. “Additionally, in 2013, the United States Preventive Services Task Force recommended annual low-dose computed tomography screening for lung cancer in select groups (grade B) based on a survival benefit in a large, randomized trial.
“The combination of improved screening and a decreasing proportion of the U.S. population using tobacco products may contribute to a steadily declining death rate from lung cancer in the coming decades.”
More people diagnosed with breast cancer in 2040, fewer dying
Although breast cancer incidence will go up by 2040, deaths will go down, the authors estimated. “We estimated that deaths from breast cancer will decline from 42,000 in 2020 to 30,000 in 2040,” they explained.
“This is consistent with a breast cancer death rate that has declined 40 percent since 1989. Observed declines in the rate and absolute number of breast cancer deaths can partially be attributed to screening and treatment advances, such as the adoption of mammography and endocrine therapy.”
They also found that black women don’t fare as well as white women. “Although black and white women had similar breast cancer death rates prior to these advances, their breast cancer death rates diverged in the 1980s and are currently 40 percent higher in black women than in white women.
“Although this disparity may in part be due to differences in breast cancer biology, people from underrepresented racial and ethnic groups are more likely to receive their mammography at nonaccredited facilities, to have longer intervals between screening mammography, and experience delays in diagnosis. There is an opportunity to accelerate the decline in breast cancer death rates by increasing access to high-quality, standard-of-care prevention and treatment services to all women.”
Cancers in gastro tract will be big killers in 2040
“Cancers of the gastrointestinal tract (pancreatic, liver, and colorectal cancer) were estimated to constitute three of the top four causes of cancer death in 2040,” the authors projected. “According to our updated estimated projections, pancreatic cancer will surpass colorectal cancer as a leading cause of cancer death in approximately 2026 and liver cancer will surpass colorectal cancer shortly before 2040.
“Irrespective of these differences, the overall message of the need to be prepared for an increase in pancreatic and liver cancer is reinforced by these estimated projections.”
Colo-rectal cancer death rates continue to trend downward due to more pervasive screening, but this form of cancer still is very deadly. “Between 1987 and 2010 the proportion of U.S. adults aged 50 years and older who underwent colorectal cancer screening rose from 35 percent to 66 percent,” the authors wrote.
“As colorectal cancer screening has the potential to remove malignant and premalignant lesions, increased screening has been mirrored by dramatically lower incidences of late-stage and early-stage colorectal cancer.
“However, one in three individuals who meet guideline recommendations for colorectal cancer screening have never been screened. Colorectal incidences and deaths in the younger age group (20 to 49 years) have been on the rise since the last decade and will continue to rise in the next two decades with colorectal cancer becoming the second leading cancer in this age group.”
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