COVID-19 clouds extent of cancer death decline The Mesa Tribune | The Hometown Newspaper for the city of Mesa, AZ

COVID-19 clouds extent of cancer death decline

January 29th, 2021 Mesa Tribune Staff
COVID-19 clouds extent of cancer death decline

By Kevin Pirehpour
Tribune Contributor

A new study from the American Cancer Society finds that the U.S. mortality rate for cancer – the second leading cause of death in Arizona – has been declining for nearly three decades, with record-breaking declines in the most recent two reported years.

The study found a 31 percent decline in the cancer death rate nationwide from 1991 to 2018, with a record single-year decline of 2.4 percent from 2017 to 2018, topping the previous years’ record 2.2 percent decline in cancer deaths. 

The decline is a testament to a widespread reduction in smoking, advances in early detection and new therapy options available for some forms of cancer. However, the report said it’s unclear how COVID-19 will affect the longstanding decline.  

“We’ve come a long way just in the past decade or so in terms of novel treatments, even when [patients] present with an advanced stage of the disease,” said Dr. Rogerio Lilenbaum, director of the Banner MD Anderson Cancer Center in Gilbert.

According to Lilenbaum, drugs that target specific molecules involved in cancer growth, combined with immunotherapies that help activate the immune system, have been “nothing short of revolutionary” in combating cancer. 

“Many of these patients who used to have a median survival of less than a year will be alive and free of disease,” Lilenbaum said. “So, it’s really remarkable how much immunotherapy has impacted the treatment of cancer.”

The report said a reduction in smoking is thought to have led to a decline in lung cancer – a driving force behind the falling cancer mortality rate.

Despite the downward trend, however, lung cancer accounts for more cancer deaths in Arizona than colorectal, pancreas, prostate and breast cancer.

Treatment of lung cancer is most effective in early stages of the disease before it has time to spread.

However, signs of lung cancer often surface at an advanced stage of the disease, leading to delays in detection and removing the option of early intervention. 

“We have not at a national level adopted lung cancer screening as widely as I think health experts and policy experts would hope,” Lilenbaum said. “My sense is that it’s even lower in the state of Arizona.”

Arizona ranks 47th in the nation for cancer-related deaths, according to the Centers for Disease Control and Prevention.

In recent years, low-dose computed tomography scans, or CT scans, have been shown to improve early detection of lung cancer in high-risk patients, such as smokers, lowering the risk of dying from the disease, according to the American Cancer Society. 

Lilenbaum said if patients “undergo a low-dose CT and are identified as having silent lung cancer, they will live longer than patients that are diagnosed by the time they develop symptoms.”

Beyond advanced screening techniques, systemic racial inequities in our healthcare system have created a gap in the cancer death rate among ethnic groups, specifically in the Black community. 

Today, Black patients “have the highest death rate and shortest survival of any racial/ethnic group for most cancers,” according to the American Cancer Society. 

“I think that we’re still working to undo the legacy of that history and it’s an issue that deserves greater attention from health care authorities all over this country,” Lilenbaum said. “It’s not unique to Arizona.”

Included in the report, are estimated U.S. cancer trends for 2021. However, the effect of COVID-19 is not included in this year’s prediction. 

Waves of COVID-19 cases since early 2020 have resulted in a “significant delay in cancer diagnosis” as more patients have avoided taking unnecessary trips to the hospital at the risk of coming in contact with the virus, according to Lilenbaum. 

“I believe that once we become more comfortable – outside of COVID – we will see a higher number of cancer diagnoses and we will see patients with more advanced disease than we typically do,” Lilenbaum said.

“But we will be prepared to manage those patients, to help those patients; to offer them all the options that are available to them.”

Despite the uncertainty surrounding the pandemic, he added, significant progress has been made in cancer treatments and mortality. 

“We continue to develop new treatments, we continue to investigate new options and we will remain on the cutting edge of this fight against cancer,” Lilenbaum said.

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