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256C448 273.7 433.7 288 416 288H32C14.33 288 0 273.7 0 256zM416 448H32C14.33 448 0 433.7 0 416C0 398.3 14.33 384 32 384H416C433.7 384 448 398.3 448 416C448 433.7 433.7 448 416 448z"></path></svg></button></div></div></header><div class="alert-banner"><div class="content"><div class="text"><strong>COVID-19 vaccinations, cases, excess mortality, and much more</strong></div><a href="/coronavirus#explore-the-global-situation" data-track-note="covid-banner-click">Explore our COVID-19 data</a></div></div><main><article class="page no-sidebar thin-banner"><div class="offset-header"><header class="article-header"><div class="article-titles"><h1 class="entry-title">Cancer death rates are falling; five-year survival rates are rising</h1></div></header></div><div class="content-wrapper"><div class="offset-content"><div class="content-and-footnotes"><div class="article-content"><section><div class="wp-block-columns is-style-sticky-right"><div class="wp-block-column"><div class="article-meta"><div class="authors-byline"><a href="/team">by Hannah Ritchie</a></div><div class="published-updated"><time>February 04, 2019</time></div></div><p>February 4th is <a href="https://www.worldcancerday.org/" target="_blank" rel="noopener noreferrer">World Cancer Day</a>. Last year we answered the question: “<a href="https://ourworldindata.org/how-many-people-in-the-world-die-from-cancer" target="_blank" rel="noopener noreferrer">How many people die from cancer?</a>“. This World Cancer Day we look at how cancer death rates are changing over time.</p><p>Global <a href="https://ourworldindata.org/cancer#global-perspective-on-cancer-deaths" target="_blank" rel="noopener noreferrer">cancer deaths are rising</a>: in 1990 5.7 million died from cancer; by 2016 this had increased to 8.9 million. But it’s also true that the world today has more people, and more <em>older</em> people, who are more likely to die from cancer. To understand what is happening we therefore have to correct for the population increase and ask for the rate – the number of deaths per 100,000 people – and we have to <a href="https://en.wikipedia.org/wiki/Age_adjustment">adjust for ageing</a>.</p><p>When we compare these metrics (shown <strong><a href="https://ourworldindata.org/grapher/cancer-deaths-rate-and-age-standardized-rate-index">here</a></strong>) we see that <strong>age-standardized cancer death rates are <em>falling </em>globally. </strong>Death rates which correct for ageing show a 17 percent decline from 1990 to 2016.</p></div><div class="wp-block-column"></div></div><div class="wp-block-columns is-style-sticky-right"><div class="wp-block-column"><h4 id="five-year-survival-rates-have-increased">Five-year survival rates have increased<a class="deep-link" href="#five-year-survival-rates-have-increased"></a></h4></div><div class="wp-block-column"></div></div><div class="wp-block-columns is-style-sticky-right">
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<p>Why are cancer death rates falling? One hypothesis is that cancer prevalence is falling (i.e. less people have cancer). Is this true?</p>
<p>Globally, no. The <a href="https://ourworldindata.org/cancer#global-perspective-on-cancer-prevalence" target="_blank" rel="noopener noreferrer">share of people with cancer</a> (even when corrected for ageing) has been slowly increasing in recent decades. Global cancer prevalence has risen from 0.54 percent to 0.64 percent since 1990 (<a href="https://ourworldindata.org/smoking#share-of-cancer-deaths-attributed-to-smoking" target="_blank" rel="noopener noreferrer">largely due to smoking</a>). In some countries – <strong><a href="https://ourworldindata.org/grapher/share-of-population-with-cancer?tab=chart&country=USA">the US, for example</a></strong> – the age-corrected prevalence has been fairly constant in recent decades (with the <a href="https://ourworldindata.org/grapher/cancer-incidence?tab=chart&country=USA" target="_blank" rel="noopener noreferrer">rate of <em>new </em>cases actually falling</a>).</p>
<p>If death rates are falling but prevalence is rising or constant, then it must be the case that people with cancer have better or longer survival rates. We see this clearly in the USA when we look at the change in five-year survival rates across cancer types. This is shown in the chart as the change from 1970-77 to 2007-2013.</p>
<p>Here we see that on aggregate five-year survival rates for all cancers increased from 50.3 to 67 percent. But we also see significant differences not only in start or end survival rates, but the change over time. Prostate cancer has close to 99 percent five-year survival, but has also seen major progress from a rate of 69 percent in the 1970s. In contrast, pancreas has low five-year survival rates at 8.2 percent, up from 2.5 percent.</p>
<p>There are two key factors which could contribute to improved five-year survival rates: earlier detection and/or improved treatment. Defining the exact attribution of each is difficult, and varies depending on cancer type. But there have been some studies which have attempted to do so. Scott Alexander published a very good overview of the relative impact of detection versus treatment <strong><a href="https://slatestarcodex.com/2018/08/01/cancer-progress-much-more-than-you-wanted-to-know/">here</a></strong>.</p>
<p>One way to test whether survival rates only increased from early diagnosis is to look at how survival has changed for <em>each stage</em> of cancer: if detection was the only improvement then we would see no increase in survival rates in later cancer stages. National cancer statistics published by the US government show increases in survival rate within all stages (from very early to late-stage).<a id="ref-1" class="ref" href="#note-1"><sup>1</sup></a></p>
<p>Other studies focused on specific cancer types show similar results.<a id="ref-2" class="ref" href="#note-2"><sup>2</sup></a></p>
<p>Tumours have gotten smaller in recent decades – the result of earlier detection. Studies have shown that this can account for a significant share of survival improvements: one study attributed early detection as 61 percent and 28 percent of improved survival in localized-stage and regional-stage breast cancer, respectively<a id="ref-3" class="ref" href="#note-3"><sup>3</sup></a> But even when correcting for size and early detection, we have seen improvements. </p>
<p>This suggests better treatment has played a role too.</p>
<p>In both detection and treatment, we’re seeing progress. This is important because of the large toll of cancer: Globally every sixth death is due to cancer – this makes it the <a rel="noreferrer noopener" href="https://ourworldindata.org/grapher/annual-number-of-deaths-by-cause" target="_blank">world’s second largest cause of death</a>. Progress here is important for many.</p>
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<figure class="wp-block-image size-large"><img loading="lazy" width="750" height="550" src="https://ourworldindata.org/uploads/2019/02/Five-year-cancer-survival-rates-USA-v2-01-768x563-750x550.png" alt="Five year cancer survival rates usa v2 01 768x563" class="wp-image-22629" srcset="https://ourworldindata.org/uploads/2019/02/Five-year-cancer-survival-rates-USA-v2-01-768x563-750x550.png 750w, https://ourworldindata.org/uploads/2019/02/Five-year-cancer-survival-rates-USA-v2-01-768x563-150x110.png 150w, https://ourworldindata.org/uploads/2019/02/Five-year-cancer-survival-rates-USA-v2-01-768x563-400x293.png 400w, https://ourworldindata.org/uploads/2019/02/Five-year-cancer-survival-rates-USA-v2-01-768x563.png 768w" sizes="(max-width: 750px) 100vw, 750px" data-high-res-src="https://ourworldindata.org/uploads/2019/02/Five-year-cancer-survival-rates-USA-v2-01-768x563.png"></figure>
<p><strong>Interactive chart:</strong> <em>The same data shown in the chart can be viewed and downloaded in this interactive </em><a href="https://ourworldindata.org/grapher/five-year-cancer-survival-in-usa?time=1977..2013"><em>here</em></a><em>. Cancer survival rates in the US by race can be seen </em><a href="https://ourworldindata.org/grapher/five-year-cancer-survival-rates-by-sex-and-race?time=1963..2013"><em>here</em></a><em>.</em></p>
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</div><footer class="article-footer"><div class="wp-block-columns"><div class="wp-block-column"><div class="blog-info">Our World in Data presents the empirical evidence on global development in entries dedicated to specific topics.<br>This blog post draws on data and research discussed in our entry on <a href="https://ourworldindata.org/entries/cancer" target="_blank" rel="noopener noreferrer">Cancer</a>.</div><h3 id="endnotes">Endnotes</h3><ol class="endnotes"><li id="note-1"><p>Jemal, A. et a. (2017). <a href="https://doi.org/10.1093/jnci/djx030">Annual Report to the Nation on the Status of Cancer, 1975–2014, Featuring Survival</a>, <em>JNCI: Journal of the National Cancer Institute</em>, Volume 109, Issue 9, 1 September 2017.</p></li><li id="note-2"><p>Rutter, C.M. et al. (2013). <a href="https://doi.org/10.1093/jnci/djt299">Secular Trends in Colon and Rectal Cancer Relative Survival</a>, <em>JNCI: Journal of the National Cancer Institute</em>, Volume 105, Issue 23, 4 December 2013.</p></li><li id="note-3"><p>Elkin, E.B. (2005). <a rel="noreferrer noopener" href="https://onlinelibrary.wiley.com/doi/pdf/10.1002/cncr.21285" target="_blank">The effect of changes in tumor size on breast carcinoma survival in the U.S: 1975–1999</a>. <em>Cancer</em>. Volume 104, Issue 6.</p></li></ol><h3 id="licence">Reuse our work freely</h3><p>All visualizations, data, and code produced by Our World in Data are completely open access under the <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank" rel="noopener noreferrer">Creative Commons BY license</a>. 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