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The Decline in U.S. Cancer Mortality in People Born since 1925

Laboratories of ¹ Molecular Epidemiology and ² Molecular Oncology, Van Andel Research Institute, Grand Rapids, Michigan and Departments of ³ Epidemiology and ⁴ Pediatrics and Human Development, College of Human Medicine, Michigan State University, East Lansing, Michigan

Requests for reprints: Eric J. Kort, Laboratory of Molecular Epidemiology, Van Andel Research Institute, 333 Bostwick Avenue NE, Grand Rapids, MI 49503. Phone: 616-234-5552; Fax: 616-234-5553; E-mail: korter{at}resident.grmerc.net.

Key Words: Cohort analysis • Cancer mortality • Cancer surveillance and screening • Methodology, modeling, and biostatistics

The conventional practice of analyzing overall age-adjusted cancer mortality rates heavily emphasizes the experience of older, higher mortality age groups. This may conceal shifts in lifetime cancer mortality experience emerging first in younger age groups. We examined age-specific cancer mortality rates and birth cohort–specific cancer mortality rates in U.S. mortality data recorded since 1955 to assess the effects of age, period, and cohort in secular mortality trends. Cancer mortality and population data were obtained from WHO Statistical Information System. Age-specific cancer mortality rates have been steadily declining in the United States since the early 1950s, beginning with children and young adults and now including all age groups. During the second half of the 20th century, each successive decade of births from 1925 to 1995 experienced a lower risk of cancer death than its predecessor at virtually every age for which such a comparison can be made. A major decline in cancer mortality has been occurring in the United States for the past 50 years, affecting birth cohorts born as long as 80 years ago. Excepting lung cancer, much of this decline has occurred despite relatively stable cancer incidence. These findings suggest that improvements in cancer detection, treatment, and/or prevention have reduced the risk of cancer death across the life span for individuals born in the last three quarters of the 20th century. [Cancer Res 2009;69(16):6500–5]