Roundup: U.S. Cancer Death Rates Still Declining Despite Early Impact of Pandemic; and More News

Cancer Death Rates Continue to Decline Nationwide—But Diagnoses for Some are Rising, U.S. Annual Report Finds

Cancer death rates in the U.S. have continued to decline steadily among both men and women from 2001 through 2022, even during the early years of the COVID-19 pandemic. These findings are detailed in the Annual Report to the Nation on the Status of Cancer, and published this month in the journal Cancer.

Nonetheless, incidence rates are on the rise for several cancers, including those linked to excess weight or obesity, such as pancreas and kidney cancers; uterine, breast and liver cancers among women; and colon and rectal cancers among adolescents and young adults.

Many U.S. adults postponed cancer screenings – such as colonoscopies, mammograms and lung scans — for several months in 2020 as COVID-19 overwhelmed doctors and hospitals. But the screening delays were not found to have a major impact on cancer rates, at least as far as researchers have noted thus far.

The report is a joint initiative from the National Cancer Institute (NCI), the U.S. Centers for Disease Control and Prevention (CDC), the American Cancer Society (ACS), and the North American Association of Central Cancer Registries (NAACCR). It serves as a key resource for tracking long-term trends in cancer incidence and mortality across the United States.

Report’s Key Findings

Overall Decline in Death Rates The most notable trend highlighted in the report is the steady decrease in overall cancer death rates over the 21-year period studied. This progress was seen in both men and women, and the downward trend persisted through the onset of the COVID-19 pandemic in 2020 and 2021.

Cancer Incidence Trends Differ by Gender While mortality rates fell, trends in new cancer diagnoses, or incidence, were more complex:

• Among men, overall cancer incidence declined from 2001 to 2013 and then stabilized through 2021.
• Among women, incidence increased slightly each year from 2003 to 2021, with a brief dip in 2020—likely influenced by the pandemic.

Lung Cancer and Smoking-Related Cancers See Improved Outcomes -- The decline in death rates is largely attributed to significant progress in reducing both incidence and mortality for lung cancer and several other smoking-related cancers. These improvements are the result of sustained public health efforts in tobacco control, advances in screening, and more effective treatments.

Obesity-Linked Cancers on the Rise -- In contrast, the report identifies a growing concern: an increase in cancers associated with obesity. These include cancers of the breast (in women), uterus, colon and rectum, pancreas, kidney, and liver. These trends highlight the continuing impact of obesity as a major public health challenge.

Breast Cancer: A Mixed Picture -- Although the rate of new breast cancer diagnoses in women has gradually increased, the overall breast cancer death rate has declined. This suggests that while more cases are being detected, improved screening and treatment are helping to reduce mortality.

Childhood and Young Adult Cancers -- Cancer death rates among children have declined consistently throughout the study period. Adolescents and young adults also saw declining death rates until recently, when the pace of improvement slowed and then stabilized.

Disparities in Cancer Incidence

The report also examines racial and ethnic disparities:

• From 2017 to 2021 (excluding 2020), cancer incidence among men was stable across all major racial and ethnic groups.
• However, incidence increased among women in all major racial and ethnic groups during the same period.
• Non-Hispanic Black men had the highest incidence rates among men, while American Indian and Alaska Native women had the highest rates among women.

Impact of the COVID-19 Pandemic

The pandemic had a notable, though temporary, effect on cancer diagnosis rates:

• In 2020, there was a sharp decline in cancer incidence, attributed to widespread disruptions in healthcare services such as screenings and routine checkups.
• By 2021, cancer diagnosis rates had returned to pre-pandemic levels.
• Interestingly, this pattern was consistent across U.S. states, regardless of how strict or lenient their public health restrictions were.

This aspect of the report underscores the importance of maintaining access to healthcare, even during public health emergencies, to ensure timely cancer detection and treatment.

The Annual Report to the Nation on the Status of Cancer draws on comprehensive data from national cancer registries and death records. Cancer incidence data come from population-based registries funded by the CDC and NCI and compiled by NAACCR. Cancer mortality data are provided by the National Center for Health Statistics.

Explore services provided by Miami Cancer Institute and Lynn Cancer Institute, partners in Baptist Health Cancer Care.

‘Dual Use’ of Cigarettes and E-Cigarettes Carries Same Cancer, Health Risks as Cigarette Use Only: New Study

A new study by scientists at the American Cancer Society (ACS) raises significant concerns about the health effects of so-called “dual use” — the simultaneous use of combustible cigarettes and electronic cigarettes (e-cigarettes or vaping products).

Contrary to the belief that combining these products might reduce harm, the findings show that dual use exposes individuals to similar levels of harmful cancer-causing chemicals as smoking cigarettes alone.

Many individuals turn to e-cigarettes in an effort to reduce their cigarette consumption, or as a step toward quitting. However, according to the study’s lead author Zheng (Ashley) Xue, senior associate scientist in Tobacco Control Research at the ACS, this strategy may be misguided.

“In the U.S., dual-use of combustible cigarettes and e-cigarettes is the most common multiple tobacco-use behavior. Some individuals try to cut back on cigarettes or work toward quitting cigarettes this way,” states Ms. Xue in a news release from the ACS. “However, our results highlight that dual-use is not an effective way to safeguard health and more evidence that tobacco use is harmful.”

Researchers analyzed data from 2,679 adult participants in Wave 5 of the Population Assessment of Tobacco and Health (PATH) Study, which is nationally representative of U.S. adults and youth. The study examined biomarkers of exposure (BOE) to four major classes of harmful constituents linked to tobacco-related illnesses, including cancer and respiratory disease.

Study participants were divided into groups based on self-reported levels of cigarette smoking and e-cigarette use, categorized as either high or low intensity. The researchers found that individuals who used both products—cigarettes and e-cigarettes—consumed roughly the same number of cigarettes per day as those who smoked cigarettes exclusively (13.1 versus 11.8 cigarettes per day, respectively).

Moreover, high-intensity dual users exhibited increased levels of tobacco-specific nitrosamines and volatile organic compounds—chemicals known to contribute to cancer and other diseases.

The intensity of e-cigarette use did not significantly affect the levels of toxicants detected in dual users. While exclusive e-cigarette users had lower overall toxicant exposure compared to those who smoked cigarettes, whether alone or in combination, the use of both products offered no reduction in harm.

“Clinicians and public health practitioners should increase awareness that dual use of cigarettes and e-cigarettes is not safe and may present similar risks as continuing to smoke cigarettes, especially if one does not reduce the number of cigarettes smoked,” Ms. Xue added.

This study reinforces the message that there is no safe level of tobacco use. Efforts to quit should be supported with scientifically backed cessation strategies—not by simply switching or combining products.

Brisk Walking Linked to Lower Risk of Heart Rhythm Disorders, Study Finds

Walking at a brisk pace — and spending more time at this intensity — may lower the risk of developing heart rhythm abnormalities, according to a new study led by the University of Glasgow and published in the journal Heart. These heart rhythm conditions include atrial fibrillation, tachycardia (rapid heartbeat), and bradycardia (very slow heartbeat).

The researchers utilized data from over 420,000 participants in the UK (United Kingdom) Biobank, which includes physical activity records collected from participants through wrist accelerometers or written data provided on questionnaire responses.

Heart rhythm abnormalities, or arrhythmias, are increasingly common. Atrial fibrillation alone affected nearly 60 million people worldwide in 2019 — double the number from three decades earlier. These conditions are known to increase the risk of cardiovascular disease, sudden cardiac death, and long-term disability. Identifying lifestyle factors that may reduce this risk is a growing priority in public health.

While previous research has linked walking pace with lower risks of cardiovascular disease and mortality, few studies have examined its role in preventing arrhythmias. This new analysis addresses that gap by exploring not only walking speed but also the role of metabolic and inflammatory processes in heart rhythm health.

Participants self-reported their usual walking pace as either slow (under 3 mph), average (3–4 mph), or brisk (over 4 mph). A subset of over 81,000 individuals also wore activity trackers, providing objective data on time spent walking at each pace. The average age of participants was 55, with women making up 55 percent of the sample.

Over a 13-year follow-up period, 9 percent of participants developed heart rhythm abnormalities, including 23,526 cases of atrial fibrillation. However, the risk of arrhythmias was significantly lower among those who reported walking at an average or brisk pace. Specifically, the risk was reduced by 35 percent and 43 percent] respectively, compared to those who walked at a slower pace.

The study also found that average and brisk walkers had lower risks of atrial fibrillation (by 38 percent and 46 percent, respectively) and other arrhythmias (by 21 percent and 39 percent, respectively).

Among those with activity tracker data, spending more time walking at a brisk pace was associated with a 27 percent lower risk of developing arrhythmias. Time spent walking at a slow pace, on the other hand, showed no significant protective effect.

The researchers observed that metabolic and inflammatory health played a key role in the relationship between walking pace and arrhythmia risk. Individuals who walked briskly generally had healthier lifestyles and lower levels of metabolic and inflammatory markers. According to the study, approximately 36 percent of the protective effect was linked to improvements in these factors.

Importantly, the association between faster walking and reduced arrhythmia risk was strongest among women, individuals under 60, non-obese participants, and those with pre-existing long-term health conditions such as high blood pressure.

“This study is the first to explore the pathways underpinning the association between walking pace and arrhythmias and to provide evidence that metabolic and inflammatory factors may have a role; walking faster decreased the risk of obesity and inflammation which in turn reduced the risk of arrhythmia,” said Professor Jill Pell, lead author of the study, in a news release.

The study is observational, meaning it cannot establish direct causality. Additionally, the reliance on self-reported data and the limited diversity of participants are noted limitations. Nevertheless, the results underscore the potential of brisk walking as a simple, accessible way to reduce the risk of serious heart rhythm disorders — especially when maintained over time and incorporated into daily routines.