Predicted Changes in Cancer Incidence and Death

All of us wish for a universal cure for cancer. Even better, all of us wish for a universal prevention of cancer. Unfortunately, although great advances have been and will continue to be made, neither goal is likely to be met anytime soon. If you would like a better understanding of how tough a problem cancer is, I strongly recommend The Emperor of all Maladies by Siddhartha Mukherjee. This book could almost be described as a biography of cancer; it begins in ancient times and describes the evidence of historical incidence and the problems of our times. It is fascinating and beautifully written, and you come away with a much better appreciation of the complexities of curing, let alone preventing, the many variants that are all called cancer.

Cancer is going to be with us for a very long time.

Every year the American Cancer Society publishes Cancer Facts & Figures, which provides numbers for predicted cancers and cancer deaths in the United States. For 2020, the prediction was an estimated 1.8 million new cancer diagnoses and 606,520 deaths from cancer. For 2021, the estimate is 1.9 million new cancer cases and 608,570 deaths. The four most common cancers are breast, colorectal, lung and prostate. If you are interested in reading more statistics and looking at their reports for other years, you can find Cancer Facts & Figures here.

JAMA Network has just released a report that predicts cancer incidence and deaths in 2040. In addition to general interest, these numbers are important in planning research, public health efforts, health policies and funding. The overall conclusion is that there will be marked changes in the cancer landscape, but not quite the changes we would all hope would happen. Breast cancer is predicted to be the most common cancer diagnosed, and lung cancer is predicted to continue to be the biggest killer. Pancreatic and liver and bile duct cancers are predicted to be the second and third deadliest, while colorectal cancers is listed as fourth, and breast cancer as fifth. Melanoma is predicted to be the second most common cancer, and colorectal cancers as the fourth. Interestingly, prostate cancer dropped to fourteenth.

Why am I writing about this and why should we care about cancer incidence twenty years from now? First, I think these numbers are sobering. We all wish for a cure and tell ourselves that cancer research and science are making amazing discoveries daily. That is true, but the big prize remains elusive. Cancer is going to be with us for a very long time. We are going to have to continue to live with it, cope with it and do our best to stay as healthy as possible. I do suspect that screening will continue to improve, and we can hope that increasing numbers of cancer will be caught early.

I am curious about the anticipated changes in the rankings of kinds of cancer. Why would prostate cancer be so much less common and why will pancreatic, liver and bile duct cancers be more common? Are there things that we, as a society, could and should be doing to minimize the risks of these lethal cancers? Should we be spending more time, energy and research money on screening or public education? And finally, how do we best prepare for this predicted future?