If current trends hold true, pancreatic and liver cancer will overtake breast and colorectal cancer to become the second- and third-most-common causes of cancer-related deaths in the United States by 2030, investigators reported May 19 in Cancer Research.
Lung cancer will remain the leading cause of cancer mortality, said Lynn Matrisian, Ph.D., M.B.A., vice president of scientific and medical affairs at the Pancreatic Cancer Action Network in Manhattan Beach, Calif., at a press briefing that coincided with publication of the paper in Cancer Research.
The forecast for pancreatic cancer – including a projected increase in deaths from 36,888 in 2010 to 63,000 in 2030 – reflects demographic shifts in the United States and the relative lack of progress in screening and treatment for the disease, said Dr. Matrisian prior to a conference on pancreatic cancer held by the American Association for Cancer Research in New Orleans.
Based on the analyses, breast, prostate, and lung cancer will remain the three most commonly diagnosed cancers in the United States in 2030, but thyroid cancer will overtake colorectal cancer for fourth place, followed by melanoma and uterine cancer, the investigators reported (Cancer Res. 2014 May 19 [doi: 10.1158/0008-5472.CAN-14-0155]).
The "big four" cancers in the United States historically have been lung, breast, prostate, and colorectal cancer, which together have accounted for more than half of new cancer cases and cancer-related deaths (Annu. Rev. Public Health 2012; 33:137-56).
In the case of colorectal cancer, colonoscopy screening has led to earlier diagnosis and treatment and lower death rates, Dr. Matrisian noted.
In contrast, 5-year survival rates for patients with operable pancreatic cancer are 15%-20%, and most cases are inoperable because of distant metastases, leading to 5-year survival rates that of less than 5% (Ann. Surg. 2013;257:17-26).
Dr. Matrisian and her associates based the projections on average annual percentage changes in incidence and death rates in the United States from 2006 through 2010, as well as demographic changes predicted to occur in the country during the next two decades.
For 2014, the top causes of cancer deaths in men were expected to be lung, prostate, and colorectal cancers, the researchers reported. The rankings were the same for women, except that breast cancer took second place. But by 2030, the leading causes of cancer-related death for men and women were projected to be lung, pancreas, and liver, the researchers found. While total deaths for both men and women were projected to decrease for breast, colorectal, and prostate cancers, they were expected to increase for pancreas, liver, leukemia, and bladder cancers.
Increasing numbers of minorities and individuals aged 60 years and older explained the trends for pancreatic cancer, Dr. Matrisian said. "We’ve been so successful in preventing deaths from other major diseases – heart disease, infectious diseases – and so we’re living much longer in the United States, and one of the biggest risk factors for cancer is age," she added.
"This paper really was a call to action," Dr. Matrisian said. "We’ve been able to turn the tide on other cancers by investing in basic research and clinical research. It’s now time to realize that we need to turn the tide on pancreatic cancer."
The Pancreatic Cancer Action Network funded the study. Dr. Matrisian is an employee of PCAN and reported no conflicts of interest.