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Cancer Death Rates Continue to Fall in U.S., Report Says

U.S. death rates from cancer continued falling from 2001 to 2017 — dropping an average 1.5% a year, a new report shows.

The annual decline was slightly larger among men (1.8%) than women (1.4%), according to the Annual Report to the Nation on the Status of Cancer.

The report is prepared by the U.S. Centers for Disease Control and Prevention; the U.S. National Cancer Institute; the American Cancer Society, and the North American Association of Central Cancer Registries. “The United States continues to make significant progress in cancer prevention, early detection, and treatment,” said CDC director, physician Robert Redfield.

“While we are encouraged that overall cancer death rates have decreased, there is still much more we can do to prevent new cancers and support communities, families, and cancer survivors in this ongoing battle,” Redfield added in a CDC news release.

There were decreases in all major racial/ethnic groups and among men, women, young adults, teens and children. Rates of new cancers leveled off among men and increased slightly among women from 2012 to 2016, according to the report.

The researchers also found that from 2013 to 2017:

• Among men, death rates fell for 11 of the 19 most common cancers. They remained stable for four cancers — including prostate — and increased for four cancers: mouth and pharynx; soft tissue including heart, brain and other nervous system, and pancreas.

• Among women, death rates decreased for 14 of the 20 most common cancers, including the three leaders — lung, breast and colon. However, death rates rose for cancers of the uterus, liver, brain and other nervous system, soft tissue including heart, and pancreas. Rates were stable for mouth and pharynx cancers.

• Overall cancer death rates among children up to 14 years fell an average of 1.4% a year. Rates among 15- to 39-year-olds decreased an average of 1% a year.

• Deaths from melanoma skin cancer fell more than 6% a year among men and women. • Lung cancer death rates decreased 4.8% a year among men and 3.7% a year among women. However, lung cancer remains the leading cause of cancer death in the United States, accounting for about one-quarter of all cancer deaths.

“The drops in mortality we’re seeing are real, sustained, and a strong indication of what we can do when we work to prevent and treat cancer,” said physician William Cance, chief medical and scientific officer of the American Cancer Society. “But we can and must do more, particularly to ensure everyone in the United States has access to the resources that are all too often benefiting only the most fortunate,” he said in the release.

The findings were published March 12 in the journal Cancer.

Healthcare in a Minute

By George W. Chapman

April 2020 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 5 George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com. Amazon’s Huge Influence

Just as Amazon changed the way we shop, resulting in the closure of 9,000 brick-and-mortar stores last year alone, so it is changing the way we receive medical care. It is opening primary care clinics, virtual medical services and an online pharmacy called PillPack. Amazon is working on an Alexa-based program whereby consumers can query drug interactions and side effects as well as manage their meds. Information will be updated regularly. The company is also working on clinical speech recognition whereby provider-patient conversations will automatically be documented in the medical record. This will have a significant impact on “he said, she said” conversations. Amazon has the wherewithal, size, money, supply chain, artificial COVID-19: NYS Approves $40 Million Emergency Response Package N ew York state has issued a directive prohibiting any insurer, including Medicaid, from charging a member for any out-of-pocket costs related to testing for the virus or any related visits to a physician’s office or emergency department. Gov. Cuomo has also approved a $40 million emergency response package. Self-insured plans are not regulated by NYS, but they would be wise to follow suit. Most commercial carriers have indicated they will follow suit and not charge their members. The federal government has budgeted $8.3 billion to combat the virus. (As of this writing in mid-March there is a huge shortage of testing kits.) Federal spending goes toward: removing restrictions for treatment via telemedicine; reimbursing states for the virus response and preparedness; buying drugs, masks and personal protection for healthcare workers; and funds for caregivers and communities facing the brunt of the virus. intelligence and IT expertise to alter the entire healthcare delivery system. Industry observers believe Amazon will have the same impact on brickand-mortar providers as it did on stores. In lieu of the dire predictions of a physician shortage, Amazon could considerably reduce the deficit with increased automation and artificial intelligence.

ACA in Limbo The fate of the Affordable Care Act remains up in the air. It won’t be determined by the Supreme Court until mid-2021 or later. Consequently, the delay exacerbates and prolongs the uncertainty and anxiety for insurers, providers and enrolled consumers. The makeup of the Supreme Court has shifted since it last upheld the ACA over a challenge regarding premium subsidies for the indigent five years ago. Last year, a court of appeals ruled the individual mandate was unconstitutional, but did not conclude the entire law was unconstitutional. Mostly “blue” states are challenging the entire law and therefore sending the issue to the Supreme Court. Politics pervades all decision-making in Washington. Experience Counts Hospitals establish minimum volume standards (experience) for every procedure performed before granting a surgeon specific operating privileges. The bigger the hospital and medical staff, the more likely higher volume standards will be required. According to the independent hospital safety watch group “Leapfrog,” the majority of 2,100 hospitals surveyed are performing high-risk procedures with inadequate volume standards. The AHA and CMS are looking into this. In the meantime, it is perfectly acceptable for a patient to ask a physician for her or his experience with a particular procedure.

Non-college-Educated Work- er “Deaths of Despair” Up A study conducted by Princeton economists Anne Case and Angus Deaton found that “deaths of despair” — caused by alcoholism, drug abuse, suicides, depression, obesity — are soaring among America’s non-college educated workers. Similar deaths among the college-educated workers have remained stable. The escalating death rate has occurred primarily over the past three decades. This phenomena is explained in their new book titled, “Deaths of Despair and the Future of Capitalism.” Similarly, advanced countries in Europe are not experiencing this awful trend. Authors Case and Deaton point out that middle-class incomes have stagnated more in the US than other industrialized countries. Exacerbating the problem is our expensive healthcare system which impacts lower paid workers more by draining resources that could be spent on other things which would improve their lives. The “deaths of despair” among the non-college educated workers are up across all ages and races. The study found a growing number of these workers are finding it increasingly difficult to socialize or exercise because of chronic physical or mental conditions. The study found that most non-college educated Americans have decreased feelings of identity or pride with their employer. The authors believe the solutions are obvious, but will be difficult. Our medical system needs to put a higher priority on the health versus wealth of our citizens. Students who graduate from college, including technical schools, make more money and do better in life overall.