New York cancer death rates plummet, biggest drop among Black residents

The chances of dying from cancer have plummeted in the past three decades, and a report released this week concludes that improvements in treatment and early detection of some types of cancer, along with a decline in smoking rates, are among the biggest reasons.

Separate data from the state Department of Health shows that the 43.5% drop in cancer death rates in New York between 1991 and 2021 is higher than the 33% decline nationwide, and unlike in most of the country, Black New Yorkers are now slightly less likely to die from cancer than white residents, a major shift from the past.

The nationwide decline in death rates resulted in 4.1 million lives saved, said the report published Wednesday by the American Association for Cancer Research, citing an American Cancer Society estimate from earlier this year.

“It’s really phenomenal to think we’ve dropped the death rate from cancer by 33% in that span of time,” said Dr. Richard Carvajal, deputy physician-in-chief and director of medical oncology at the Northwell Health Cancer Institute.

But experts said progress in the battle against some types of cancer has been less robust than others, and some types of cancer, such as breast and colon, have increased in young people.

The development of new therapies and treatments has accelerated rapidly in recent years, with more than 80 new cancer drugs in the last decade alone, he said. There currently are nearly 20,000 clinical trials worldwide looking at potential new cancer therapies, Carvajal said.

One of the big advances has been in immunotherapy, which uses the body’s disease-fighting immune cells to fight cancer, said Dr. Ashish Sangal, chief of oncology at Catholic Health.

“We have more options for our patients now,” he said. “That is leading to less cancer mortality.”

It’s easier today to locate a tumor early on, said Dr. Ryan Sugarman, an oncologist and medical site director of Memorial Sloan Kettering Cancer Center in Uniondale.

“We're able to detect cancer when it's smaller,” he said. “It would have been harder to visualize in the [past]. And if you catch cancer at that earlier stage, it's more likely to be curable.”

Mammograms, MRIs and ultrasounds are more precise, he said.

In New York, the cancer death rate fell from 214.5 per 100,000 people in 1991 to 121.2 in 2021 — a 43.5% decline.

The biggest decline was among non-Hispanic Black residents. Their cancer death rate dropped from 245.1 to 124, a 49.4% reduction. Black New Yorkers now have a lower rate than non-Hispanic whites, at 128.8, and non-Hispanic American Indians, 150.9, but higher than Hispanics, 93, and non-Hispanic Asians, 81.5.

Nationwide, the mortality gap between Black and white people with cancer has narrowed in recent years, but the death rate remains higher among Black patients, said John Cleveland, a member of the steering committee for the newly released report and director of the Moffitt Cancer Center in Tampa, Florida.

Reasons New York rates, especially among Black residents, are falling more sharply than national rates could include greater access to quality health care, including early screening, as well as lower smoking and obesity rates, Sugarman said.

New York has one of the highest rates of health insurance in the country, according to a KFF analysis of 2022 federal data, and among the lowest rates of smoking and obesity, Centers for Disease Control and Prevention data shows.

Smoking, obesity, physical inactivity and excessive alcohol use are linked to nearly half of cancer diagnoses, said Dr. Ahmedin Jemal, senior vice president for surveillance and health equity science for the American Cancer Society.

The metropolitan area also has more clinical trials, meaning people in the region are more likely to have “access to the newest and best therapies,” Carvajal said.

Nationwide, one reason the racial gap is narrowing is a greater focus than in the past on racial differences in how cancer develops and is treated, and more of an effort to recruit people of color to clinical trials, Cleveland said.

People’s bodies may react differently to treatments and drugs based on their ethnicity, he said.

“We need to really tailor therapies in much more precise ways to get an effective response,” Cleveland said.

Jemal said research advances are uneven. For example, it’s still unclear what causes pancreatic cancer in most people.

“We don’t know how to prevent it, and we don’t have an effective treatment,” he said.

There are more than 200 types of cancer, and each has a unique way of mutating, he said.

Cleveland said he expects the drop in mortality to accelerate in the future, as research builds upon itself and more effective treatments are developed.

Artificial intelligence and machine learning will be an increasing factor in treatment, he said. For example, one goal is to integrate vast amounts of data collected on patients from across the country with molecular data, radiological images and digital pathology from individual patients, to help doctors determine optimal treatment plans for their patients, he said.

“We should see a dramatic improvement in outcomes,” he said. “The future is exceptionally bright.”

By David Olson

david.olson@newsday.com@DavidOlson11

David Olson covers health care. He has worked at Newsday since 2015 and previously covered immigration, multicultural issues and religion at The Press-Enterprise in Southern California.