What a just-released report says about Canada's most common and deadly form of cancer

Hospital beds are seen in this stock image. (Pixabay)

A report released Wednesday by the Canadian Cancer Society (CCS) details how deaths from lung cancer—the most common and deadly form of cancer in Canada—have taken a significant tumble in recent years, a step forward believed to be connected largely to reductions in smoking and tobacco use.

The report shows lung cancer death rates have decreased by 4.3 per cent per year since 2014 for men, and 4.1 per cent per year since 2016.

According to the report, this is the largest annual decline in mortality rates for any cancer type in the data, and the fastest decrease in lung cancer mortality that has been seen in Canada to date.

“We are making considerable headway to reduce lung cancer deaths in Canada,” Dr. Jennifer Gillis, senior manager of surveillance at the Canadian Cancer Society (CCS), said in a press release. “This promising news gives people affected by lung cancer – and the entire cancer community – hope for the future and encouragement to continue to work for more progress. It means a better prognosis and more positive outcomes for cancer patients.”

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The lung cancer death rate for men in 2023 is expected to be less than half of what it was at its peak in 1988, according to the report. For women, the 2023 rate of lung cancer death should be 24 per cent lower than its peak in 2006.

It’s significant progress considering lung cancer is the deadliest cancer in Canada, causing more annual deaths than colorectal, pancreatic and breast cancers combined. An estimated 20,600 Canadians are still expected to die in 2023 from lung cancer, according to the report.

It’s a harrowing experience to go through, cancer survivor MaryAnn Bradley said in the release.

She first got worried when she felt a pain on the left side of her neck in 2014, where the carotid artery carries blood to the brain. Doctors searched for heart issues, but finally located a 2.5 centimetre tumour in her right upper lung—the result of cancer.

Surgery was able to successfully remove the tumour, and Bradley is now cancer free, working with CCS to spread awareness about the disease.

“It’s important to have empathy for the person who has cancer no matter what type of cancer it is – all people with lung cancer deserve to have their voices heard,” says MaryAnn. “That’s why I’m proud to stand with Canadian Cancer Society alongside fellow advocates to back lung cancer. Together, we can raise greater awareness about the disease and improve cancer care for all.”

The report looked at statistics and estimates for all cancers in Canada in 2023, as well as the impact of research on early detection for cancer.

The probability of a person in Canada developing cancer at some point in their lifetime is 45 per cent, according to the report, and one in four Canadians are expected to die from cancer.

Rates of cervical cancer are increasing the fastest out of all cancers affecting women, with rates going up by 3.7 per cent per year since 2015. Around 1,550 people will be diagnosed with cervical cancer in 2023, the report estimates.

For men, the largest increase in cancer rates was cases of melanoma, which have increased by 2.2 per cent per year since 1984.

Men are slightly more likely to die from cancer than women are, with a 24 per cent probability compared to 21 per cent.

LESS SMOKING, LESS LUNG CANCER DEATHS

Smoking has long been linked to lung cancer, with research showing a clear link between the habit and the development and severity of lung cancer.

According to the report, around 72 per cent of lung cancer cases in Canada are due to smoking tobacco.

The significant decrease in lung cancer deaths seen recently can be traced back to Canada’s efforts to cut down on the smoking of tobacco.

The report noted that Canada has one of the strongest set of regulations for the tobacco industry compared to other countries around the globe. Canada is currently working towards a target of reaching less than five per cent tobacco use by 2035.

“Canada has some of the best tobacco regulations in the world, and they are making an impact,” Gillis said. “Over 50,000 cancer cases could be prevented in Canada by 2042 if we reduce smoking prevalence to 5 per cent by 2035.”

In 1965, half of all Canadian adults smoked tobacco, including 61 per cent of men and 38 per cent of women, according to Statistics Canada, but as of 2021, only 11.8 per cent of the population aged 12 years or older smoked tobacco.

The reason that lung cancer deaths have declined so much more among men is because smoking was so much more prevalent among men decades ago, the report stated, with the decrease beginning in the 1960s, whereas the rate of women who were smoking didn’t start to decrease significantly until the 1980s.

CCS has been involved in advocacy work over the years to cut down on the population’s smoking and advise on legislation surrounding tobacco use.

In August, Canada became the first country in the world to require health warnings be printed directly on individual cigarettes. The requirement is being implemented in phases, with the first stage to roll out by April 2024. By the end of April 2025, all regular sized cigarettes and cigars will feature individual health warnings.

Rob Cunningham, senior policy analyst at CCS, said in the press release that there was still more work to be done if Canada hopes to hit the 2035 goal.

“To drive down tobacco use, CCS advocates that all levels of government implement comprehensive tobacco control strategies that include higher tobacco taxes, strengthened legislation, and enhanced programs,” he said. “In particular, provinces should ensure that the historic tobacco lawsuit settlement, currently being negotiated by provinces and the tobacco industry, contains significant measures to reduce tobacco use.”

The report noted that statistics related to tobacco and advocacy work around tobacco control relate specifically to the sale and use of commercial tobacco, and that other lung cancer risks include air pollution, asbestos and certain workplace exposures.

The report also found that among men, the largest decreases in cancer deaths after lung cancer were bladder cancer deaths , which fell by 3.4 per cent every year since 2016 and kidney and renal pelvis cancer deaths, which fell by 3.1 per cent per year since 2014; and melanoma deaths, which fell by three per cent per year since 2014.

Among women, the largest decreases in cancer deaths after lung cancer were Hodgkin lymphoma deaths, which dropped by 3.2 per cent annually since 1984 and colorectal cancer deaths, which decreased by 3.1 per cent per year since 2014.

Melanoma deaths for both men and women decreased by three per cent per year since 2014, the report found.

The report noted that while expanding early detection for various cancers has enabled more precise and effective treatments over the last 30 years, we can still benefit from more investment in this area of research.

Gillis noted that lung cancer, despite being the leading cause of cancer death in Canada, still receives less funds for research than many other cancers, adding that more investment will lead to even better treatments for patients.

"For the lung cancer community, this is a time of innovation and acceleration in all aspects of lung cancer research and there is much to be excited about," Gillis said. “Researchers have pioneered advances to find lung cancer earlier and more easily, explored minimally invasive surgeries with shorter recovery times, employed stereotactic targeted radiation to reduce damage to healthy tissues and implemented precision medicine therapies and immunotherapies that use the body's own immune system. These advances are saving lives.”