Tag Archives: Death rates

Health

Covid-19 is a leading cause of death for children in the US, despite relatively low mortality rate

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CNN
 — 

Covid-19 has become the eighth most common cause of death among children in the United States, according to a study published Monday.

Children are significantly less likely to die from Covid-19 than any other age group – less than 1% of all deaths since the start of the pandemic have been among those younger than 18, according to federal data. Covid-19 has been the third leading cause of death in the broader population.

But it’s rare for children to die for any reason, the researchers wrote, so the burden of Covid-19 is best understood in the context of other pediatric deaths.

“Pediatric deaths are rare by any measure. It’s something that that we don’t expect to happen and it’s a tragedy in a unique way. It’s a really profound event,” said Dr. Sean O’Leary, chair of the American Academy of Pediatrics’ Committee on Infectious Diseases.

“Everyone knows that Covid is the most severe in the elderly and immunocompromised and that it’s less severe in children, but that does not mean it’s a benign disease in children. Just because the numbers are so much lower in children doesn’t mean that they’re not impactful.”

In 2019, the last year before the pandemic, the leading causes of death among children and young adults ages 0 to 19 included perinatal conditions, unintentional injuries, congenital malformations or deformations, assault, suicide, malignant neoplasms, diseases of the heart and influenza and pneumonia.

The researchers’ analysis of data from the US Centers for Disease Control and Prevention found that there were 821 Covid-19 deaths in this age group during a 12-month period from August 2021 to July 2022. That death rate – about 1 for every 100,000 children ages 0 to 19 – ranks eighth compared with the 2019 data. It ranks fifth among adolescents ages 15 to 19.

Covid-19 deaths displace influenza and pneumonia, becoming the top cause of death caused by any infectious or respiratory disease. It caused “substantially” more deaths than any vaccine-preventable disease historically, the researchers wrote.

According to CDC data, children are less vaccinated against Covid-19 than any other age group in the US. Less than 10% of eligible children have gotten their updated booster shot, and more than 90% of children under 5 are completely unvaccinated.

“If we looked at all those other leading causes of death – whether you’re talking about motor vehicle accidents or childhood cancer – and we said, ‘Gosh, if we had some simple, safe thing we could do to get rid of one of those, wouldn’t we just jump at it?” And we have that with Covid with vaccines,” said O’Leary, who is also a professor of pediatric infectious disease at the University of Colorado School of Medicine and Children’s Hospital Colorado.

A CDC survey of blood samples suggest that more than 90% of children have already had Covid-19 at least once.

There is uncertainty about exactly how much risk the virus will continue to pose, O’Leary said, but the potential benefits of vaccination clearly outweigh any potential risks.

“Vaccination clearly is our best option right now,” and the benefits clearly outweigh the risks, he said. “Better safe than sorry.”

The findings of the new study, published in JAMA Network Open, may underestimate the mortality burden of Covid-19 because the analysis focuses on deaths where Covid-19 was an underlying cause of death but not those where it may have been a contributing factor, the researchers wrote. Also, other analyses of excess deaths suggest that Covid-19 deaths have been underreported.

As Covid-19 continues to spread in the US, the researchers say that intervention methods such as vaccination and ventilation will “continue to play an important role in limiting transmission of the virus and mitigating severe disease.”

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The Surprising Reason for the Decline in Cancer Mortality

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This is Work in Progress, a newsletter by Derek Thompson about work, technology, and how to solve some of America’s biggest problems. Sign up here to get it every week.

Last year, I called America a “rich death trap.” Americans are more likely to die than Europeans or other citizens of similarly rich nations at just about every given age and income level. Guns, drugs, and cars account for much of the difference, but record-high health-care spending hasn’t bought much safety from the ravages of common pathogens. Whereas most of the developed world saw its mortality rates improve in the second year of the coronavirus pandemic, more Americans died of COVID after the introduction of the vaccines than before.

But this week, America finally got some good news in the all-important category of keeping its citizens alive. Since the early 1990s, the U.S. cancer-mortality rate has fallen by one-third, according to a new report from the American Cancer Society.

When I initially read the news in The Wall Street Journal, my assumption was that this achievement in health outcomes was principally due to medical breakthroughs. Since the War on Cancer was declared by President Richard Nixon in 1971, the U.S. has spent hundreds of billions of dollars on cancer research and drug development. We’ve conducted tens of thousands of clinical trials for drugs to treat late-stage cancers in that time. Surely, I thought, these Herculean research efforts are the primary drivers of the reduction in cancer mortality.

As it turns out, however, behavioral changes and screenings seem just as important as treatments, if not more so.

Let’s start with an obvious but crucial point: There is no individual disease called “cancer.” (Relatedly, nothing like a singular “cure for cancer” is likely to materialize anytime soon, if ever.) Rather, what we call cancer is a large group of diseases in which uncontrolled growth of abnormal cells makes people sick and possibly brings about their death. Different cancers have different causes and screening protocols, and as a result, progress can be fast for one cancer and depressingly slow for another.

The decline in cancer mortality for men in the past 30 years is almost entirely for a handful of cancers—lung, prostate, colon, and rectal. Little progress has been made on other lethal cancers.

Consider the diverging histories of two cancers. In 1930, death rates for lung cancer and pancreatic cancer were measured as similarly low among the American-male population. By the 1990s, however, lung cancer mortality had exploded, and that disease became one of the leading causes of death for American men. Since 1990, the rate of lung cancer has declined by more than half. Meanwhile, pancreatic-cancer rates of death rose steadily into the 1970s and have basically plateaued since then.

What explains these different trajectories? In the case of lung cancer, Americans in the 20th century participated en masse in behaviors (especially cigarette smoking) that dramatically increased their risk of contracting the disease. Scientists discovered and announced that risk, then public-health campaigns and policy changes encouraged a large reduction in smoking, which gradually pulled down lung-cancer mortality. In the case of pancreatic cancer, however, the causes are mysterious, and the disease is tragically and notoriously difficult to screen.

Treatments for late-stage lung cancers have improved in the past few decades, according to the American Cancer Society report. But for all the money we’ve spent on treatments, most of the decline in deaths in the past three decades seems to be the result of behavioral changes. Smoking in America declined from a historic high of about 4,500 cigarettes per person per year in 1963—enough for every adult to have more than half a pack a day—to less than 2,000 by the end of the century. It’s fallen further since then.

Another possible factor in declining cancer mortality is better screening, though the question of how much to screen is still contentious. In the early 1990s, doctors started using blood tests that turned up prostate-specific toxins. This period coincided with a decline in prostate cancer. But many positive results from these tests were false alarms, turning up asymptomatic cases that never would have bloomed into serious cancers. As a result, the federal government discouraged these prostate-cancer tests for men in the 2010s. Since then, advanced diagnoses for prostate cancer have surged, and mortality rates have stopped falling—suggesting that the previous testing regime may have been better after all.

This cancer-screening debate could define the next generation of medicine. As I wrote in last year’s “Breakthroughs of the Year,” companies such as Grail now offer blood tests that look for circulating-tumor DNA in order to detect 50 types of cancer. As these kinds of tests become cheaper and more available, they could reduce the mortality of more cancers, just as antigen tests have helped reduce the death rate of prostate cancer. On their face, these advances sound simply miraculous. But deploying them effectively will require a delicate balancing act on the part of regulators. After all, how much information is too much information for patients if many cancer tests detect false alarms? “They sound wonderful, but we don’t have enough information,” Lori Minasian of the National Cancer Institute has said of these tests. “We don’t have definitive data that shows that they will reduce the risk of dying from cancer.”

The Biden administration’s Cancer Moonshot Initiative should heed the lessons of this latest report. Much of the decline in cancer mortality since the 1990s comes from upstream factors, such as behavioral changes and improved screening, even though the overwhelming majority of cancer research and clinical-trial spending is on late-stage cancer therapies. A cure for cancer might be elusive. But a moonshot for cancer screenings and tests might be the most important front in the future war on cancer.

Office hours are back! Join Derek Thompson and special guests for conversations about the future of work, technology, and culture. The next session will be January 26. Register here and watch a recording anytime on The Atlantic’s YouTube channel.

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Health

US cancer death rate drops 33% since 1991, partly due to advances in treatment, early detection and less smoking, new report says

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CNN
 — 

The rate of people dying from cancer in the United States has continuously declined over the past three decades, according to a new report from the American Cancer Society.

The US cancer death rate has fallen 33% since 1991, which corresponds to an estimated 3.8 million deaths averted, according to the report, published Thursday in CA: A Cancer Journal for Clinicians. The rate of lives lost to cancer continued to shrink in the most recent year for which data is available, between 2019 and 2020, by 1.5%.

The 33% decline in cancer mortality is “truly formidable,” said Karen Knudsen, chief executive officer of the American Cancer Society.

The report attributes this steady progress to improvements in cancer treatment, drops in smoking and increases in early detection.

“New revelations for prevention, for early detection and for treatment have resulted in true, meaningful gains in many of the 200 diseases that we call cancer,” Knudsen said.

In their report, researchers from the American Cancer Society also pointed to HPV vaccinations as connected to reductions in cancer deaths. HPV, or human papillomavirus, infections can cause cervical cancer and other cancer types, and vaccination has been linked with a decrease in new cervical cancer cases.

Among women in their early 20s, there was a 65% drop in cervical cancer rates from 2012 through 2019, “which totally follows the time when HPV vaccines were put into use,” said Dr. William Dahut, the society’s chief scientific officer.

“There are other cancers that are HPV-related – whether that’s head and neck cancers or anal cancers – so there’s optimism this will have importance beyond this,” he said.

The lifetime probability of being diagnosed with any invasive cancer is estimated to be 40.9% for men and 39.1% for women in the US, according to the new report.

The report also includes projections for 2023, estimating that there could be nearly 2 million new cancer cases – the equivalent of about 5,000 cases a day – and more than 600,000 cancer deaths in the United States this year.

During the early days of the Covid-19 pandemic, many people skipped regular medical exams, and some doctors have seen a rise in advanced cancer cases in the wake of pandemic-delayed screenings and treatment.

The American Cancer Society researchers were not able to track “that reduction in screening that we know we all observed across the country during the pandemic,” Knudsen said. “This time next year, I believe our report will give some initial insight into what the impact was in the pandemic of cancer incidence and cancer mortality.”

The new report includes data from national programs and registries, including those at the National Cancer Institute, the US Centers for Disease Control and Prevention and the North American Association of Central Cancer Registries.

Data showed that the US cancer death rate rose during most of the 20th century, largely due to an increase in lung cancer deaths related to smoking. Then, as smoking rates fell and improvements in early detection and treatments for some cancers increased, there was a decline in the cancer death rate from its peak in 1991.

Since then, the pace of the decline has slowly accelerated.

The new report found that the five-year relative survival rate for all cancers combined has increased from 49% for diagnoses in the mid-1970s to 68% for diagnoses during 2012-18.

The cancer types that now have the highest survival rates are thyroid at 98%, prostate at 97%, testis at 95% and melanoma at 94%, according to the report.

Current survival rates are lowest for cancers of the pancreas, at 12%.

The finding about a decreasing cancer death rate shows “the continuation of good news,” said Dr. Otis Brawley, an oncology professor at Johns Hopkins University who was not involved in the research.

“The biggest reason for the decline that started in 1991 was the prevalence of smoking in the United States started going down in 1965,” said Brawley, a former chief medical officer of the American Cancer Society.

“That’s the reason why we started having a decline in 1991, and that decline has continued because the prevalence of people smoking in the United States has continued to go down,” he said. “Now, in certain diseases, our ability to treat has improved, and there are some people who are not dying because of treatment.”

Although the death rate for cancer has been on a steady decline, the new report also highlights that new cases of breast, uterine and prostate cancer have been “of concern” and rising in the United States.

Incidence rates of breast cancer in women have been increasing by about 0.5% per year since the mid-2000s, according to the report.

Uterine corpus cancer incidence has gone up about 1% per year since the mid-2000s among women 50 and older and nearly 2% per year since at least the mid-1990s in younger women.

The prostate cancer incidence rate rose 3% per year from 2014 through 2019, after two decades of decline.

Knudsen called prostate cancer “an outlier” since its previous decline in incidence has reversed, appearing to be driven by diagnoses of advanced disease.

On Thursday, the American Cancer Society announced the launch of the Impact initiative, geared toward improving prostate cancer incidence and death rates by funding new research programs and expanding support for patients, among other efforts.

“Unfortunately, prostate cancer remains the number one most frequently diagnosed malignancy amongst men in this country, with almost 290,000 men expected to be diagnosed with prostate cancer this year,” Knudsen said. Cancer diagnosed when it is confined to the prostate has a five-year survival rate of “upwards of 99%,” she said, but for metastatic prostate cancer, there is no durable cure.

“Prostate cancer is the second leading cause of cancer death for men in this country,” she said. “What we’re reporting is not only an increase in the incidence of prostate cancer across all demographics but a 5% year-over-year increase in diagnosis of men with more advanced disease. So we are not catching these cancers early when we have an opportunity to cure men of prostate cancer.”

Breast, uterine and prostate cancers also have a wide racial disparity, in which communities of color have higher death rates and lower survival rates.

In 2020, the risk of overall cancer death was 12% higher in Black people compared with White people, according to the new report.

“Not every individual or every family is affected equally,” Knudsen said.

For instance, “Black men unfortunately have a 70% increase in incidence of prostate cancer compared to White men and a two- to four-fold increase in prostate cancer mortality as related to any other ethnic and racial group in the United States,” she said.

The data in the new report demonstrates “important and consistent” advances against cancer, Dr. Ernest Hawk, vice president of cancer prevention and population sciences at the University of Texas MD Anderson Cancer Center, said in an email.

“Cancer is preventable in many instances and detectable at an early stage with better outcomes in many others. When necessary, treatments are improving in both their efficacy and safety. That’s all great news,” Hawk wrote.

“However, it’s well past time for us to take health inequities seriously and make them a much greater national priority. Inequities in cancer risks, cancer care and cancer outcomes are intolerable, and we should not be complacent with these regular reminders of avoidable inequities,” he said. “With deliberate and devoted effort, I believe we can eliminate these disparities and make even greater progress to end cancer.”

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Health

Dr. Sanjay Gupta: After two years of Covid-19 vaccines, here’s why they’re still vital

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CNN
 — 

In the United States, approximately 658 million Covid-19 vaccine doses have been administered since they were first distributed exactly two years ago Wednesday.

Framing the significance of preventive measures like vaccines can be challenging, which is why a new report from the Commonwealth Fund and Yale School of Public Health made headlines: According to their modeling of disease transmission across all age demographics and taking into account the existing health conditions in so many Americans, Covid vaccines prevented an estimated 3.2 million deaths and 18.5 million hospitalizations from their introduction in December 2020 to November 30, 2022.

That is why it is surprising to hear, according to a Kaiser Family Foundation analysis of data from the US Centers for Disease Control and Prevention, that from April through August – the last month included in the analysis – there were more vaccinated than unvaccinated people dying of Covid. The vaccinated categories include people who were vaccinated with the primary series and people who had been vaccinated and received at least one non-bivalent booster.

According to a CNN analysis of additional CDC data for September, 12,593 people died of Covid. A CDC sample of the deaths found 39% were unvaccinated, and 61% were vaccinated.

This phenomenon has many people – especially vaccine skeptics, but even stalwart vaccine supporters – confused and wondering if Covid vaccines and boosters are still effective and warranted.

The short answer is yes – but understanding why requires a crash course in statistics. We enlisted the help of Jeffrey Morris, a professor and the director of the Division of Biostatistics at the Perelman School of Medicine at the University of Pennsylvania, who helped us define three key reasons more vaccinated than unvaccinated people are dying of Covid.

One of the main reasons we see more vaccinated than unvaccinated people dying of Covid is a basic one. At this point in time, there are simply many more people who are vaccinated.

Think of it like this: If we round the September deaths to 13,000 and use the CDC sampling percentages, approximately 7,800 were vaccinated and approximately 5,200 were unvaccinated. The conclusion might be that you are far more likely to die if you are vaccinated. And, mathematically that would be true based on the raw numbers alone. If you stopped your analysis at this point, you will have committed a statistical error known as a base rate fallacy.

If instead, you take the extra step of accounting for the total number of fully vaccinated adults 18 and older in the United States (around 203 million) versus the total number of unvaccinated adults (around 55 million), a very different picture emerges.

Among the vaccinated population, 7,800/203 million died in September, which equals a rate of 38 deaths for every 1 million people. For the unvaccinated population, 5,200/55 million died, which equals a rate of 95 deaths for every 1 million people. That means an adult who is unvaccinated is roughly 2.5 times more likely to die than one who is vaccinated.

“You have to take into account the size of those groups,” explained Morris, who also publishes a blog, COVID-19 Data Science, to “just communicate what the emerging data suggest.”

There is another important difference when looking at the vaccinated versus unvaccinated populations in the United States. The vaccinated population skews older and has more health conditions. These are the same groups that are much more likely to have worse outcomes, like hospitalization and death, when infected with SARS-CoV-2, the virus that causes Covid-19. For example, CDC data show more than 90% of deaths through mid-November have been in those 65 or older.

“So those things lead to a higher risk of death and also a higher probability of being vaccinated,” Morris said. “That’s the key: if the vaccine uptake of those high-risk groups is high enough, then we can have a majority of the hospitalized or fatal cases be higher in the vaccinated population.”

You are more likely to die if you are older, and also more likely to be vaccinated if you are older. It does not mean vaccination is more likely to lead to death.

So if age isn’t taken into account when assessing vaccine efficacy, it can lead to something known as Simpson’s paradox, where a trend can appear to be the opposite of reality.

Morris said those kinds of errors not only result in a serious underestimation of the benefit of vaccines but also to downright wrong conclusions, even flipping the results – in this case, making it appear that vaccines increase the risk of death.

This happened in August 2021, with a study out of Israel – a highly vaccinated country – showed 60% of those hospitalized with severe Covid were fully vaccinated, causing misinterpretation and raising questions about the continued value of vaccination.

Morris said he has also seen Simpson’s paradox when people look at the rate of Covid deaths before vaccines were rolled out in 2020 versus since then, or comparing countries with higher vaccination rates to countries with lower vaccination rates.

“It’s a lot more subtle, but the pandemic has provided a number of pure examples of it. So the bottom line with all of that is, we can’t accurately assess the effects of vaccines from simple summaries,” Morris said, however “seemingly intuitive” they may appear.

A more telling and accurate comparison is between the death rate per 100,000 among unvaccinated people compared to the death rate of vaccinated people, adjusted for age.

CDC data show that for the week of September 25, people age 12 and older who were unvaccinated had a death rate of 1.32 per 100,000. Those who were vaccinated (but without an updated, bivalent booster) had a death rate of 0.26 per 100,000. And those who were vaccinated and boosted had a death rate of 0.07 per 100,000.

Broken down further by age, the numbers are even starker: The death rate during that week for those in the oldest age group, 80 and above, was 14.16 per 100,000 for the unvaccinated, 3.69 for those who were vaccinated but had not received the bivalent booster, and 0.0 for those who were vaccinated and boosted.

Overall, the CDC estimates that for the whole month of September, among those 12 and older, there was an almost 15 times lower risk of dying from Covid-19 for the vaccinated and boosted compared to the unvaccinated.

Unfortunately, uptake of the booster is low: Only 13.5% of the US population 5 and older is vaccinated and has gotten the new updated (bivalent) booster. Among those 65 and older, that percentage is 34.2%.

It’s not to say that vaccines are entirely risk free. For example, in people – especially males – between the ages of 5 and 39, there were 224 verified cases of myocarditis or pericarditis, inflammation of the heart and lining, reported to the CDC after vaccination with an mRNA vaccine between December 14, 2020, and May 31, 2022. But that was out of almost 7 million vaccine doses administered.

A study examining those figures found myocarditis/pericarditis occurred within seven days approximately 0.0005% of the time after the first dose, 0.0033% of the time after the second dose of the primary series, and 0.002% after the first booster – but it varied by age and sex, and was much more common among 16- to-17-year-old males after a second shot or a booster.

According to a separate analysis of nearly 43 million people in England, the researchers found that for younger men, the Moderna vaccine in particular had the highest rates of post vaccine myocarditis – although this number was still very low, 97 per million people exposed (0.0097%) – leading some to suggest a different vaccine for that age group or a longer interval between vaccine doses.

Statistical optical illusions aside, the fact is, there are more so-called breakthrough cases among the vaccinated. They have always existed. Since December 2020, we have known these vaccines are not 100% effective at preventing severe illness and death, let alone infection. When vaccines were first introduced, their efficacy was estimated to be an astonishing 95% against severe illness and death. They even protected people at a very high rate against infection.

But the efficacy keeps ticking downward. Part of it is waning immunity: Over the course of several months, antibody levels fade away – that’s just how the body works – even though there is still some protection, thanks to B cells and T cells. Getting boosted – or catching Covid – can help increase antibody levels for a few months at least. Between those two options, it’s far safer and less disruptive to get a booster than to risk illness.

Meanwhile, new variants keep cropping up, and they are increasingly able to evade our immune system. Unlike earlier variants, including the highly transmissible Delta variant, descendants of the Omicron lineage are escape artists.

“The emergence of Omicron at the end of 2021 was a game changer, as Omicron and its subsequent subvariants demonstrated strong immune evasion properties, with mutations in the spike protein and especially the [receptor binding domain] that reduced the neutralizing ability of the vaccine-induced antibodies,” Morris noted. The result is a great reduction in vaccine efficacy against infection, as well as against severe and fatal disease.

This actually means it’s more important to get boosted, especially if you are in a high-risk category, and as the weather gets colder and we gather indoors to spend time together.

The newest booster – the bivalent booster – is designed to protect against the original SARS-CoV-2 virus and against the more recent Omicron subvariants, although how much and for how long is still unknown.

Covid cases, and deaths have slowed down in recent months, but those numbers are trending up like they’ve done during the holidays in previous pandemic years. For the week of December 7, weekly new cases topped 65,000 and Covid claimed the lives of almost 3,000 people. Both represent an increase of around 50% from the week before, according to CDC data.

All of this is happening at a time when hospitals are already full of patients sick with the flu and RSV.

I know we’re all tired of hearing that we need to roll up our sleeves and get yet another Covid-19 booster.

But remember, many of us get the flu shot every year: We don’t assume we are protected from a flu vaccine a year ago. We get the shot even in seasons when the flu vaccine is much less effective than the Covid vaccine (the latest one appears to be a good match). We don’t call it a booster – it’s just the annual flu vaccine. And we don’t track the rate of so-called breakthrough flu infections; unlike Covid, we don’t routinely test people for flu unless they are demonstrably sick, so we have no way of knowing how many people, vaccinated or not, are infected and asymptomatic or mildly ill.

For some diseases, like measles, a single vaccine or a previous infection provides us with a near lifetime of protection. Even though we hoped for a one-and-done scenario when the Covid vaccines rolled out two years ago, the virus didn’t lend itself to that. Newer vaccines are being studied that could offer far more durable protection.

Analyzing all of this data without falling into the trap of a base rate fallacy or Simpson’s paradox isn’t easy, as you can see. And it is also clear the overall effectiveness of the vaccines have waned over time and with new variants.

However, two years later, a more thorough statistical analysis of vaccine effectiveness shows they are still cause for celebration.

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Health

Cancer death rates fall steadily in the US, with more survivors than ever

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CNN
 — 

More people are surviving cancer than ever before in the United States, according to a new report from the American Association for Cancer Research.

In the past three years, the number of cancer survivors in the US – defined as living people who have had a cancer diagnosis – increased by more than a million. There are 18 million survivors in the US as of January, with that number expected to increase to 26 million by 2040, the association said. The report notes that there were only 3 million US cancer survivors in 1971.

For all cancers combined, the five-year overall survival rate has increased from 49% in the mid-1970s to nearly 70% from 2011 to 2017, the most recent years for which data is available.

The overall cancer death rate, adjusted for age, continues to drop, with reductions between 1991 and 2019 translating into nearly 3.5 million deaths avoided, the association said.

Declines in smoking and improvements in catching and treating cancer early are driving the change, according to the AACR Cancer Progress Report 2022, released Wednesday.

Dr. Lisa Coussens, president of the association, said in a statement that part of the credit goes to an investment in research – both for treatments and for understanding the disease.

“Targeted therapies, immunotherapy, and other new therapeutic approaches being applied clinically all stem from fundamental discoveries in basic science,” she said. “Investment in cancer science, as well as support for science education at all levels, is absolutely essential to drive the next wave of discoveries and accelerate progress.”

For example, between August 1 and July 31, the US Food and Drug Administration approved eight anticancer therapeutics, expanded the use of 10 previously approved medications to treat new cancer types, and approved two diagnostic imaging agents, Coussens said at a news conference Wednesday.

Increased funding for cancer research is a cornerstone of President Joe Biden’s relaunched Cancer Moonshot initiative.

Biden – who lost a son to brain cancer – said this month that his goal is to cut cancer death rates in the United States by at least half in the next 25 years.

“Cancer does not discriminate red and blue. It doesn’t care if you’re Republican or Democrat. Beating cancer is something we can do together,” said Biden, who initially helmed the initiative when he was vice president under Obama.

The new report urges Congress to fully fund and support Biden’s goal to “end cancer as we know it.”

“The reignited Cancer Moonshot will provide an important framework to improve cancer prevention strategies; increase cancer screenings and early detection; reduce cancer disparities; and propel new lifesaving cures for patients with cancer,” the report says, adding that the “actions will transform cancer care, increase survivorship, and bring lifesaving cures to the millions of people whose lives are touched by cancer.”

Although nearly 3.5 million cancer deaths were avoided between 1991 and 2019, more than 600,000 people in the US are still expected to die from cancer this year, according to the association.

“In the United States alone, the number of new cancer cases diagnosed each year is expected to reach nearly 2.3 million by 2040,” the report says.

About 40% of cancer cases in the US are attributable to preventable risk factors, such as smoking, drinking too much alcohol, eating a poor diet, not exercising enough and being obese, according to the report.

But there are also ongoing challenges such as health disparities that affect racial and ethnic minorities and barriers to health care such as limited health insurance coverage and living in rural areas.

In a recorded statement played at the news conference, US Rep. Nikema Williams said she learned after her mother died of cancer that “health care in America is not a human right yet.”

“We have two health care systems in this country: one for people who can afford preventative services and quality treatment and one for everyone else,” said Williams, a Democrat from Georgia.

The reversal of Roe v. Wade is also expected to affect cancer care by limiting health care options for pregnant women with cancer, the report said.

“With the recent Supreme Court decision to overturn Roe v. Wade, which ends the constitutional right to an abortion, there is uncertainty surrounding how a particular cancer treatment may lead to the termination of a pregnancy. Such uncertainty may prohibit some physicians from prescribing a drug or performing other health services in a timely manner due to the potential legal consequences for both physician and mother,” according to the report.

The Covid-19 pandemic had an effect on cancer in the US, with nearly 10 million breast, colorectal and prostate cancer screenings missed in 2020.

The report offers recommendations to build on the progress and regain momentum.

“Making progress to end cancer means more birthdays, more Christmases, more graduations and everyday moments for families everywhere,” Williams said.

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COVID-19, overdoses pushed US to highest death total ever

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NEW YORK — 2021 was the deadliest year in U.S. history, and new data and research are offering more insights into how it got that bad.

The main reason for the increase in deaths? COVID-19, said Robert Anderson, who oversees the Centers for Disease Control and Prevention’s work on death statistics.

The agency this month quietly updated its provisional death tally. It showed there were 3.465 million deaths last year, or about 80,000 more than 2020’s record-setting total.

Early last year, some experts were optimistic that 2021 would not be as bad as the first year of the pandemic — partly because effective COVID-19 vaccines had finally become available.

“We were wrong, unfortunately,” said Noreen Goldman, a Princeton University researcher.

COVID-19 deaths rose in 2021 — to more than 415,000, up from 351,000 the year before — as new coronavirus variants emerged and an unexpectedly large numbers of Americans refused to get vaccinated or were hesitant to wear masks, experts said.

The coronavirus is not solely to blame. Preliminary CDC data also shows the crude death rate for cancer rose slightly, and rates continued to increase for diabetes, chronic liver disease and stroke.

Drug overdose deaths also continued to rise. The CDC does not yet have a tally for 2021 overdose deaths, because it can take weeks of lab work and investigation to identify them. But provisional data through October suggests the nation is on track to see at least 105,000 overdose deaths in 2021 — up from 93,000 the year before.

New research released Tuesday showed a particularly large jump in overdose deaths among 14- to 18-year-olds.

Adolescent overdose death counts were fairly constant for most of the last decade, at around 500 a year, according to the paper published by the Journal of the American Medical Association. They almost doubled in 2020, to 954, and the researchers estimated that the total hit nearly 1,150 last year.

Joseph Friedman, a UCLA researcher who was the paper’s lead author, called the spike “unprecedented.”

Those teen overdose deaths were only around 1% of the U.S. total. But adolescents experienced a greater relative increase than the overall population, even though surveys suggest drug use among teens is down.

Experts attributed the spike to fentanyl, a highly lethal drug that has been cut into heroin for several years. More recently it’s also been pressed into counterfeit pills resembling prescription drugs that teens sometimes abuse.

The total number of U.S. deaths often increases year to year as the U.S. population grows. But 2020 and 2021 saw extraordinary jumps in death numbers and rates, due largely to the pandemic.

Those national death trends affect life expectancy — an estimate of the average number of years a baby born in a given year might expect to live.

With rare exceptions, U.S. life expectancy has reliably inched up year after year. But the CDC’s life expectancy estimate for 2020 was about 77 years — more than a year and a half lower than what it was in 2019.

The CDC has not yet reported its calculation for 2021. But Goldman and some other researchers have been making their own estimates, presented in papers that have not yet been published in peer-reviewed journals.

Those researchers think U.S. life expectancy dropped another five or six months in 2021 — putting it back to where it was 20 years ago.

A loss of more than two years of life expectancy over the last two years “is mammoth,” Goldman said.

One study looked at death data in the U.S. and 19 other high-income countries. The U.S. fared the worst.

“What happened in the U.S. is less about the variants than the levels of resistance to vaccination and the public’s rejection of practices, such as masking and mandates, to reduce viral transmission,” one of the study’s authors, Dr. Steven Woolf of Virginia Commonwealth University, said in a statement.

Some experts are skeptical that life expectancy will quickly bounce back. They worry about long-term complications of COVID-19 that may hasten the deaths of people with chronic health problems.

Preliminary — and incomplete — CDC data suggest there were at least 805,000 U.S. deaths in about the first three months of this year. That’s well below the same period last year, but higher than the comparable period in 2020.

“We may end up with a ‘new normal’ that’s a little higher than it was before,” Anderson said.

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The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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World

UK hits record COVID-19 levels; nearly 5 million infected

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LONDON (AP) — The prevalence of COVID-19 in the U.K. has reached record levels, with about 1 in 13 people estimated to be infected with the virus in the past week, according to the latest figures from Britain’s official statistics agency.

Some 4.9 million people were estimated to have the coronavirus in the week ending March 26, up from 4.3 million recorded in the previous week, the Office for National Statistics said Friday. The latest surge is driven by the more transmissible omicron variant BA.2, which is the dominant variant across the U.K.

Hospitalizations and death rates are again rising, although the number of people dying with COVID-19 is still relatively low compared with earlier this year. Nonetheless, the latest estimates suggest that the steep climb in new infections since late February, when British Prime Minister Boris Johnson scrapped all remaining coronavirus restrictions in England, has continued well into March.

The figures came on the same day the government ended free rapid COVID-19 tests for most people in England, under Johnson’s “living with COVID” plan. People who do not have health conditions that make them more vulnerable to the virus now need to pay for tests to find out if they are infected.

“The government’s ‘living with COVID’ strategy of removing any mitigations, isolation, free testing and a considerable slice of our surveillance amounts to nothing more than ignoring this virus going forwards,” said Stephen Griffin, associate professor at the University of Leeds’ medical school.

“Such unchecked prevalence endangers the protection afforded by our vaccines,” he said. “Our vaccines are excellent, but they are not silver bullets and ought not to be left to bear the brunt of COVID in isolation.”

More than 67% of people 12 years old and above in the U.K. have been vaccinated and had their booster or a third dose of the coronavirus vaccine. Beginning Saturday, parents can also book a low-dose vaccine for children between 5 to 12 years old in England.

James Naismith, a biology professor at the University of Oxford, said he believed that except for those who are completely shielded or not susceptible to the virus, most people in the country would likely be infected with the BA.2 variant by the summer.

“This is literally living with the virus by being infected with it,” he said.

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Follow all AP stories on the coronavirus pandemic at https://apnews.com/hub/coronavirus-pandemic.

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World

Death rates soar in Southeast Asia as virus wave spreads

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KUALA LUMPUR, Malaysia (AP) — Indonesia has converted nearly its entire oxygen production to medical use just to meet the demand from COVID-19 patients struggling to breathe. Overflowing hospitals in Malaysia had to resort to treating patients on the floor. And in Myanmar’s largest city, graveyard workers have been laboring day and night to keep up with the grim demand for new cremations and burials.

Images of bodies burning in open-air pyres during the peak of the pandemic in India horrified the world in May, but in the last two weeks the three Southeast Asian nations have now all surpassed India’s peak per capita death rate as a new coronavirus wave, fueled by the virulent delta variant, tightens its grip on the region.

The deaths have followed record numbers of new cases being reported in countries across the region which have left health care systems struggling to cope and governments scrambling to implement new restrictions to try to slow the spread.

When Eric Lam tested positive for COVID-19 and was hospitalized on June 17 in the Malaysian state of Selangor, the center of the country’s outbreak, the corridors of the government facility were already crowded with patients on beds with no room left in the wards.

The situation was still better than in some other hospitals in Selangor, Malaysia’s richest and most populous state, where there were no free beds at all and patients were reportedly treated on floors or on stretchers. The government has since added more hospital beds and converted more wards for COVID-19 patients.

Lam, 38, recalled once during his three weeks in the hospital hearing a machine beeping continuously for two hours before a nurse came to turn it off; he later learned the patient had died.

A variety of factors have contributed to the recent surge in the region, including people growing weary of the pandemic and letting precautions slip, low vaccination rates and the emergence of the delta variant of the virus, which was first detected in India, said Abhishek Rimal, the Asia-Pacific emergency health coordinator for the Red Cross, who is based in Malaysia.

“With the measures that countries are taking, if people follow the basics of washing the hands, wearing the masks, keeping distance and getting vaccinated, we will be seeing a decline in cases in the next couple of weeks from now,” he said.

So far, however, Malaysia’s national lockdown measures have not brought down the daily rate of infections. The country of some 32 million saw daily cases rise above 10,000 on July 13 for the first time and they have stayed there since.

The vaccination rate remains low but has been picking up, with nearly 15% of the population now fully inoculated and the government hoping to have a majority vaccinated by year’s end.

Doctors and nurses have been working tirelessly to try to keep up, and Lam was one of the fortunate ones.

After his condition initially deteriorated, he was put on a ventilator in an ICU unit filled to capacity and slowly recovered. He was discharged two weeks ago.

But he lost his father and brother-in-law to the virus, and another brother remains on a ventilator in the ICU.

“I feel I have been reborn and given a second chance to live,” he said.

With India’s massive population of nearly 1.4 billion people, its total number of COVID-19 fatalities remains higher than the countries in Southeast Asia. But India’s 7-day rolling average of COVID-19 deaths per million peaked at 3.04 in May, according to the online scientific publication Our World in Data, and continues to decline.

Indonesia, Myanmar, and Malaysia have been showing sharp increases since late June and their seven-day averages hit 4.37, 4.29 and 4.14 per million, respectively, on Wednesday. Cambodia and Thailand have also seen strong increases in both coronavirus cases and deaths, but have thus far held the seven-day rate per million people to a lower 1.55 and 1.38, respectively.

Individual countries elsewhere have higher rates, but the increases are particularly alarming for a region that widely kept numbers low early in the pandemic.

With the Indian experience as a lesson, most countries have reacted relatively quickly with new restrictions to slow the virus, and to try to meet the needs of the burgeoning number of people hospitalized with severe illnesses, Rimal said.

“People in this region are cautious, because they have seen it right in front of them — 400,000 cases a day in India — and they really don’t want it to repeat here,” he said in a telephone interview from Kuala Lumpur.

But those measures take time to achieve the desired effect, and right now countries are struggling to cope.

Indonesia, the world’s fourth most populous nation with some 270 million people, reported 1,449 deaths on Thursday, its deadliest day since the start of the pandemic.

Daily cases through about mid-June had been about 8,000, but then began to spike and peaked last week with more than 50,000 new infections each day. Because Indonesia’s testing rate is low, the actual number of new cases is thought to be much higher.

As hospitals there began to run out of oxygen, the government stepped in and ordered manufacturers to shift most production from industrial purposes and dedicate 90% to medical oxygen, up from 25%.

Before the current crisis, the country needed 400 tons of oxygen for medical use per day; with the sharp rise in COVID-19 cases, daily use has increased fivefold to more than 2,000 tons, according to Deputy Health Minister Dante Saksono.

Though the production of oxygen is now sufficient, Lia Partakusuma, secretary general of Indonesia’s Hospital Association, said there were problems with distribution so some hospitals are still facing shortages.

In Indonesia, about 14% of of the population has had at least one vaccine dose, primarily China’s Sinovac.

There are growing concerns that Sinovac is less effective against the delta variant, however, and both Indonesia and Thailand are planning booster shots of other vaccines for their Sinovac-immunized health workers.

In Myanmar, the pandemic had taken backseat to the military’s power seizure in February, which set off a wave of protests and violent political conflict that devastated the public health system.

Only in recent weeks, as testing and reporting of COVID-19 cases has started recovering, has it become clear that a new wave of the virus beginning in mid-May is pushing cases and deaths rapidly higher.

Since the start of July its death rate has been climbing almost straight up, and both cases and fatalities are widely believed to be seriously underreported.

“With little testing capacity, low numbers in the country vaccinated, widespread shortages of oxygen and other medical supplies, and an already beleaguered health care system under increasing strain, the situation is expected to get increasingly worse in the coming weeks and months,” said ASEAN Parliamentarians for Human Rights, a regional advocacy group.

“Meanwhile, the junta’s confiscation of oxygen, attacks on health care workers and facilities since the coup, and the lack of trust in any services they provide by the majority of the population, risks turning a crisis into a disaster.”

On Tuesday, the government reported 5,860 new cases and 286 new deaths. There are no solid figures on vaccinations, but from the number of doses that have been available, it’s thought that about 3% of the population could have received two shots.

Officials this week pushed back at social media postings that cemeteries in Yangon were overwhelmed and could not keep up with the number of dead, inadvertently confirming claims that hospitals were swamped and many people were dying at home.

Cho Tun Aung, head of the department that oversees the cemeteries told military-run Myawaddy TV news on Monday that 350 staff members had been working three shifts since July 8 to ensure proper cremations and burials of people at Yangon’s seven major cemeteries.

He said workers had cremated and buried more than 1,200 people on Sunday alone, including 1,065 who had died at home of COVID-19 and 169 who had died in hospitals.

“We are working in three shifts day and night to inter the dead,” he said. “It is clear that there is no problem like the posts on Facebook.”

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Rising reported from Bangkok. Associated Press writers Edna Tarigan and Niniek Karmini in Jakarta, Indonesia, and Grant Peck in Bangkok contributed to this report.

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