Cancer deaths will rise slightly this year, to 556,500 from 555,500 last year, but the increase reflects the aging of the population, the cancer society says in its annual Cancer Facts & Figures report.
The five-year survival rate for all cancers except non-melanoma skin cancer and most non-invasive cancers is expected to be 62 percent -- the same as last year, the report says.
Death rates, however, will decline for lung, breast, colon and prostate cancer, according to the report.
Lung cancer, the top cancer killer, is expected to claim 157,200 lives this year; colorectal cancer, 57,100; breast cancer, 39,800; and prostate cancer, 28,900. The society predicts new cases of lung cancer in 2003 will total 171,900; colorectal cancer, 147,500; breast cancer, 211,300; and prostate cancer, 220,900.
Cancer is the second leading cause of death in America behind heart disease, accounting for one in every four deaths and claiming more than 1,500 lives a day, the cancer society says.
For blacks, the cancer death rate is about 30 percent higher than that of white, and prostate cancer death rates are more than twice as high in black men, the cancer society says.
Dr. Michael Thun, vice president for epidemiology and surveillance research at the cancer society, says poverty and lack of access to health care contributed to higher cancer rates among blacks.
On a positive note, cancer incidence and mortality has decreased more among black men than any other racial or ethnic group between 1992 and 1999, statistics show.
Tobacco use remains the most preventable cause of death and is expected to account for about 180,000 deaths in 2003 -- about 30 percent of all cancer deaths and 87 percent of lung cancer deaths, the cancer society says.
Many other cancer deaths could also be prevented because they result from disease linked to poor nutrition, physical inactivity, obesity and other factors related to lifestyle.
"There's great progress still to be made in improving treatment for cancer, but I think there is much we can do to apply what we already know," Thun says.
Most of the variation in cancer death rates among states, Thun says, relates to lung cancer. Nationwide, about 23 percent of adults over 18 smoke, the cancer society says. Kentucky had the highest percentage of adult smokers, about 31 percent, and the highest lung cancer death rate in men.
Thun called for more aggressive anti-smoking efforts, such as tobacco taxes, public smoking restrictions, anti-smoking ads, and smoking-cessation programs.
On the up side, Thun points to declines in smoking among high school students between 1999 and 2001 after years of increases.
Noting budget crunches in many states, Thun says, "Now is not the time to shift money away from smoking prevention. Now's the time to build on ongoing success."
Among nonsmokers, diet and physical activity are the two most important lifestyle factors in determining cancer risk, the cancer society says in Cancer Prevention & Early Detection, a report accompanying the annual statistical survey.
Poor nutrition causes about a third of U.S. cancer deaths, and Americans still fall well short of the cancer society's dietary guidelines. For example, less than one in five adults eats the recommended five or more fruits and vegetables a day.
Sedentary lifestyles also contribute to cancer, as exercise reduces the risk of breast and colon cancer and possibly pancreatic, prostate, lung and endometrial cancers. Yet, in 2000, 39 percent of American adults had no leisure-time physical activity and only about a third had moderate physical activity, the cancer society says.
Inactivity combined with overeating, of course, contributes to obesity, a risk factor for cancers including colon, endometrial, prostate, kidney, esophageal and, in postmenopausal women, breast cancer. And the percentage of obese Americans aged 20 to 74 has soared from about 13 percent in 1960 to 31 percent in 2000, the cancer society says.
"A huge challenge is to stop obesity and help people achieve and maintain healthy body weight," Thun says.
The cancer society also stresses early detection through screening for breast, colon, rectal, prostate and uterine cancer. And it recommends cancer-related checkups that can detect thyroid, oral, skin lymph node, testicular and ovarian cancers.
Dr. Anna Pavlick, an oncologist and assistant professor of medicine at the New York University School of Medicine and the NYU Cancer Institute, says the findings highlight the fact that many people remain unaware of the relationship between risk factors and cancer.
"It's just not looked at as a priority," Pavlick says. "I think because of the hours we work and the crazy life we live, things like exercise and proper nutrition -- things that should be obvious -- just kind of fall by the wayside."
Some continue risky habits, she says, because of a lack of awareness about risks. For example, she says, many of those who visit tanning booths and sunbathe on the beach without sunscreen don't distinguish between non-melanoma skin cancer and the much more dangerous melanoma.