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Cancer Rates Declining

Deaths dropped by 1.1 percent a year in 1990s

WEDNESDAY, June 6 , 2001 (HealthDayNews) -- Cancer cases and deaths in the United States declined in the 1990s, in a picture that was generally encouraging even though it had some dark spots, officials report.

Overall, the age-adjusted cancer death rate decreased by about 1.1 percent per year from 1992 to 1998, says a report in the Journal of the National Cancer Institute that combines data from private and government sources. That decline reversed a pattern of increased cancer incidence from 1973 to 1992.

"The key point is that we are continuing to make progress," says Brenda K. Edwards, associate director of the National Cancer Institute surveillance research program and final author of the report. "But there are exceptions, notably a continuing rise in lung cancer in women."

That rise was one reason why the decrease in cancer deaths was less for women (0.8 percent a year) than for men (1.6 percent per year).

"The significant decrease in all cancers combined was driven mainly by declines in prostate cancer in men and lung cancer in men," says Dr. Michael J. Thun, head of epidemiological research for the American Cancer Society.

One encouraging note was a greater decline in cancer deaths in black men, 3.1 percent a year compared to 2.9 percent a year in white men, Thun says. But cancer incidence and deaths remain higher among minority groups, Edwards says.

"Cancer in members of minority groups is being diagnosed later," Edwards says. "It shows that they are not benefiting from the advances that have been made. It calls for more awareness by this population and their providers."

For example, an overall decrease of 0.7 percent a year in colorectal cancer cases was due to a 1.3 percent drop in white males and a 0.4 percent drop in white females, compared to a 1.1 percent decrease in black males and a 0.3 percent decrease in black females.

New breast cancer cases in women increased, but the number of deaths decreased, indicating that more cases are being diagnosed at an early, more treatable stage, Edwards says. "If we look at the data by stage, we see an increase in early-stage disease and a decline in more advanced disease," Edwards says. "When you see that mix, it indicates that screening is being utilized more."

Four cancers -- breast, prostate, lung and colorectal -- accounted for 55.9 percent of new cancers and 52.7 percent of cancer deaths in 1998, says the report, which combines data from the National Cancer Institute, the Centers for Disease Control and Prevention, the American Cancer Society and the North American Association of Cancer Control Registries.

Lung cancer leads the list, accounting for 29 percent of all cancer deaths and 13.2 percent of cases. Men's lung cancer rates declined 2.7 percent each year, but women's rates leveled off, mainly due to changes in smoking habits. Breast cancer accounts for 16.3 percent of cases and 7.8 percent of deaths, followed by prostate cancer accounts (14.8 percent of cases) and colorectal cancer (11.6 percent of cases).

One cancer on the increase is melanoma, the deadliest form of skin cancer. While they accounted for just 1.4 percent of all cancer deaths, melanoma deaths increased by 1 percent a year among white males; the rate remained steady in white females. New cases of melanoma increased by 2.7 percent a year in white males and 2.9 percent in white females.

"There is continuing progress overall, but we have a long way to go," says Thun. "To sustain this current progress will take increased efforts in prevention, applying what we know in such areas as tobacco control, and early detection, with use of screening tests that we know are effective, such as Pap smears, mammography and tests for colorectal cancer."

What To Do

In addition to avoiding known cancer-causers, such as excessive sun exposure and smoking, "you should avail yourself of self-screening measures," Edwards says. "If you are diagnosed with cancer, you should ask questions of your physician, what are the treatment options. And we encourage people to join clinical trials of new treatments."

Detailed statistics about cancer are available from the American Cancer Society and the National Cancer Institute and more from the NCI. If you're interested in seeing what clinical trials are available, take a look at Veritas Medicine.

Or, you may want to check out these previous HealthDay stories.

SOURCES: Interviews with Brenda K. Edwards, Ph.D, associate director, National Cancer Institute, Bethesda, Md.; Michael J. Thun, M.D., head of epidemiological surveillance, American Cancer Society, New York, N.Y., June 6, 2001, Journal of the National Cancer Institute
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