U.S. Cancer Survival Rates Improving

But death rates hit harder among blacks and poor, report finds

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HealthDay Reporter

WEDNESDAY, Jan. 14, 2004 (HealthDayNews) -- Cancer continues to increase its hold on American life, but survival rates from the disease are improving.

That's the main conclusion of the American Cancer Society's (ACS) annual report on the state of the disease.

But the report, released Wednesday, finds that cancer hits blacks and the poor harder than it does people of other racial and socioeconomic groups, and death rates remain much higher for blacks than for whites.

And for women, lung cancer has now overtaken breast cancer as the leading cause of cancer deaths.

"Cancer is not an inescapable fact of life," Dr. Michael Thun, vice president of ACS epidemiology and surveillance research, told a news conference. "There are things that we do in our culture that make a huge difference in cancer death rates."

This year, 1,368,030 new diagnoses of cancer are expected, an increase of almost 35,000 over last year. And the disease will kill 563,700 people, according to the society's report, Cancer Facts and Figures 2004.

That works out to a daily death toll of approximately 1,540 people, which represents about one out of every four deaths. Cancer remains the second-leading killer of Americans, behind heart disease.

The report says that one-third of this year's predicted deaths are preventable because the cancer results from lifestyle factors, such as being overweight or obese, or inactive. And, it points out, more than 180,000 of the predicted cancer deaths will be linked to smoking. The statistics in the report are actually age-adjusted to the U.S. population in the year 2000.

On the bright side, the five-year survival rate for all cancers is 63 percent. And for those cancers detected early through screening programs, the survival rate is 84 percent.

"If all these cancers were diagnosed at a localized stage through regular cancer screenings, the five-year survival would increase to about 95 percent," the report states.

Specifically, the report found:

  • The incidence of lung cancer among men has dropped by more than 15 percent since 1990.
  • Stomach cancer, once the leading cause of cancer death in the United States, is now rare. This is due to a reduction in infection from the bacterium Helicobacter pylori and through improved nutrition and sanitation, Thun says.
  • Prostate cancer death rates have also declined, by 32 percent from 1991 to 2000. "This is real reduction in death from prostate cancer, and represents real progress," Thun says.
  • For women, however, there has been an increase in deaths from lung cancer, although there is also a leveling-off.
  • The breast cancer death rate declined in 2000 by almost 20 percent from its peak in 1988, Thun notes.
  • In addition, death rates from cervical, colorectal cancer, oral and throat cancer, and Hodgkin's lymphoma have also declined.

"There is clear progress in reducing death rates," Thun says.

One exception is death from liver cancer and cancer of the esophagus among men, which has been increasing since 1980.

The increase in liver cancer may be due to the increase in hepatitis C in the United States and because of the rising rates of obesity, which can lead to chronic hepatitis, Thun says.

In terms of smoking-related cancer deaths, cigarette smoking has now declined to levels not seen since the start of World War II.

"This represents huge progress and shows the kind of progress that's possible if you implement measures to control tobacco. But there is still a long way to go -- the job's not done," he says. "The myth that we've beaten tobacco is wrong."

Deaths from smoking-related cancers still account for 80 percent of all cancer deaths.

There continues to be increases in the incidence of melanomas. However, due to early detection and treatment, the death rate has remained flat since the 1980s. "This is another clear case in which early detection saves lives," Thun says.

Over the past 25 years, the incidence of childhood cancers has been relatively flat, and there has been a steady decrease in deaths, thanks to improvements in treatment.

Thun points out that less than half the people who should be screened for cancer are doing so. More progress is needed in getting people screened and in improving screening techniques, he adds.

"Improved cancer survival across the board reflects earlier diagnosis and treatment," Thun says.

However, Thun says, there is a tremendous disparity by race and economic class. "The disparities cover the spectrum from detection, diagnosis, quality of care and survival," he says.

For example, the gap in the death rates from cancers including colorectal, prostate, and breast cancer among blacks is dramatically higher than it is among whites.

In addition, five-year cancer survival is substantially reduced among blacks and the poor.

"We are doing more things we know are helpful interventions in more affluent populations and in majority populations than we are in the African-American population," Thun says.

More information

For more statistics, you can find the 2004 report at the American Cancer Society. For more on various cancers, visit the National Cancer Institute.

SOURCES: Jan. 14, 2004, teleconference with Michael Thun, M.D., vice president, epidemiology and surveillance research, American Cancer Society, Atlanta; Cancer Facts and Figures 2004

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