Here's a cancer update:
US Cancer Rates Fall For First Time
NEW YORK (Reuters) -- The number of new cases of cancer in the US
population declined by 0.7% annually between 1990-1995, reversing a
1973-1990 trend of 1.2% average annual increases in cancer incidence,
according to this year's cancer "report card" released Thursday.
"Progress is the subject of our report card today," said Dr. John Seffrin,
CEO of the American Cancer Society, which, along with the National
Cancer Institute (NCI), and the Centers for Disease Control and Prevention
(CDC), helps produce the annual cancer summary.
The report, published this month in the journal Cancer, also found that
annual cancer death rates in the US began to fall by 0.5% per year between
1990-1995. The experts say cancer death rates had been increasing by
0.4% per year in the years between 1973-1990.
Seffrin said he believes that "reporting progress in cancer is a bit like taking
snapshots of a child. That child's growth may seem small, certainly from day
to day, or even year to year, but when growth, or progress is considered
from a 5-year perspective, or 10 years, or nearly 30 years -- say, since the
1971 National Cancer Act -- the progress is indeed profound."
Other major findings of the report include:
-- lung cancer incidence declined by 1.1% per year between 1990-1995,
compared with the annual increases of 1.9% noted in the period
1973-1990. Most of the recent decrease occurred among men and black
women, with the authors noting that "...we have not yet observed the impact
of decreased smoking among white women."
-- prostate cancer incidence fell by 1% per year between 1990-1995,
compared with 1973-1990 annual increases of 3.4%. However, the report
authors caution that the recent rise in prostate screenings may have resulted
from the "...consequent deficit of prevalent cases that occurs after
widespread screening." Actual prostate cancer incidence may rebound again
before leveling out in the coming years.
-- annual breast cancer incidence rates remained virtually unchanged
between 1990-1995, ending yearly 1.8% increases in breast cancer
incidence reported between 1973-1990. "Decreasing incidence and
mortality from breast cancer in white women most likely is a reflection of the
increasingly widespread diffusion of breast cancer screening into routine
medical care," the experts say. However, they add that "...mortality benefits
have not yet been observed in black women."
-- colon and rectum cancer incidence declined by 2.3% per year in the first
five years of the 1990s, reversing the steady 0.3% annual increases charted
in previous years. "Increased polyp removal, advancement in treatment
protocols... and other factors (e.g. daily use of aspirin or estrogen
replacement therapy, or changes in population dietary patterns) may be
contributing factors," speculate the report authors.
-- there were also steady declines in cancers at other sites during the
1990-1995 period. These included urinary bladder cancers (down 0.5% per
year), leukemias (down 1% per year), and cancers of the oral cavity or
larynx (down 1.8% per year).
-- incidence of non-Hodgkin's lymphoma rose 3.5% per year between
1990-1995, compared with smaller, earlier average annual increases of
0.8%. Most of that increase was AIDS-related, the study authors say. The
suppressed immune systems of AIDS patients leaves them more vulnerable
to this form of cancer.
-- malignant melanoma incidence continued to rise, increasing 2.5% per year
during 1990-1993, although these numbers marked a decline from pre-1990
annual incidence increases of 4.3%.
-- incidence of uterine cancers rose by 0.2% per year during 1990-1993,
after annual declines of 2.5% during the 1973-1990 period.
-- researchers say 1990-1995 death rates for the four major cancers (lung,
prostate, female breast, and colon/rectum) fell by 0.3%, 1.1%, 1.7%, and
1.5% per year, respectively.
These declines mark a dramatic turnaround from pre-1990 levels, when
deaths from lung, prostate, and breast cancer charted steady annual
increases of 2.1%, 1%, and 0.2%, respectively. Increases in deaths from
colon/rectum cancer had already begun to decline by 0.9% per year during
1973-1990, according to the report authors.
The researchers add that "during 1990-1995, the largest annual decreases in
incidence occurred in persons who were ages 35-44 years and persons who
were at or above 75 years at diagnosis." And "...except for female breast
cancer, blacks had higher incidence rates than whites."
Dr. James S. Marks, director of the CDC's National Center for Chronic
Disease Prevention and Health Promotion, said his organization realizes that
"...declines in cancer incidence and deaths have not been seen for all
Americans and that our collective efforts must be directed at reaching
populations with a disproportionate cancer burden."
The cancer "report card's" incidence rates are based on data collected by
the NCI's Surveillance, Epidemiology, and End Results (SEER) program.
Statistics are drawn from nine population centers (five states and four urban
areas), representing 9.5% of the American population. Death rate data
comes from death certificate information filed by every state, and
consolidated within the CDC's National Center for Health Statistic database.
SOURCE: Cancer (1998;82(6):1197-1207) |
